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 Sexual health
Emergency contraception

  • Every woman should be aware of this method for an emergency situation (rape, incest, failed contraception: broken condom, missed pill).
  • Emergency contraception aims to prevent pregnancy after unprotected intercourse has taken place. It is also referred to as postcoital contraception or "morning-after pill".
  •  
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    Oral emergency contraception must be administered within 72 hours of unprotected intercourse and is available in two forms:
    • Oestrogen-progestogen regimen
    • Progestogen-only regimen
  • The oestrogen-progestogen treatment regimen consists of two Ovral® tablets 12 hourly for two doses, starting as soon after unprotected sex as possible, and not later than 72 hours.
  • Another product, registered for emergency contraception, is E-gen-C® containing four tablets of ethinylestradiol and levonorgestrel. The first dose is two tablets, followed by the other two tablets 12 hours later.
  • An antiemetic drug can be taken before each oestrogen-progestogen treatment regimen for the prevention of nausea and vomiting. If vomiting occurs within two hours of the first dosage, it could diminish the effectiveness of oral emergency contraception and another two hormonal pills should be taken.
  • The progestogen-only treatment regimen consists of a total dose of 0.75 mg levonorgestrel to be taken immediately and to be repeated 12 hours later. A product (Norlevo®), licensed for emergency contraception in this dosage, is available in South Africa.
  • An alternative method for the progestogen-only regimen is taking 25 pills Microval® on two occasions with a 12 hour interval.
  • The progestogen-only regimen is more effective than the combined pill regimen and has a lower incidence of nausea and vomiting.
  • It does not help to swallow any extra pills for emergency contraception than those prescribed. More pills will probably not decrease the risk of pregnancy any further, but will increase the risk of nausea.
  • If the time interval has exceeded 72 hours or oral contraceptives are contraindicated or the patient suffered from severe vomiting, a copper containing IUD may be inserted into the uterus for a time of up to 120 hours after unprotected sex. The IUD has the advantage of providing ongoing contraception.
  • Following emergency contraception. the next period may start a few days earlier or later than usual. If the period does not start within four weeks, the doctor or clinic should be attended again for an examination and a pregnancy test.
  • Emergency contraception should not be used as a replacement for ongoing birth control, because of ongoing birth control's higher efficacy and lesser side-effects.

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Got pregnant on the pill?
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