Emergency concentration tablets without prescription. Emergency contraception - various methods and their effectiveness. Classification of emergency concentration tablets

This article examines the issue of emergency contraception. She is also called "firefighter" or radical. What types and methods exist, how to use them, pros and cons, as well as cases when it is worth using emergency contraception.

Emergency contraception is used if:

• happened unprotected sexual intercourse, you did not use protection at all
• your usual method of contraception Not worked, for example, the condom broke
• You forgot take a birth control pill

Emergency contraception drugs are called “firefighters” because they are used in exceptional cases. An analogy can be made with calling an ambulance.

We'll talk about two types radical contraception:

• tablet (they are also called “The Morning After Pill” or the morning after pill)
• intrauterine device

The most important information can be gleaned from tables below. Further in the text, each of the points in the table is discussed in more detail:

What you need to know about emergency contraception

• You need to remember the golden rule: than earlier If you take the pill, you will have a better chance of getting pregnant less.
• The intrauterine device is considered more efficient tablets. According to statistics, less than 1% of women became pregnant after using the IUD. The statistics for tablets are much worse.
• Side effects phenomena of emergency contraceptive pills: nausea, increased fatigue and excitability, dizziness, pain in the mammary glands and lower abdomen.
• Your menstrual cycle will be unstable.
• If within 2 hours after taking the pill you vomit, you should take another pill because the effect of the first one may wear off and your chance of getting pregnant will increase.
• The intrauterine device can be yours regular method of contraception, and not just emergency.
• It is worth knowing that frequent use of an intrauterine device will lead to longer, heavier and more painful periods.
• The process of inserting the IUD may be slightly painful, so you can take a painkiller tablet.
• Despite the presence of side effects from the use of “fire” contraception, this method is considered more “beneficial” and humane for health than any other type. abortion.
• If you have calculated your “safe” days, and unprotected sexual intercourse occurred precisely on these days, with a small degree of risk, you can not take the pills. Since emergency contraception methods are a strong blow to a woman’s body.

Tablets Postinor, Escapelle, Levonel

These tablets contain an artificial analogue of the hormone progesterone.

When the hormone progesterone is found in natural quantities, it prepares the uterus to receive a fertilized egg, that is, it plays a direct role in the onset of pregnancy.

An increased level of this hormone in a woman’s body changes the structure of the uterine mucosa and changes the course of follicle maturation. The pregnancy process is blocked. The hormone interferes with the process ovulation(release of the egg).

And even if ovulation has occurred, the uterine lining changes so much that a fertilized egg cannot attach to its wall.

How to use

Postinor, Escapelle, Levonel should be taken no later than 72 hours after unprotected sexual intercourse.

That is, for example, if sexual intercourse occurred at 10 pm on May 10, then the pills (Postinor, Escapelle, Levonel) must be taken strictly before 12 noon on May 14.

In the case of Escapelle and Levonel, it is enough to take one tablet.

In the case of Postinor, first one tablet is taken, then after 12 (not later than 16) hours the second one is taken.

Contraindications for use

The drugs Postinor, Escapelle, Levonel have practically no contraindications, except for individual intolerance.

We recommend that you see your doctor before taking any of the above tablets. Your doctor can advise you on the tablets that are right for you and the recommended dosage. These tablets can already be used for 21 the day after childbirth and after miscarriages and abortions.

Side effects

There are virtually no mid- or long-term side effects from taking emergency contraceptive pills.

• Some women feel nausea, fatigue or, conversely, increased excitability, headache, pain in the lower abdomen and mammary glands.
• A small percentage experience vomiting.

In this case, the effect of the tablet may decrease, so it is better to take another one.

• Your menstrual cycle will be disrupted, but then it will recover again.

All of these side effects usually go away within a few days.

How will it affect your next menstruation?

After taking radical contraceptive pills, your period may come either earlier or later than expected.

Sometimes you may experience some bleeding between periods.

Do I need to go to the doctor?

You need to see a doctor if:

• you are more than 7 days late
• your next period is shorter and less heavy than usual
• you are experiencing pain in the lower abdomen
• these could be signs of an ectopic pregnancy (this is a very rare case, but you need to take action as quickly as possible)
• you are concerned that you may have contracted a sexually transmitted disease

Is it possible to get pregnant after Postinor, Escapel, Levonel?

Some women still get pregnant, even if they took the pills as directed.

These are quite rare cases. If you decide to keep your child, his health will not be at risk after taking the pills.

Basically, pregnancy occurs if:

• the pills were taken 72 hours after unprotected intercourse
• if vomiting occurs within 2 hours after taking the pills

There are rough statistics showing that emergency contraceptive pills prevented:

• 95% of pregnancies when taken within 24 hours of unprotected sex;
• 85% of pregnancies when taken within 25-48 hours;
• 58% of pregnancies when delivered within 49-72 hours

“Firefighter” contraceptive pills take about 2 hours to be completely absorbed in a woman’s body. Vomiting after 3 hours will not affect the contraceptive effect of the pills.

It is better to be observed by a doctor during the entire process. In this case, your doctor will be able to recommend an additional method of contraception.

Emergency contraception together with regular contraception

After taking Postinor, Escapel, Levonel for 12 hours, use your regular contraceptive:

• have a drink contraceptive tablet
• vaginal ring
• contraceptive patch

In addition, for several days you need to use an additional means of contraception - a condom:

• during 7 days if you use patch, ring or combination tablets
• during 2 days if yours contraceptives tablets are based on the hormone progesterone

If you are breastfeeding, taking emergency contraceptive pills is safe for your baby's health.

ellaOne tablets (ellaOn)

Recently, the drug ellaOne appeared on the market, which can be taken within 120 hours after unprotected intercourse (that's 5 days).

ellaOne tablets contain Ulipristal Acetate.

The principle of operation of all oral contraceptives is to delay or prevent ovulation, the release of a mature egg, which, when it meets a sperm, will lead to pregnancy.

Who can accept

Almost all women can take ellaOne tablets. Among the contraindications:

• asthma
• liver disease
• pregnancy

You should also refrain from breastfeeding for one week.

