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| Method 1: The emergency contraceptive pill |
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Does emergency contraception cause an abortion?
No. Emergency contraception may stop ovulation, or fertilisation of an egg, or stop a fertilised egg from implanting in the womb. Medical research and legal judgement are quite clear that emergency contraception (the pill or an IUD) prevents pregnancy and is not abortion. Abortion can only take place after a fertilised egg has implanted in the womb. People who believe life begins when the egg is fertilised may not wish to use the emergency contraception methods outlined in this leaflet.
Where can I get emergency contraception?
- Family planning association of Sri Lanka
- any general practice that provides contraceptive services
- It is available in most of the pharmacies as an over the counter medication.
| Method 1: The emergency contraceptive pill |
What is the emergency pill?
The emergency contraceptive pill is a tablet containing progestogen, a hormone which is similar to the natural progesterone women produce in their ovaries.
How do I take it?
There are several types of emergency contraceptive pills.The most common, emergency contraceptive pill in Sri Lanka is postinor-2.
How to use POSTINOR-2 properly
- Take one tablet as soon as possible (but no later than 72 hours) after you have had unprotected sex. Swallow the tablet whole, with water if necessary. Do not delay taking the first tablet. The tablets work better the sooner you take them after having unprotected sex.
- It is important to take the second tablet 12 hours (and no longer than 16 hours) after the first tablet. This may mean that you need to set your alarm clock for the second tablet. If you are unsure about the timing of the tablets, ask your doctor, nurse, family planning clinic or pharmacist to advise you.
- If you are already using a regular method of contraception such as the contraceptive pill, you can continue to take this at your regular times.
What to do if you are sick (vomit)
- If you are sick (vomit) within three hours of taking the first tablet, you should take the second tablet in the pack at once and contact your doctor, nurse, pharmacist, or family planning clinic immediately for another tablet.
- If you are sick (vomit) within three hours of taking the second tablet you should contact your doctor, nurse, pharmacist, or family planning clinic for advice as soon as possible.
What to do if you miss a tablet
- You must take both tablets in the pack (as described above) and leave no longer than 16 hours (preferably 12 hours) between taking the tablets.
- If you are late taking the second tablet, (more than a 16 hour gap), take it as soon as you remember and contact your doctor, nurse, pharmacist or family planning clinic for advice as soon as possible.
Overdosage
Although there have been no reports of serious harmful effects from taking too many tablets at once, you may feel sick, actually be sick (vomit), or have vaginal bleeding. You should ask your doctor, nurse, pharmacist, or family planning clinic for advice, especially if you have been sick, as the tablets may not have worked properly.
How does the emergency pill work?
The emergency pill is most likely to:
- stop an egg being released (ovulation)
- delay ovulation.
It may also stop a fertilised egg settling in your womb (implanting).
How effective is the emergency pill?
It is very effective and is more effective the sooner it is taken after sex. However, it is not as effective as using other methods of contraception regularly and does not protect you against sexually transmitted infections.
Of the pregnancies that could be expected to have occurred if no emergency contraception had been used the emergency pill will prevent:
- up to 95 per cent if taken within 24 hours
- up to 85 per cent if taken between 25-48 hours
- up to 58 per cent if taken between 49-72 hours.
If the emergency pill is taken after 72 hours it is not known how effective it will be.
Who can use the emergency pill?
Most women can use the emergency pill. This includes women who are breastfeeding and women who can’t use estrogens – the hormone that is used in the combined pill and the contraceptive patch. However, if you are taking certain prescribed medicines, or complementary medicines you will need special advice and the dose of the emergency pill may need to be increased or you may need to use the copper IUD.
What are the side-effects?
- There are no serious short- or long-term effects from using the emergency pill.
- Some women may feel sick, dizzy or tired, or may get headaches, breast tenderness or abdominal-sri-lanka pain.
- A very small number of women will vomit.
- It can disrupt your periods.
How will the emergency pill affect my next period?
