Emergency contraceptives (e-pills) are one of the most commonly used drugs and hence commonly abused. There are also a lot of questions that go unanswered about these pills. Most often than not, those who use e-pills do so following advice from a friend and not a medical practitioner.
E-pills are hormonal emergency contraceptives. They are usually presented as a blister pack with two tablets. Each tablet contains 0.75mg of Levonorgesterol plus other excipients.
They work by stopping the ovaries from releasing an egg. It’s not clear whether or not it can stop an egg from being implanted in the wall of the uterus.
It is important to note that the pills are used in emergency cases and are not meant for use as a regular contraceptive. It should not be taken more than once within one menstrual cycle. It is recommended that an e-pill can be used once in 3months but only in case of an emergency. Otherwise, long term methods of contraception are available and one is advised to consult a doctor to determine which one will be suitable for them if they do not wish to get pregnant.
The first tablet should be taken as soon as possible and not later than72hours after unprotected intercourse. The second tablet should be taken 12hours after the first tablet and not later than 16hours. It is therefore important to work out the timing such that the time for the second tablet does not fall at odd times like at night when one is a sleep.
The two tablets may also be taken at the same time, preferably within 12hours after unprotected intercourse.
If one vomits within 3hours of taking either tablet, she may need an additional tablet.
An e-pill can be used on any day of the menstrual cycle.
An e-pill may help to prevent pregnancy if taken within 72hours of unprotected intercourse or failure of a contraceptive method. Its efficacy decreases with time hence the sooner you take it, the higher the chances of preventing pregnancy.
It is estimated that P2 is 90% effective. Efficacy appears to decline with time with 95% efficacy within 24hours, 85% between 24hours and 48hours and 58% within 48hours and 72hours.
Note that the e-pills are less effective than insertion of an intra-uterine device. The copper intra-uterine contraceptive devices can be inserted up to 120hours after unprotected intercourse. They can also be covered by antibacterial prophylaxis in case of a sexually transmitted infection.
Note that all drugs have side effects. Do not be alarmed at the side effects of e-pills. You may not experience any or experience just a few of the side effects.
The common side effects include tiredness, nausea and vomiting. Stomach pain, diarrhea, dizziness, headache, increased vaginal bleeding and skin reactions may also occur. It may also result in breast tenderness, that is, pain on applying pressure on the breasts.
Regular use of e-pills disrupts the pattern of one’s periods and may lead to uncertainty as to whether one is pregnant or not.
All contraceptives pose the risk of cancer especially Breast Cancer. The risk increases with age. Women above 35years have a higher risk of developing breast cancer. There has also been a reported risk of Ischemic Heart Disease. Few cases of Hypertension also exist.
E-pills are not recommended for children; that is, below 16years.
It does not prevent pregnancy at every instance and is not effective as a conventional regular method of contraception.
Before taking the pills, one should confirm if she is already pregnant. It should not be used in pregnancy. Do not use it if you previously had unprotected intercourse more than 72hours earlier in the same menstrual cycle. You may already be pregnant.
It should not be used if one has vaginal bleeding whose cause is not known and also in those with breast cancer.
Avoid using e-pills if you are taking drugs used to treat epilepsy, tuberculosis, HIV and fungal infections.
One may experience spotting or vaginal bleeding earlier than expected.
You know it has worked when you have your next period and it is normal. If you do not experience your period within 3weeks after taking the pills, you may be pregnant. It is recommended that a pregnancy test be done to ascertain this. If your period is more than 5days late or unusually heavy or light, please seek medical attention.
Severe stomach pains may indicate an ectopic or tubal pregnancy. If you experience severe stomach pains, please seek medical attention as soon as possible. If pregnancy occurs after treatment with e-pill, there is a possibility of having an ectopic pregnancy.
Do not breastfeed within 3days of taking e-pill.
Products in the Market
There are several brands of e pills in the market. The brands available in Kenyan market include Ecee2, Emcon, Levo-72, Levogest, P2, Postinor-2, Smart Lady (Pregnon) and Truston-2.
There are also several counterfeit products in the market that have lead to an increase in the reported cases of failures of e pills. One is advised purchase the pills from reputable pharmacy outlets registered with the Pharmacy and Poisons Board (PPB). These outlets are available on their website.
A brand like Postinor 2 has designed a way of confirming the authenticity of the product since its one of the brands with several counterfeits. The pack, which is green in colour, has a white spot at the back which on scratching with a metal reveals the company logo.