Side effects

They are the same as with other emergency contraceptive pills.

Within a few days after taking the pill you may feel:

• pain in the lower back or lower abdomen
• more painful periods
• frequent mood changes

Do you need a doctor?

Be sure to consult a doctor if:

• there was a delay in menstruation by more than 7 days
• periods are not as heavy as usual
• they are accompanied by pain, which was not there before
• you want to make sure you haven't contracted any sexually transmitted diseases

Could ellaOne not work?

In rare cases, as with other radical contraceptive pills, ellaOne may not work and pregnancy will occur.

In this case, you will need to consult a doctor.

The contraceptive effect of ellaOne may be reduced if you vomit within 3 hours of taking the pill. Contact your doctor immediately (he may advise you to take another pill, or use by another means emergency contraception).

If you vomit after 3.5 hours or more, the contraceptive properties of the pill are completely preserved.

There is a general rule for taking all medications: don’t delay. The sooner you take the pill, the greater the chance that its contraceptive properties will work 100%.

ellaOne and contraception

If you have missed taking your regular contraceptives, within 12 hours of taking ellaOne tablet you should:

• take your regular contraceptive tablet or
• insert vaginal ring
• use contraception bandage

You will definitely need to use an additional contraceptive - a condom:

• for 14 days if you are using the ring, patch, and combined birth control pills
• within 9 days if you are using hormonal birth control

Effect on next menstruation

As a rule, they arrive on time. But there are times when the cycle is disrupted for several days.

Intrauterine (contraceptive) device

This emergency contraception can be used for 5 days after unprotected sex or during 5 days after ovulation. The spiral will not allow the egg to be fertilized and settle in the uterus.

It is important to know that after unprotected sexual intercourse, you need to get tested for sexually transmitted diseases, because no method will protect you from these diseases.

The intrauterine (contraceptive) device can be used both as a means of contraception and as a regular contraceptive means.

Is it a spiral?

The intrauterine device, or contraceptive device, is made of plastic and copper and is T-shaped. It is inserted into the vagina.

After unprotected sexual intercourse, it can easily be used as a method of emergency contraception. The main thing is to introduce it within 5 days after unprotected sex.

The introduction of the spiral lasts about 15-20 minutes.

Pain may occur during insertion. In this case, ask your doctor to give you pain medication.

Who is the spiral suitable for?

Suitable for almost all women, but there are a number of contraindications.

The contraceptive device can be used even after miscarriages and abortions.

Before installation, it is better to consult a doctor, perhaps if you have an infection, you need to take antibiotics.

Side effects

For a few days after installation, you may experience discomfort in your lower abdomen (similar to a painful period).

In this case, you need to take painkillers.

There is a small chance that within 20 days After installation you will catch some kind of infection.

The coil may sometimes move or fall out. In this case, you need to consult a doctor and put it in place.

How will the IUD affect my next period?

Your period may become heavier and more painful, but it usually comes on time.

How often should you go to the doctor?

After the spiral is installed, it is advisable to go to the doctor through 3-4 weeks, to:

• make sure you are not pregnant
• make sure the IUD is seated correctly (if you want to continue using the IUD as a regular contraceptive)
• remove the IUD (if your goal was only emergency contraception)

When is the coil usually removed?

If you use it only as a “fire” contraception, you can remove it during your next period.

How reliable is the spiral?

The intrauterine device is one of the most reliable means of both regular and emergency contraception.

IN 99 % case, it protects against unwanted pregnancy.

Periodically feel the tendrils from the spiral in the vagina. If you do not feel them, there is a possibility that the device has moved and its contraceptive properties have weakened.

You should not feel the presence of a spiral in your body. If for any reason you feel it, consult your doctor. And use an additional means of contraception, for example, a condom, until you figure out the problem.

The IUD and other methods of contraception

As already mentioned, the intrauterine device is itself one of contraceptive methods, in addition to emergency.

If your regular method of contraception is contraceptives tablets, after the spiral is removed, you can continue to take them.

How much will emergency contraception cost you?

Emergency contraception is not cheap.

Postinor, for example, is the cheapest of all means - about 300 rubles.

Escapelle, Levonel are a little more expensive (about 350 rubles).

The drug ellaOne is already 10 times more expensive ( 3390 rubles), because it is more gentle, modern and can be used within 5 days after unprotected sex.

Intrauterine device can be used as a regular means of contraception for a long time, so its cost does not fall below 3500 rubles and comes to 7000 rubles.

From the article you learned about all the methods of emergency (fire, radical) contraception: pills and intrauterine device. Your doctor will tell you which remedy is right for you.

Emergency contraception methods are the use of various medications and techniques that prevent pregnancy from occurring after sex without a contraceptive. These methods prevent ovulation from occurring, reduce the likelihood of fertilization of the egg or subsequent implantation of the blastocyst, and are not considered an abortion. Therefore, emergency postcoital contraception is safer for women, but its regular use results in hormonal imbalance and infertility.

What emergency methods have been developed

Contraception after sexual intercourse cannot be used later than 72 hours after intimate intercourse. After this, its effect rapidly decreases. Several methods of unscheduled contraception have been developed, but only a few have found widespread use:

• Yuzpe method – combined contraceptives are taken in an increased daily dose according to the scheme;
• mifepristone tablets;
• antigonadotropin Danazol tablets;
• postcoital contraceptives with levonorgestrel for oral administration;
• intrauterine device with copper wire winding.

Not all tablets for emergency contraception can be purchased at a pharmacy without a prescription; without a doctor’s instructions, a woman can only purchase levonorgestrel-based drugs and some mifepristone tablets. The intrauterine device must also be installed by a doctor under aseptic conditions.

Oral medications

For emergency contraception, you can purchase drugs based on estrogen-progestogen components. This method of emergency birth control is called the Yuzpe method. Combined oral contraceptives are used for it. The regimen includes taking a certain number of tablets twice with an interval of 12 hours. In total, they should provide 100 mcg of ethinyl estraliol and 500 mcg of levonorgestrel. Drugs with high dosages of hormones are often used:

• Rigevidon;
• Miniziston;
• Microgynon;
• Oralcon.