- Your period is likely to either come on time or be a few days early or late. For some women it can be up to a week late or sometimes even longer
- You may have some irregular bleeding between taking the emergency pill and your next period. This can range from spotting to being quite heavy.
Do I need to see a doctor or nurse after I've taken the pill?
Not usually, but do go and see a doctor or nurse if:
- you think you may be pregnant
- your next period is more than seven days late
- your period is shorter or lighter than usual
- you have any sudden or unusual pain in your lowerabdomen.
These could be signs of an ectopic pregnancy – a pregnancy that occurs outside the womb, usually in a fallopian tube. Although this is not common, it is very serious.
You should also see a doctor or nurse if:
- you want to talk about using regular contraception
- you are worried that you might have caught a sexually transmitted infection.
Can the emergency pill fail?
The emergency pill is very effective and should be taken as soon as possible after unprotected sex. However, in some women it fails and they become pregnant even though the pill was taken correctly. You may also become pregnant if you:
- delay taking the emergency pill
- vomit within two hours of taking the pill
- have had unprotected sex at another time, either since your
last period or since taking the emergency pill.
What if I vomit within two hours of taking the pill?
Speak to your doctor, nurse or pharmacist. They may give you another pill and a medicine to stop you vomiting again, or suggest having a copper IUD fitted. If you vomit later than two hours, don’t worry, the pill will have been absorbed.
How will I know if the emergency pill has worked?
If you have taken the pill correctly and your next period seems normal, it is unlikely that you will be pregnant. After you have taken the emergency pill it is recommended that you do a pregnancy test to make sure you are not pregnant if:
- you think you feel pregnant
- you have not had a normal period within three weeks of taking the emergency pill
- you do not have a bleed when you have the seven-day break from using the contraceptive patch or combined pill or when
you take the placebo tablets with ED combined pills.
A pregnancy test result will be accurate if the test is done from three weeks after the last time you had unprotected sex.
Are there any risks if the emergency pill fails?
The emergency pill has not been shown to affect a pregnancy or harm a developing baby. As with any pregnancy there is a small chance that an ectopic pregnancy may occur. If you think that you may be pregnant it is important to seek advice as soon as possible to check that you do not have an ectopic pregnancy.
Will the emergency pill protect me from pregnancy until my next period?
No. The emergency pill will not protect you from pregnancy if you have unprotected sex again. Seek advice - you can use emergency contraception again.
Can I continue to use regular contraceptive pills after the emergency pill?
Yes. If you needed emergency contraception because you forgot some of your regular pills correctly, you should take a contraceptive pill again. You will need to use an additional contraceptive method, such as condoms, for:
- seven days with the combined pill
- two days with the progestogen-only pill.
How many times can I use the emergency pill?
You can take the emergency pill as many times as you need to and more than once in any one menstrual cycle. It is not dangerous to do this but it may disrupt your periods. However, using the emergency pill is not as effective as using other methods of contraception. Speak to the fpa-sri-lanka helpline or ask your doctor, nurse or pharmacist for advice on contra
Can I get emergency pills in advance?
Yes, if you are worried about your contraceptive method failing, you are going on holiday, or you cannot get emergency contraception easily. Ask your doctor or nurse about this.
What is the copper IUD?
An IUD is a small plastic and copper device that is put into your womb by a specially trained doctor or a nurse. It can be fitted up to five days after unprotected sex at any time in the menstrual cycle provided this is the only unprotected sex that has occurred since your last period.
If you have had unprotected sex more than once since your last period then an IUD can be fitted up to five days after the earliest time you could have released an egg (ovulation).
If the IUD cannot be fitted immediately you may be advised to take the emergency pill in the meantime.
How does the IUD work?
It may stop an egg being fertilised or implanting in your womb.
How effective is a copper IUD?
The IUD is the most effective method of emergency contraception. It will prevent up to 99 per cent of pregnancies expected to occur if no emergency contraception had been used.
