A woman may need to use emergency contraception, if she had an unplanned sexual intercourse. Also, one may also need it if the usual birth control method has failed. For example: if you forgot multiple doses of your OC pill or the condom broke.

In these cases, it is important to know your options and the urgency to do the needful.

How soon do you have to do emergency contraception?

Emergency contraceptive measure has to be taken within five days of unplanned intercourse.

The hormonal contraceptive pills work best within three days of the intercourse.

If its already more than three day, you should consider an IntraUterine Device (Copper Containing IUD such as Copper T) or a special emergency contraceptive pill called ‘Ulipristal’

Is there any option other than the ‘morning after’ pill?

There are two broad choices available: pills and  Intra Uterine Device (IUD). The commonest IUD that you might have heard of is a Copper T.  A little more detail about both options:

Emergency contraception with pills

There are three ways in which you could use pills for emergency contraception.

  1. If you are on OCPs (birth control pills), you could use higher than normal dose of OCPs for emergency as well. A total dose of 100mcgm ethynyl estradiol and 1mg norethisteron OR 500 mcgm levonorgestrel have to be taken within 72 hours of unprotected intercourse. This should be followed by another such dose taken 12 hours later. This means two  tablets of high doses of combined OC pills (ex. Ovral) or 3.5 tablets of low dose pills such as Ovral L, Norelon etc.  Regular oral contraceptive pill use can be started after the second dose.
    Saheli contraceptive: two tablets (60mgm) Taken twice within 24 hours of an unprotected intercourse can prevent implantation in 99% of the women
  2. You could take ‘morning after’ pills containing levonorgestrel . In India, common brands are i-pill , Unwanted-72 etc. Depending on the manufacturers instructions, you could need two pills. But in most cases, only one pill is enough. Levonorgestrel 0.75mg tab to be taken within 72 hours of unprotected intercourse and another 12 hours later OR two tab let as a single dose .
  3. You could take pill containing Ulipristal (trade name Ulitop, Elata, Fibristal) within 120 hours of intercourse. But, you will need a prescription for this drug

Emergency contraception with IUD (Copper T etc.)

Copper T as emergency contraception will be excellent choice if:

  1. More than 72 hours have passed since the intercourse.
  2. You weight more than 75 kilograms
  3. You desire long term contraception and follow safe sex practices ( low chance of STD)

Do you need regular contraception in the same cycle after emergency contraception?

If you have sex again after you take the pills, you can still get pregnant. Make sure you use a condom or another type of birth control if you have sex again after you took emergency contraception.

If you used regular OCPs as emergency contraception, you have to get back to regular OC use after the second dose.

If you took ulipristal and you normally use birth control pills, wait at least 5 days before starting your regular pills again. That’s because ulipristal can cause problems with the way birth control pills work. Even after you start taking your pills again, you should still use a condom every time you have sex until your next period.

Copper T gives long time protection, of course

What if you throw up soon after you take the pills?

If you throw up less than an hour after you take the pills, you have to take them again. Before you take them again, take a medicine that helps keep you from throwing up . If you throw up with birth control pills, try levonorgestrel instead, since it gives less nausea. If you throw up within 3 hours of taking Ulipristal, ask your doctor for guidance

Is emergency contraception 100% successful or do I need to check for pregnancy?

You should get your period within a week of when you expect it. If you took ulipristal you can be a few days late. But if you do not get your period within 3 or 4 weeks, no matter which form of emergency contraception you took, get a pregnancy test.

Is Emergency contraception safe? Can I use it as regular contraception?

Emergency contraception is a safe for emergency use. Even in women who can not be put on OCPs, emergency contraception is considered safe.

But, using this as your regular contraception will lead to chaotic unpredictable menstrual cycles in disrupt the cyclical changes in ovarian hormones, which is needed for not only reproductive function, but others such as bone health etc.

This is why it is not advised as a good option for women who have sex regularly, so start using regular contraceptive methods : pills or others

If you suspect you could be pregnant, read ‘how soon can I know if I am pregnant’

Also read: HIV and other STDs should you get tested and what tests?