It is advisable to take the first 4-5 tablets as soon as possible after sex, depending on the dose in one. But it is allowed to take them within 72 hours.

Emergency contraceptives, which are used after unprotected sexual intercourse, containing levonorgestrel, are sold without a doctor's prescription, unlike COCs. Such drugs include:

• Escapelle;
• Postinor;
• Modell-911;
• Eskinor-F.

Emergency protection pills against unwanted pregnancy need to be taken only once as soon as possible, you need to do this within 3 days. It takes 3 hours for the pill to be absorbed; if vomiting occurs during this time, the method cannot be considered effective, so a repeat pill is taken.

These are one of the best emergency contraceptives, but they should not be used more than once a month. This scheme is harmful and leads to hormonal imbalance and can cause uterine bleeding.

Mifepristone is a non-hormonal safe drug. It is an antiprogestin, blocks progesterone receptors in the endometrium and prevents implantation. Mifepristone is included in the following drugs:

• Genale;
• Gynepristone;
• Ginestril;
• Miropriston.

Express pills for unwanted pregnancy are taken, regardless of the day of the menstrual cycle, for 3 days after unprotected sex. Food affects the absorption of emergency contraception, so they are drunk 2 hours before or 2 hours after meals. During this period, mifepristone prevents fertilization and implantation. But the drug is also used for medical abortion in combination with misoprostol.

Emergency contraception with mifepristone is the safest and has fewer side effects. The dosage of the active substance in tablets is only 10 mg, which is significantly lower than in tablets that cause miscarriage. But you should resort to them only in emergency cases.

An alternative method of emergency contraception for girls is Danazol. This is a drug that belongs to the class of antigonadotropins. It should be drunk within 12 hours at a dosage of 400 mg. Then repeat taking the drug 3-4 more times. Research shows that this drug has fewer side effects than COCs. But the technique has not yet received approval.

Intrauterine devices

If the time period for taking emergency contraceptives is missed, then there is another 2 days to use an alternative method. For 5 days, contraception after sex is carried out using regular contraception. This method is highly effective; it prevents pregnancy in 92-99% of cases.

You need to see a doctor. The procedure is not performed on young people due to the risk of injury to the cervix. Also, you should not install the IUD if you are likely to be pregnant or if you suspect a sexually transmitted infection. This method can be recommended for women during lactation, because... it does not affect milk production, does not change its composition and does not harm the baby.

Folk remedies for emergency prevention

Emergency contraception has low effectiveness and is not always safe. They are used at home when it is not possible to buy birth control pills at the pharmacy. Traditional medicine offers the following methods:

• douching with acidic solutions;
• use of herbal decoctions;
• use of antiseptic drugs.

Acids that are introduced into the vagina must have time to destroy sperm and prevent them from penetrating into the uterine cavity. A slice of lemon, a solution of vinegar or citric acid are used as acidifying agents. Potassium permanganate has a similar effect. But choosing them as an emergency contraceptive is dangerous. They can cause burns to the vaginal mucosa.

Some women use emergency contraception or. But they will not give effect after sex. It takes several minutes for the contraceptive to dissolve, and 60 seconds are enough for sperm to penetrate the uterus.

Traditional medicine recommends using methods of early termination of pregnancy, when implantation has already taken place. For this purpose, decoctions of ginger, shepherd's purse, pineapple juice, and marjoram are used. These methods are not recommended by official medicine, because they can lead to dangerous complications.

How do emergency contraception work?

To protect against pregnancy, rapid contraception is necessary. The action of the tablets is based on their ability to influence hormonal levels. They change the normal concentration of sex hormones, so fertilization cannot take place, and if it does occur, the endometrium changes its receptive properties, so the blastocyst cannot implant. But in cases where implantation has occurred, hormonal pills are not capable of causing a miscarriage.

Post-fertilization birth control pills that use mifepristone work in several ways:

• block egg maturation;
• make the endometrium unsuitable for implantation;
• stimulate the ability of the myometrium to contract;
• increase sensitivity to prostaglandins;
• promote the separation and removal of the endometrium.

Mifepristone should not be used monthly or as a regular method of contraception. It causes bleeding and disruption of the menstrual cycle, which can negatively affect subsequent planned pregnancies and overall health. Emergency tablets should only be used in a fire emergency.

The action of the intrauterine device is based on the ability to cause aseptic inflammation after insertion into the uterus, which changes the ability of the endometrium to accept an embryo. Copper ions are also active against sperm, disrupting their motility and ability to conceive.

If a woman has a regular menstrual cycle and the day of ovulation is known, then the IUD can be installed within 5 days after it.

Indications for use

A woman should quickly take a contraceptive after unprotected sex, and also when she is not sure of the desired result after using a contraceptive:

• with a torn condom;
• violation of the rules for the use of spermicides;
• when used and ejaculation occurs into the genital tract.

Rapid-acting oral contraceptive pills can be used by nulliparous women. But copper IUDs are not recommended for them due to the risk of developing cervical injuries and subsequent complications during pregnancy and childbirth.

Who is contraindicated for emergency contraception?

Before using emergency contraception, you should carefully study the composition and contraindications. For levonorgestrel-based drugs the following:

• hypersensitivity or allergy to any component of the drug;
• severe liver dysfunction;
• during the period of bearing a child;
• lactase intolerance;
• glucose-galactose malabsorption syndrome;
• Crohn's disease.

They are used with caution in women with jaundice or gallbladder dysfunction during lactation. Breastfeeding mothers need to express for 24 hours after taking levonorgestrel tablets and only then resume feeding the baby.

Research shows that mifepristone pills, which are used for emergency contraception, are safer when followed properly. But they have many contraindications:

• allergy to the drug;
• acute or chronic renal, liver failure;
• long-term treatment with glucocorticoids or adrenal insufficiency;
• blood clotting disorder;
• porphyria;
• anemia;
• taking anticoagulants.

