Everything you need to know about the morning-after pill

How much do you know about the morning-after pill?

Or … how much do you think you know about it?

Clare Boerma, assistant medical director at Family Planning New South Wales, says there is still a lot of misunderstanding about what it is and how it works. And that can be quite worrying when you need accurate information in a rush.

“Condoms can break. We can forget to take pills. Sex can happen if we are not prepared for it, ”says Dr. Boerma.

With this in mind, we have Dr. Boerma and Safeera Hussainy, a pharmacist and associate professor who specializes in emergency contraception, asked to rectify the matter.

What is the morning-after pill?

This is the term most of us use when talking about emergency contraception. But our experts say that in itself this is misleading.

This is because there is actually more than one type of emergency contraceptive pill in Australia and you can use it much later than just the “morning after.”

“A lot of the patients I see don’t know there are two different options,” says Dr. Boerma. “And the pills have a few minor differences.”

  • the Levonorgestrel emergency contraceptive pill is licensed for use for up to three days after unprotected intercourse (but may last for up to four days).
  • the Ulipristal acetate pill for emergency contraception is licensed for up to five days after unprotected sex.

“The ulipristal acetate pill is slightly more effective than the levonorgestrel pill,” says Dr. Boerma.

“But it can also be a bit more expensive and not always that accessible.”

Professor Hussainy says the levonorgestrel pill usually costs around $ 20 while the ulipristal acetate option costs around $ 50 to $ 70.

However, that’s not the only thing to consider when deciding between the two. The pills may also react differently to certain medications (ulipristal acetate, for example, may not be the best choice if you’re taking regular birth control pills on both sides).

A pharmacist will be able to figure out which one is right for you by asking a few questions – but more on that in a moment.

If you don’t want to or can’t take a pill, you can also consider a copper intrauterine device (IUD). Although it comes with its own barriers (you need a skilled doctor to introduce it, and it’s a more invasive process), Dr. Boerma is a big proponent of IUDs as an emergency method and continuous contraception.

“It’s often not considered emergency contraception, but it’s 99 percent effective and works for up to five days after unprotected intercourse.”

How do emergency contraceptive pills work?

“It’s about preventing the egg cell and sperm from coming together,” says Dr. Boerma.

Levonorgestrel and ulipristal acetate are both hormonal drugs that delay ovulation (the process by which the egg is released from the ovary).

“The logic is that if you keep the egg from coming out until any sperm that might be in it has died, then you’re preventing those things from coming together to begin a pregnancy.”

Dr. Boerma says people often think that emergency contraception “causes an abortion,” but it doesn’t.

If you were already pregnant and didn’t know it before, she says that the pill has no effect on this pregnancy at all.

How effective are they?

Professor Hussainy says the levonorgestrel pill is about 80 to 85 percent effective and the ulipristal acetate pill, when taken for the first three days, is 95 to 98 percent effective.

Dr. However, Boerma notes that your exact chances of getting pregnant are still influenced by other factors, including your age (since fertility decreases with age), where you are in your cycle, and when you had sexual intercourse.

“The general rule is, the sooner you take the pill after unprotected sex, the better,” says Dr. Boerma.

Your body mass index (BMI) can also be a factor. Professor Hussainy says the pills may be less effective if your BMI is 30 or higher.

“If you fall into this category, a pharmacist may recommend a double dose of the levonorgestrel pill. Or you can consider a copper intrauterine device (IUD).”

What makes you think that?

The emergency pill should be available from your pharmacy without a prescription.

You don’t need a prescription, you can just come over and buy it after a quick chat with the pharmacist.

Professor Hussainy says the Pharmaceutical Society of Australia has guidelines on how it is sold and to whom, but each pharmacist is free to choose at their own discretion.

“The data shows that it is safe for anyone aged 14 and over, for example. But pharmacies could be of their own age.”

You also don’t need to keep the drugs on hand and can refuse delivery – although Professor Hussainy says this is pretty unusual these days.

And if someone turns you away, they have a “duty of care” to refer you to another pharmacist.

If you’re not feeling well, sometimes a partner can step in for you, says Professor Hussainy (although the pharmacist may want to speak over the phone to confirm this).

You can also often buy it in advance to have on hand.

What to expect in the pharmacy

There are a few questions you need to answer so that the pharmacist can figure out which option is right for you. Professor Hussainy says this will likely include:

  • “When did the unprotected sex take place?”
  • “When was the first day of your last period?”
  • “What medications do you take?”
  • “What diseases do you have?”

You can also ask your age, weight, and height.

A good pharmacist, she says, makes this more of a casual conversation than a formal checklist. They can even invite you to a meeting room for a little more privacy.

“The pharmacist should make the interaction comfortable for you. He should ask these questions with empathy, not judgment.”

Dr. Boerma agrees, adding: “[they] They have no right to teach you about your sexual health or relationships. “

A pharmacist fetches medicines from the shelf.
“The pharmacist should make the interaction pleasant for you,” says Professor Hussainy. (Adobe)

What happens after that

Dr. Boerma says there is a common misconception that emergency contraceptives make you sick, “but most people take it really well”.

Some people get a little nauseous, she says, but that is less common than it used to be. And, in general, using it more than once in a cycle if necessary is not a problem (although both experts recommend using continuous birth control whenever possible).

A common side effect with any dose, says Dr. Boerma, is that you may be delaying your next period.

“And if you end up getting pregnant, you can see a doctor to discuss your options. You have decisions to make afterward.”

This article contains general information only. You should consider seeking independent professional advice regarding your particular circumstances.

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