CHAPTER 3 - Emergency Contraceptive Pills

Key Points for Providers and Clients
  • Emergency contraceptive pills help to prevent pregnancy when taken up to 5 days after unprotected sex. The sooner they are taken, the better.
  • Do not disrupt an existing pregnancy.
  • Safe for all women—even women who cannot use ongoing hormonal contraceptive methods.
  • Provide an opportunity for women to start using an ongoing family planning method.
  • Many options can be used as emergency contraceptive pills. Dedicated products, progestin-only pills, and combined oral contraceptives all can act as emergency contraceptives.

What Are Emergency Contraceptive Pills?

  • Pills that contain a progestin alone, or a progestin and an estrogen together—hormones like the natural hormones progesterone and estrogen in a woman's body.
  • Emergency contraceptive pills (ECPs) are sometimes called "morning after" pills or postcoital contraceptives.
  • Work primarily by preventing or delaying the release of eggs from the ovaries (ovulation). They do not work if a woman is already pregnant (see Question 1).

What Pills Can Be Used as Emergency Contraceptive Pills?

  • A special ECP product with levonorgestrel only, or estrogen and levonorgestrel combined, or ulipristal acetate
  • A special ECP product with estrogen and levonorgestrel
  • Progestin-only pills with levonorgestrel or norgestrel
  • Combined oral contraceptives with estrogen and a progestin—levonorgestrel, norgestrel, or norethindrone (also called norethisterone)

When to Take Them?

  • As soon as possible after unprotected sex. The sooner ECPs are taken after unprotected sex, the better they prevent pregnancy.
  • Can prevent pregnancy when taken any time up to 5 days after unprotected sex.

How Effective?

  • If 100 women each had sex once during the second or third week of the menstrual cycle without using contraception, 8 would likely become pregnant.
  • If all 100 women used progestin-only ECPs, one would likely become pregnant.
  • If all 100 women used estrogen and progestin ECPs, 2 would likely become pregnant.

Effectiveness of Emergency Contraceptive Pills (ECPs)

Return of fertility after taking ECPs: No delay. A woman can become pregnant immediately after taking ECPs. Taking ECPs prevents pregnancy only from acts of sex that took place in the 5 days before. They will not protect a woman from pregnancy from acts of sex after she takes ECPs—not even on the next day. To stay protected from pregnancy, women must begin to use another contraceptive method at once (see Planning Ongoing Contraception).

Protection against sexually transmitted infections (STIs): None

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