Mifepristone quickly penetrates into the blood and breast milk, it has a negative effect on the baby and remains in the systemic circulation for a long time. The instructions recommend stopping breastfeeding for 14 days. Also, you cannot combine the drug with the simultaneous use of non-steroidal anti-inflammatory drugs.

Intrauterine contraceptives also have contraindications for use. They should not be installed in women with signs of inflammation in the vagina or existing chronic inflammatory processes in the pelvis. The spiral promotes the penetration of microflora into the uterine cavity and the occurrence of endometritis. Subsequently, this leads to persistent infertility and spontaneous abortions.

Yuzpa contraception should not be used by women who are taking Quinapril for blood pressure. This drug is negatively affected by estrogens, so another method of protection against pregnancy is recommended.

What does frequent postcoital contraception lead to?

Emergency contraceptive measures can have their own side effects even when used correctly. This is an interference with natural processes in the body, hormonal levels, so the consequences can be severe.

After using gestagens, the following undesirable reactions occur:

• itching and burning as signs of allergies, skin rash;
• headache and dizziness often occur;
• lower abdominal pain;
• engorgement of the mammary glands;
• acyclic bleeding;
• delay of menstruation by 5-7 days.

In most cases, these side effects go away on their own and do not require treatment.

Mifepristone may cause other unwanted effects:

• weakness and headache;
• discharge with blood of varying intensity from the genital tract;
• pain in the lower abdomen;
• exacerbation of adnexitis and endometritis;
• hives.

Sometimes bleeding occurs after emergency intrauterine contraception. It should not last long; normally it ends on its own. If this does not happen and the discharge increases, the help of a doctor is necessary.

Review of popular emergency contraception

The following drugs for emergency contraception have become widespread, the cost of express method contraceptives:

Any T-shaped contraceptives can be used as an intrauterine device. The price starts from 291 rubles. You can install a spiral for several months or years at once.

Emergency contraception should be used as rarely as possible. They can cause a large number of negative reactions, the most severe of which is infertility. Express contraceptives help solve the problem of the likelihood of pregnancy, but can lead to serious consequences.

You need to select a contraceptive based on age. Young women should not have the IUD installed to avoid injuring the cervix. Only after childbirth are all methods of protection against accidental conception available to her.

Emergency contraception methods should be used as a last resort and are not suitable for permanent use. WHO recommends using them as rarely as possible, ideally never. But it is allowed no more than once a year.

No method of contraception, with the possible exception of sterilization, is considered completely effective. In addition, there are cases of unprotected sexual intercourse, which can lead to unwanted pregnancy. Therefore, emergency contraception methods are a pressing topic in gynecology. There is even an International Consortium on the use of such methods, the recommendations of which are taken into account in our article.

Postcoital contraception can be used by any woman of fertile age - from the beginning of the first menstruation (menarche) to 1 year after the last menstruation (menopause).

Types of emergency contraception

To prevent unplanned pregnancy urgently in different countries, several methods are used:

• taking a combination of estrogens and gestagens (Yuzpe method);
• introduction of a copper-containing intrauterine device in a medical institution;
• use of tablets containing gestagen;
• use of progesterone antagonists (mifepristone).

In Russia, the last two methods are most often used (you can read about other types of contraception in). However, when asked which emergency contraception is best, scientists from the World Health Organization answer that it is an intrauterine contraceptive device (IUD) installed within the next 5 days. It is most effective in preventing pregnancy. However, this method is expensive, not available to all women, and is not recommended for adolescents and nulliparous women.

As a result of numerous studies by scientists involved in evidence-based medicine, it was concluded that the new generation of emergency contraception is the use of drugs containing 10 mg of mifepristone.

Effect of oral medications

Emergency contraceptive pills have been studied for the last 30 years and have proven to be effective and fairly well tolerated by women. These medications are used to prevent pregnancy during unprotected sex in the following cases:

• there were no means of planned contraception;
• there is a rupture or displacement of the condom (one of the means), vaginal cap, diaphragm;
• two or more doses were missed in a row;
• a timely injection of long-acting contraceptives was not given;
• interrupted sexual intercourse ended with ejaculation in the vagina or on the skin of the external genitalia;
• the spermicidal tablet used in advance has not completely dissolved;
• error when determining “safe” days for ;
• rape.

In all these cases, you need to take the medication as quickly as possible.

Two types of drugs are used:

• medications based on levonorgestrel (progestin);
• a combination of ethinyl estradiol (estrogen) and levonorgestrel (progestin).

Monocomponent drugs can be taken once after sexual intercourse or in two doses with a break of 12 hours. Combined drugs are taken twice. This allows you to reduce the single dose and reduce the likelihood of adverse events. You should take the drug as early as possible, because every hour of delay increases the likelihood of pregnancy. However, the effectiveness still lasts for 120 hours after coitus, and not 72 hours, as previously thought.

How emergency contraceptive pills work:

• prevent or delay ovulation;
• prevent the fusion of sperm and egg;
• make it difficult for a fertilized egg to penetrate the endometrium for further development (although this statement has not been proven, and there is evidence that it is incorrect).

The effectiveness of levonorgestrel reaches 90%; combination drugs are less effective. No drug for emergency contraception is as effective as modern means for permanent contraception.

Safety of hormonal drugs

Possible unwanted symptoms:

• nausea and vomiting;
• abdominal pain;
• feeling of weakness;
• headache and dizziness;
• soreness of the mammary glands;
• bloody discharge from the vagina (not in the nature of menstruation);
• change in the start date of the next menstruation (usually a week earlier or later than expected).

If your period is delayed by more than a week after emergency contraception, you must rule out pregnancy by purchasing a test at the pharmacy or consulting your doctor. Bleeding after administration is not dangerous and will stop on its own. Its likelihood increases with repeated use of tablets during one cycle. However, if it occurs in combination with delayed menstruation and abdominal pain, it is recommended to consult a doctor. This may be a sign of ectopic () pregnancy. However, it has been proven that taking postcoital contraception does not increase the likelihood of such an event. Women who have had an ectopic pregnancy before can also take these drugs.