Who can use an IUD?
Most women can use an IUD for emergency contraception. An IUD may be suitable if:
- you want to use the most effective method of emergency contraception
- you do not want to, or cannot, take progestogen
- you want to use the IUD as an ongoing method of contraception.
What are the disadvantages of using an IUD for emergency contraception?
- It is not as easily available as the emergency pill.
- Not all women can use the IUD (for example, women who have certain problems with their cervix or womb).
- There is a small chance of getting an infection in your womb within the first 20 days after the IUD is put in. If you have been at risk of getting a sexually transmitted infection you may have screening tests done at the time the IUD is fitted and you may also be given some antibiotics. This will help to reduce the chance of getting a pelvic infection.
- An IUD might go through (perforate) your womb or cervix when it is fitted. This may cause pain, but often there are no symptoms. If this happens, the IUD may need to be removed by surgery. Perforation is uncommon when the IUD is fitted by an experienced doctor or nurse.
- The IUD can be pushed out by your womb (expulsion).
How is the IUD put in?
The doctor or nurse will first examine you internally to check the position and size of your womb.
Fitting an IUD takes about 15–20 minutes. It can be uncomfortable or painful for some women, and you might want to have a painkiller beforehand or a local anaesthetic. You may get a period-type pain and some light bleeding for a few days after the IUD is fitted. Painkillers can help with this.
How will I know that the IUD is still in place?
An IUD has one or two threads attached to the end that hang a little way down from your womb into the top of your vagina. The doctor or nurse will teach you how to feel the threads to make sure the IUD is still in place. It is very unlikely that it will come out, but if you cannot feel the threads, or if you think you can feel the IUD itself, you may not be protected against pregnancy. See your doctor or nurse straight away and use an extra contraceptive method, such as condoms.
When will I get my next period?
Your next period should come at about the same time as you would normally expect it. If you have not had a normal period within three weeks of having the IUD fitted it’s recommended that you do a pregnancy test.
Are there any risks if the emergency IUD fails?
The emergency IUD is highly effective. If however it does fail and you become pregnant there is a risk that the IUD can cause a miscarriage or that an ectopic pregnancy may occur. If you know that you are pregnant or think that you might be, it is important to seek advice as soon as possible.
Do I need to see a doctor or nurse after the IUD is fitted?
Yes. It is recommended that you see a doctor or nurse three to four weeks after the IUD is fitted, whether or not you have had a period. This is to:
- check you are not pregnant (if you have not had a normal period)
- discuss any problems
- remove the IUD if this is what you want
- discuss your future contraception needs.
If you are ever worried about anything to do with your IUD do contact your doctor or nurse as soon as you can. You should see your doctor or nurse straight away if you think you are pregnant or have any of the following:
- a sudden or unusual pain in your lower abdomen
- a shorter, lighter or delayed period
- an unusual or smelly discharge from the vagina
- a high temperature. These could be signs of an ectopic pregnancy or an infection, which can be serious.
Will the IUD protect me from pregnancy until my next period?
Yes. As soon as it’s fitted it will protect you against pregnancy and it will provide ongoing contraception until it is taken out. If you want to, you can carry on using this method as your regular contraception. You can discuss this with your doctor or nurse. You will also find more information in our section on Your guide to the IUD.
When can I have the IUD removed?
If you do not want to keep the IUD as your regular method of contraception, it can be removed during your next period. This is done by a doctor or nurse, who gently pulls on the threads.
If it is removed at any other time you will need to use an extra contraceptive method such as condoms, for seven days before the IUD is taken out. This is because sperm can live inside your body for up to seven days and could fertilise an egg once the IUD is removed.
Sexually transmitted infections. Most methods of contraception do not protect you from sexually transmitted infections.
Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. Diaphragms and caps may also protect against some sexually transmitted infections. If you can, avoid using condoms containing Nonoxinol 9 (spermicidally lubricated), as this does not protect against HIV and may even increase the risk of infection
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