About the emergency oral contraception
The emergency oral contraception, also known as the "morning-after pill" is, as its name suggests, a method of contraception to help prevent an unwanted pregnancy. This method exists because it happens that the contraceptive method used was ineffective (eg loss or breakage of the condom, forgotten oral contraceptives, miscalculation of the menstrual cycle) or no contraceptive method had been used voluntarily, by omission or after a rape.
It is important to talk about a first myth: it is a method of contraception and not abortion. If there is already a pregnancy, it will not be affected by the EOC.
What is the EOC? Two methods are currently available in Quebec. The first method is called the Yuzpe method. It is a method used for over 25 years. It consists of high doses of estrogen (100 micrograms of ethinyl estradiol) and progesterone (500 micrograms of levonorgestrel). Two doses should be taken 12 hours apart. The doses are obtained by taking multiple tablets of oral contraceptives. The contraceptives OvralTM, AlesseTM, AvianeTM, TriquilarTM, MinovralTM and PortiaTM can be used for the Yuzpe method. This method must be used within 120 hours after the sexual intercourse.
The second method consists of a high dose of levonorgestrel only. It is the drug Plan BTM which each tablet contains 750 micrograms of levonorgestrel. The treatment consists of two tablets of Plan BTM taken simultaneously (single dose) or 12 hours apart. This method must be used within 120 hours after the sexual intercourse.
Which method to choose? Traditionally, the Yuzpe method was used. However, since the advent of Plan BTM on the market, this method is mostly used. It is easier (taking 2 tablets in a single dose rather than taking several tablets at 12 hour intervals), it causes fewer side effects (about half) and it is more effective. Plan BTM is the method of preference. How does oral emergency contraception? The EOC operates in several ways. As you can see, the goal is to prevent pregnancy and not to cause an abortion. The EOC may:
Prevent the transport of the egg or sperm in the fallopian tube
Change the endometrium to prevent implantation of a fertilized ovum
Other mechanisms of action are also possible. The EOC does not disturb a pregnancy already in progress. If for personal or religious beliefs, abortion was forbidden to you, know that the emergency oral contraception is not abortion.
When to use emergency oral contraception? It is prudent to consult for the EOC as soon as possible after having had sex without using a contraceptive or after the failure of a method of contraception. Although the EOC can be used up to 120 hours after a failure of contraceptive method, it is more effective if used quickly. It is therefore important to use emergency oral contraception as soon as possible for it to be as effective as possible. A period of less than 24 hours is desirable. However, the EOC is still a good choice up to 120 hours after sex. Where to get the emergency oral contraception? In order to obtain easily the EOC, it was made available in pharmacies in Quebec. At the Pharmacy Pierre-Marc Gervais, the EOC is available every day during our opening hours. The EOC can also be obtained at CLSCs. You can get a prescription from your doctor to get it. However, the prescription by a physician is not required to obtain the EOC. The pharmacist can prescribe the EOC. How to get the EOC? In Quebec, for the EOC, you need a prescription. This prescription may be issued by an authorized prescriber. A doctor or pharmacist may issue the prescription. For the EOC in pharmacy, the pharmacist must meet the patient. The pharmacist will ask some questions about whether the EOC is warranted and if there are no counterindications. The pharmacist will explain how to use the EOC, which side effects your might get and how to manage them. What are the side effects? Approximately 1 in 4 women will have side effects with Plan BTM while 1 in 2 women will have with the Yuzpe method. These side effects may include:
These side effects are generally tolerable. They can be reduced and controlled. Talk to your pharmacist.
What if I have vomiting? If you vomit the pills that you took less than an hour after taking, the effectiveness will be
compromised. It is therefore important to take a new dose. Your pharmacist can suggest an antiemetic to prevent vomiting again.
What is the cost of emergency oral contraception? The cost varies from one pharmacy to another. It may be $ 30 at a pharmacy as $ 50 at another pharmacy. This is the cost of consultation with the pharmacist that varies as the drug used for EOC. The consultation is paid by the Quebec government if you have health insurance card (carte-soleil). Pulic and private insurance plans cover the drug. What about privacy? All the information that the pharmacist will collect will be strictly confidential and kept this way. If you are 18 year-old or older, your file is confidential. Myths about emergency oral contraception Here are some myths and answers:
Myth: emergency oral contraception can make infertile. Reality: emergency oral contraception does not reduce fertility. Myth: emergency oral contraception can not be used more than 2 times in your life. Reality: emergency oral contraception can be used multiple times. No safe limit has been established.
Myth: emergency oral contraception protects against diseases. Reality: emergency oral contraception does not protect against STIs (STDs) like HIV, herpes, syphilis, chlamydia, condylomata.
Myth: emergency oral contraception is abortion. Reality: As demonstrated by the mechanism of action, oral emergency contraception does not interrupt a pregnancy that is already underway. The EOC is used to prevent pregnancy. The use of the EOC reduces the risk of having to rely on the voluntary interruption of pregnancy (abortion).
Paper by Pierre-Marc Gervais, pharmacist Last updated on March 20th 2009
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