To reduce the risk of vomiting, the use of combination drugs should be minimized, since levonorgestrel very rarely causes this side effect. If vomiting occurs within two hours after taking the medicine, you need to repeat the dose. In case of intense vomiting, antiemetic drugs (Metoclopramide, Cerucal) can be used.

If you experience a headache or discomfort in the mammary glands, you should use a regular painkiller (paracetamol, etc.).

Emergency contraceptive tablets have no contraindications as they are considered safe. They are not prescribed during an existing pregnancy, because there is no point in doing so. However, if pregnancy has not yet been diagnosed, taking levonorgestrel is harmless to the developing fetus. Levonorgestrel drugs are not able to terminate an existing pregnancy, so their effect is not similar to medical abortion. A normal pregnancy after emergency contraception can occur in the next cycle.

Serious adverse effects on women's health have not yet been reported following the use of levonorgestrel drugs for postcoital contraception. Therefore, they are allowed to be used even without a doctor’s examination, including in many countries around the world they are sold without a prescription.

Use of hormones in special cases

1. Emergency contraception during lactation is considered safe for both mother and baby. However, some doctors advise first feeding the baby, then taking the drug, periodically expressing milk over the next 6 hours without using it to feed the baby, and only then resuming feeding. It is better if this time is up to 36 hours. If less than 6 months have passed since the birth of the child, and the woman is breastfeeding and does not have menstruation, then it is possible that she does not need to use protection, since she has not yet ovulated.
2. If more than 120 hours have passed since sexual intercourse, then the use of emergency contraception medications is possible, but its effectiveness has not been studied. In this case, emergency intrauterine contraception becomes preferable.
3. If several unprotected contacts have occurred over the past 120 hours, then one dose of the pill will eliminate the possibility of pregnancy. However, it should be taken after the first such sexual intercourse.
4. Emergency postcoital contraception can be used as often as needed, even during a single cycle. The harm from frequent use of such drugs has not been proven in large studies, and in any case, the occurrence of an unwanted pregnancy is much more dangerous. However, it is much more effective and convenient to take oral contraceptives regularly or use other planned methods.

The most common emergency contraceptives

The most common drugs for post-coital contraception

• Postinor;
• Escapelle;
• Eskinor-F.

One tablet contains 750 mcg or 1500 mcg of the hormone levonorgestrel; depending on the dosage, you need to take one or two tablets.

Although these drugs are safe when taken once, they should be used with caution for the following conditions:

• severe liver diseases with liver failure (liver cirrhosis, hepatitis);
• Crohn's disease;
• lactose intolerance;
• age up to 16 years.

Combined estrogen-progestin agents:

• Microgynon;
• Rigevidon;
• Regulon and others.

These are monophasic contraceptives, usually used for planned protection against pregnancy, but in emergency cases they can also be used for postcoital contraception. This method of emergency contraception is considered the most dangerous, since estrogens in the composition of the drugs have contraindications and quite a lot of side effects, which are intensified due to the high dosage of hormones: 4 tablets are prescribed twice with a break of 12 hours. The use of these drugs is especially undesirable in the following situations:

• thrombosis of arteries and veins;
• migraine;
• vascular damage due to diabetes mellitus, atherosclerosis, hypertension;
• severe diseases of the liver and pancreas;
• tumors of the reproductive organs;
• period after injuries, operations, immobilization.

The main danger is increased blood clotting and the threat of blockage of arteries or veins by the resulting blood clots.

Non-hormonal postcoital contraception

Emergency non-hormonal contraception is carried out using products containing mifepristone. This is a synthetic substance that blocks progesterone receptors in a woman’s body. The mechanism of action of the drug includes:

• suppression of ovulation;
• a change in the inner lining of the uterus - the endometrium, which prevents the implantation of a fertilized egg;
• If, however, implantation of the egg occurs, under the influence of mifepristone, uterine contractility increases, and the fertilized egg is rejected.

So, the main difference between mifepristone and levonorgestrel tablets for postcoital contraception is the ability to cause a “mini-abortion,” the death and release of an egg already implanted in the uterine wall. Indications for use are the same as for hormonal drugs - unprotected sexual intercourse.

Medicines containing mifepristone 10 mg:

• Agesta;
• Gynepristone;
• Genale.

Emergency contraception with Zhenale is possible if you are sure that the woman is not pregnant. In addition, mifepristone should be taken with great caution in the following cases:

• liver or kidney failure;
• changes in the blood (anemia, clotting disorders);
• adrenal insufficiency or long-term use of prednisolone;
• lactation, after taking the drug you should not feed your baby breast milk for 2 weeks;
• pregnancy.

Mifepristone-based products can cause undesirable effects:

• bloody discharge from the vagina, pain in the lower abdomen;
• exacerbation of chronic adnexitis, endocervicitis,;
• dyspeptic disorders and diarrhea;
• dizziness, headache;
• weakness, fever, skin rash and itching.

Mifepristone-based emergency contraceptives cannot be used every month. It is strongly recommended to start using routine contraception. If, despite taking the pill, pregnancy does occur, it is recommended to terminate it, as there is a risk of damage to the fetus.

Mifepristone is a more powerful, but also more dangerous drug for preventing unwanted pregnancy. It is recommended to take it only after consulting a doctor. The drug is available by prescription.

Contraception without pills

Let’s say right away that the effectiveness of the methods we will discuss is low, and the application is inconvenient. However, women should be aware of such methods.

In the first minute after ejaculation, while sperm have not yet penetrated through the cervical canal into its cavity, you can douche with clean water or with the addition of potassium permanganate, that is, potassium permanganate. Then you should immediately insert a suppository with a spermicidal effect into the vagina.

Of course, the effect of spermicides will be much better if you use them as expected - 10-15 minutes before coitus. Suppositories such as Pharmatex, Contraceptin T, Patentex oval and others are used.

Contraindications for local contraception:

• inflammation of the mucous membrane of the external genitalia (colpitis);
• individual intolerance to the drug.

Intrauterine contraception

Intrauterine device T Cu 380 A

It is recommended to use copper-containing IUDs, which release this metal into the uterine cavity. Copper has a spermicidal effect, and the presence of a foreign body in the uterine cavity prevents implantation of the egg if fertilization does occur.

The most famous remedies from this group:

• T Cu-380 A;
• Multiload Cu-375.

The second model is preferable because its soft shoulders do not injure the uterus from the inside, which reduces the risk of spontaneous removal of the IUD.

The introduction of an intrauterine contraceptive is contraindicated in the following cases:

• an existing pregnancy that the woman did not know about;
• tumors and inflammatory processes of the reproductive organs;
• previous ectopic pregnancy;
• acquired immunodeficiency syndrome;
• individual intolerance;
• promiscuous sex life;
• adolescence (up to 18 years);
• abnormalities of the uterus, and other cases when the internal shape of the organ is changed.

So, the choice of means for emergency contraception is quite large. Some of them are more effective, but have more restrictions on their use, others are safe, but often do not have the desired effect. In any case, postcoital contraception is preferable to terminating an unwanted pregnancy.

After using any of the methods of emergency prevention of pregnancy, you must consult a doctor and choose an acceptable option for planned contraception. Emergency contraception should not be used regularly, also because of its low effectiveness.

Emergency contraception: what is it and when is it used?

Purpose of emergency contraception (EC) consists of protection from pregnancy in “emergency situations” after unprotected traditional sex in the first three days. Abuse of medicinal post-coital remedies causes significant harm to women's health, so they are not intended for regular use.

The essence of the protection of EC drugs is the inhibition of ovulation, and in the case of fertilization of the egg, the impossibility of its consolidation and development.

How does emergency contraception work?

First, on their way, sperm meet an obstacle in the form of thick cervical mucus located at the cervix. The acid-base balance of the vaginal environment changes in an unfavorable direction. Alkaline pH reduces the activity of seminal fluid.

The main effect of EC is to inhibit the development and release of the egg by the hormonal components contained in the preparations. If fertilization does occur, then the changed endometrium will not allow the egg to attach to the inner lining of the uterus.

The intrauterine device, which acts as an EC after sexual intercourse without protection from possible pregnancy, has a toxic, detrimental effect on sperm due to its copper content. During fertilization, the activity of the fallopian tubes increases. The egg is quickly delivered to the uterus and dies there. This is facilitated by non-infectious inflammation and endometrial atrophy.

The use of folk remedies for emergency contraception at home is possible, but gynecologists are against their use. Lemon, boric acid, potassium permanganate, used as contraceptives, are ineffective and harmful. Douching disrupts the vaginal microflora and changes the acid-base balance, which is unsafe for the health of the genital organs.

After coitus without protection, contact your gynecologist as soon as possible. The doctor will select a drug suitable for a particular case.

First, calculate what day of the cycle you had sex on. If intercourse occurs in the first or last week of the cycle, then emergency contraception is not needed at all, since ovulation does not occur during these periods, which means conception is impossible.

In what cases are emergency contraceptives used?

Let's consider cases when they resort to EC:

• vaginal rape;
• traditional sex without contraception;
• loss or removal before the term of the vaginal cap, shift of the diaphragm, rupture of the male or female condom;
• missing the time of taking two or more contraceptive pills taken as planned, or a hormonal injection;
• prolapse of the intrauterine device;
• interrupted sexual intercourse;
• peeling off the patch.

There are various EC agents available on the pharmacological market. Depending on the type, they are sold in pharmacies both with a prescription and without a prescription. Emergency contraception has been tested for decades and has proven its effectiveness.

Emergency contraception methods

EC methods include: taking combined oral contraceptives (COCs) according to a specific regimen (Yuzpe method), hormonal pills specially designed for use after sexual intercourse, installation of copper-containing intrauterine devices.

Method 1 – Yuzpe method

The Yuzpe method is used within three days after unprotected sexual intercourse. Combined hormonal drugs containing estradiol and levonorgestrel are taken at intervals of 12 hours.

The shorter the period between unprotected vaginal sex and the use of pills, the higher the effectiveness of contraception.

Methods of using the drugs most popular in our country:

1. Four tablets are taken to choose from - Femoden, Microgynon, Regulon or Rigevidon . Repeated use of the drug in the same dose occurs after 12 hours.
2. Combined oral contraceptives Logest, Novinet, Marsilon are used according to the same scheme, only in this case a single dose is 5 pills.

The dose of active ingredients per dose is 1 mg of levonorgestrel, 200 mcg of estradiol.

The maximum effect is achieved if the COC is used for the first time no later than 12 hours after ejaculation. Effectiveness decreases noticeably if coitus occurs before ovulation.

The Yuzpe method has side effects and contraindications. To minimize negative consequences, consult a doctor to select medication and dosage. If this method of protection does not work and pregnancy occurs, it is better to terminate it, since there is a high risk of developing an abnormal fetus.

Method 2 - hormonal contraceptives

The modern EC method includes protection against conception after unprotected intercourse using specially designed pills. They are divided into those containing gestagens and antiprogestins.

Gestagens

Progestogen analogues, in turn, are divided into synthetic levonorgestrel and norethisterone, which are similar in their effects to natural progesterone. These substances actively suppress the maturation and release of the egg from the ovary, thereby preventing pregnancy.

A common drug of this type is Postinor , containing two tablets, which are taken one at a time at 12-hour intervals. The effectiveness is 90% when used in the first 24 hours after coitus. Taking tablets after 3 days reduces the effectiveness by up to 55%.

Postinor has side effects such as nausea, impaired intestinal motility, headaches, pain in the lower abdomen, and bleeding.

A more modern drug containing twice as much levonorgestrel - Escapelle . It is taken once within three days after unprotected sex. The side effects are the same.

Proved to be effective: Nordiol, Neogest, Microval, taken in the same way as Postinor.

Artificial antiprogestin

Mifepristone known as a short-term abortifacient and as a drug for emergency contraception in the presence of contraindications to other methods of protection against pregnancy.

Antigestagens act throughout the entire cycle. If sexual intercourse occurs before the maturation and release of the egg, then the substance mifepristone suppresses ovulation; if after, it prevents the endometrium from increasing in volume and the egg from attaching to the wall of the uterus.

The drug is used in a dose of 600 mg once.

Headache, tension in the mammary glands, nausea, and vomiting go away quickly after use. A more distant side effect is the failure of menstruation after emergency contraception. To restore the menstrual cycle, it is recommended to take planned hormonal medications after the first menstruation.

The best among emergency contraception containing mifepristone are considered Zhenale, Ginepriston . These tablets are available at the pharmacy with a prescription.

Gynepristone delays the maturation and release of the egg, atrophies the endometrium. Take one tablet once on an empty stomach. In addition to the negative consequences inherent to all medicinal emergency contraceptives, allergic reactions may occur.

Genale - an antiprogestagenic agent, containing 1 tablet per package, slows down the ovulation process, changes the endometrium. Taking a contraceptive can provoke an exacerbation of inflammatory processes in the reproductive organs.

Both drugs are effective for three days after ejaculation.

If we compare the safety and effectiveness of hormonal and non-hormonal contraceptives, both indicators are higher for drugs containing mifepristone 10 mg.

Women who used products with levonorgestrel 1.5 mg had more severe consequences - one and a half times more cases of uterine bleeding, menstrual irregularities, and a twice as high risk of ectopic pregnancy.

Method 3 – intrauterine device

Safe emergency contraception includes intrauterine device . A foreign body made of plastic and copper placed in the uterine cavity causes non-infectious inflammation, leading to the death of sperm and eggs. The spiral acts as a “firefighter” if it is installed 5 days after unprotected coitus.

At first, a nagging pain is felt in the lower abdomen. Menstruation becomes heavy and painful.

After three weeks, a visit is made to the doctor, who examines the patient for pregnancy and checks the correct placement of the drug. If you plan to use other contraceptives as planned in the future, the IUD is removed.

More often it is left as long-term protection against unwanted pregnancy.

Installation and removal of the intrauterine contraceptive takes place in a gynecological office.

Emergency contraception methods do not reduce the risk of contracting sexually transmitted infections. If unprotected intercourse occurred with a one-time partner, then you need to exclude sexually transmitted diseases by passing the appropriate tests at a medical institution.

When and how to take emergency contraceptives

To get results from using emergency contraception follow simple rules:

• before purchasing an emergency contraceptive, consult a gynecologist;
• read the instructions for use;
• COCs, Postinor are used twice with an interval of 12 hours in the first three days after ejaculation;
• Escapelle and tablets with mifepristone are taken once in the first 72 hours after unprotected sexual intercourse;
• tablets taken in the first 12 hours after the act are more effective;
• it is important to use Ginepristone, Zhenale on an empty stomach and after taking it not to eat for at least 2 hours;
• If you vomit after using an oral contraceptive in the first 2–3 hours, take the pill twice.

Consequences of taking emergency contraceptives

To side effects body for emergency contraception include:

• abdominal pain, migraines;
• dizziness, general weakness;
• nausea, less often vomiting;
• bowel dysfunction;
• allergy;
• bloody vaginal discharge;
• tension in the mammary glands;
• delay of the next menstruation.

Untimely onset of menstruation, accompanied by bleeding, pain in the lower abdomen, can be caused by an ectopic pregnancy. This case requires contacting a doctor.

Consequences of taking medications:

1. The risk of uterine bleeding increases with repeated use of emergency contraceptives.
2. Vomiting occurs more often after using combined oral medications; this side effect is rarely observed in women using levonorgestrel.
3. Medicinal means of “fire” protection against unplanned pregnancy cause harm to breastfed children. The active substances are able to partially penetrate into breast milk.
4. Emergency contraception attacks the hormonal system. This is especially true in the case of frequent use of EC drugs. Constant suppression of follicle maturation leads to infertility over time.
5. A decrease in the level of estrogen and testosterone in the female body reduces bone density. Menopause begins prematurely. As osteoporosis develops, the risk of fractures increases.
6. Changes in ovarian function and hormonal imbalance lead to excess weight gain, increased blood sugar, and increased blood pressure.
7. Women with varicose veins are more likely to develop blood clots.
8. An intrauterine device can cause significant harm to women's health. The drug can perforate into the endometrium and cause gynecological diseases.

To prevent irreversible consequences, use long-term means of protection, and use emergency contraceptives no more than once every six months.

Contraindications to taking emergency contraceptives

The use of emergency contraceptive medications is contraindicated for the following diseases and conditions:

• pregnancy, breastfeeding period;
• hepatitis, cirrhosis, liver cancer;
• renal failure;
• individual intolerance to active substances;
• long-term nicotine addiction;
• thromboembolism, thrombophlebitis, hereditary tendency to form blood clots;
• young age due to the possible development of infertility;
• oncogenic tumors of the endometrium and mammary glands;
• bleeding from the uterus of unknown origin;
• irregular periods;
• blood clotting disorders;
• constant migraines.

Installation of an intrauterine contraceptive device is contraindicated in the presence of:

• changes in the shape of the uterus caused by abnormal development, fibroids, cancer;
• history of ectopic pregnancy;
• inflammation of the endometrium, ovaries.

Emergency contraception is a high-risk drug. To avoid possible complications, you should follow the dosage, time of administration, and see a doctor.

Even with a list of side effects, pills and IUDs used after unprotected intercourse cause less harm to women’s health than abortion.

1. It is possible to use EC while breastfeeding, but take precautions. Before taking the drug, feed the baby, and after it, express and pour out the milk for six hours. This is the minimum period of abstinence from breastfeeding. Optimal - up to one and a half days.
2. If 5 days have passed since unprotected sexual intercourse, then the best means of emergency contraception is an intrauterine device.
3. Possible pregnancy during several sexual acts within three days is prevented by a single dose of the drug. Take it after your first unprotected coitus.
4. Do not use EC more than once every six months.
5. Take the tablets before bed, drink plenty of water, this will prevent vomiting.
6. Use emergency contraception strictly as directed. Failure to observe the interval between taking tablets reduces effectiveness.
7. If after using the drug your next period is delayed, purchase a pregnancy test and double-check the result by visiting your doctor. It is possible for the fertilized egg to be fixed in the uterine cavity, since the products are not 100% effective.
8. Before starting a new cycle, protect yourself with barrier methods of protection.

Emergency contraception will not replace planned contraception.

Consult a gynecologist who will select products in accordance with your state of health, number of pregnancies, births, age and physiological characteristics.

Although emergency contraception is harmful to the body, and many women know about it, despite this it remains very, very popular. In some situations, the use of this kind of drugs is really the only way out of the situation, while in others it causes unjustified harm to the body. Let's look at the most popular emergency contraceptive drugs recommended by gynecologists, how to take them correctly, what side effects they have, what contraindications, etc.

When is emergency contraception needed?

The main reason for taking drugs for this purpose is unprotected sexual intercourse. Yes, despite the widespread use of modern contraceptive methods and their convenience, some couples forget about it. At the most necessary moment there is no condom at hand or... it just breaks. Should we panic in this case?

First, you should calm down and try to calculate which day of the menstrual cycle is currently underway. After all, emergency contraception is not so safe; pills taken can lead to unpleasant consequences. So, if you have unprotected sexual intercourse in the first or last 7-8 days of the menstrual cycle, and its (menstrual cycle) duration is the classic 28-30 days and it is regular, then most likely you should not take pills, since ovulation (the day when pregnancy may occur) falls in the middle of the menstrual cycle.

Another common question is whether emergency contraception can be used in conjunction with planned contraception? For example, in the first 14 days of the first cycle of taking oral contraceptives, you should use another method of contraception at the same time, since the first one has not yet fully “taken effect”. Or there was simultaneous use of OCs with antibiotics or other drugs that tend to reduce the effectiveness of contraceptives. In this case, you should not take additional “emergency” medications. In addition to OCs, non-hormonal contraception should be used. Another thing is the use of spermicides (if, for example, a suppository was inserted into the vagina not before sexual intercourse, but after or immediately before sexual intercourse, without waiting the recommended time interval of 5-10 minutes) or condoms (they tend to sometimes tear).

What to do if a woman is breastfeeding? Is emergency contraception necessary in this case? Of course, it is better to avoid such situations, but if something goes wrong, you can use emergency medications. But in this case, you will have to postpone breastfeeding for one day, until the drug is completely removed from the body.

Emergency protection options

Gynecologists offer several possible drug regimens and there is a whole range of drugs themselves.

The most famous and still popular is postinor. But it is considered an “old generation” drug that has a huge number of side effects. Reception is carried out as follows: within 48 hours (but no later than 72 hours) after sexual intercourse, a woman drinks one tablet, and after 12 hours - another one. Moreover, the earlier the first pill is taken, the higher the likelihood that emergency contraception will take effect, the drugs are taken for a reason, and pregnancy will not occur.

Escapelle is a more modern drug. Its distinctive feature is the content of 1.5 mg of levonorgestrel in 1 tablet. In connection with this, there is no need to take a second pill (previous generation emergency contraceptive drugs contained 2 times less of this hormone, which is why a double dose was required). WHO advises giving preference to drugs that contain 1.5 mg of levonorgestrel. Although both have side effects. Different women's reactions to taking pills are individual. Excapel should be taken no more than 72 hours after unprotected sexual intercourse.

And finally, the third option is to take regular combined oral contraceptives in a larger dosage according to a special regimen. Or take 3 tablets of Silest at a time (or its analogues - Regividon, Miniziston) and after 12 hours take 3 more tablets. Or take 4 tablets of Marvelon, and after 12 hours - the same amount.

The following rule applies to all the drugs described above - if vomiting or diarrhea occurs within 2-3 hours after taking them, it is likely that the tablets have not been fully absorbed and, accordingly, will not have a full effect, which means pregnancy is possible. You need to repeat the procedure.

By the way, what happens if pregnancy occurs? Will this emergency contraception affect her and the health of her unborn child? Doctors agree that an abortion should not be done due to taking drugs; they will not have any effect on the child’s health. Another thing is if the drug is taken already during pregnancy (thus some people try to cause a miscarriage on their own), in which case problems may arise. However, in the early stages, the “all or nothing” principle applies, therefore, if a miscarriage did not occur in the early stages, most likely, everything turned out well, or rather, the screenings that the woman will undergo if she wants to continue the pregnancy will show.

Side effects and frequency of use

Emergency contraception should be used only in force majeure situations when there is no other option. It is advisable - no more than 2-3 times a year, and even better - if less often. The most common side effect from emergency contraceptive pills is uterine bleeding, which usually occurs a few days after taking them. But other women, on the contrary, experience delays in their periods and the menstrual cycle is disrupted. Other common side effects are headaches, dizziness, diarrhea and vomiting, and various allergic reactions.

Other emergency contraception options

There are other methods of postcoital contraception - effective, and not very effective. The first includes emergency installation of an intrauterine device (not always feasible in a short time, since you need to pass a number of tests and undergo an ultrasound; in addition, there are many contraindications to installation). If this is done within 3 days after unprotected sexual intercourse, then even if the egg is fertilized, it most likely will not be able to implant into the wall of the uterus. This option is suitable for women who were already planning to install a spiral. A significant disadvantage is that the cervix may be injured, since only at the beginning of the menstrual cycle the cervix is ​​softened and more adapted to the safe insertion of an IUD.

Other methods are folk, with unproven effectiveness and even dangerous. With their help, women try to provoke the onset of menstruation ahead of schedule, but in fact, they want to cause a miscarriage in the early stages of pregnancy. Folk methods of emergency contraception include a “food” made from sugar with iodine, ascorbic acid, parsley, hot baths, herbs like tansy and much, much more. But we do not recommend using these means.

Always remember that emergency contraception is quite dangerous, but less dangerous than abortion. In order not to test either the first or the second from your own experience, choose a reliable method of planned contraception.

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