Contraception is usually thought of as a measure to be taken in advance of or during sex. But even though many women don't realize it, something still can be done after the factafter unprotected sex; after a condom breaks; after a diaphragm, cap, or sponge becomes dislodged; or after a rape. Called by several names such as the morning-after pill, postcoital contraception, emergency contraception, or interceptionthe regimen involves ingesting higher-than-normal doses of contraceptive hormones within 72 hours of intercourse, and then ingesting even more of the same hormones 12 hours later.
The Food and Drug Administration in 1997 affirmed the safety and efficacy of this technique and recently approved a product specifically designed for it, the Preven Emergency Contraceptive Kit. In addition, a number of ordinary combined oral contraceptives can be used after the fact, including brands such as Ovral, Alesse, Levlite, Nordette, Levlen, Levora, Lo/Ovral, Triphasil, Tri-Levlen, and Trivora.
Here's an example of how Ovral is used for emergency contraception: Two Ovral tablets are taken within 72 hours of unprotected sex; then 2 more Ovral tablets are taken 12 hours after the first dose. Because this much hormone can upset your system, always talk with your doctor before attempting emergency contraception of this type.
Depending on where you are in your menstrual cycle, postcoital pills work by either stopping release of an egg from the ovary, disrupting fertilization by the sperm, or preventing a fertilized egg from implanting in the lining of the uterus.
The most significant side effect is severe nausea, which affects about one-third of women using this regimen. However, this should stop a day or so after treatment. If the nausea is so severe that you have to vomit within an hour of taking the dose, you may need to take extra pills. You can also get anti-nausea medication from your doctor. Other side effects you might experience include headache, breast tenderness, dizziness, and fluid retention.
You should have your period in 2 or 3 weeks. If it hasn't started in 3 weeks, consider taking a pregnancy test. And don't forget to watch out for other potential side effects of the Pill (refer to the "See Your Doctor If..." box nearby).
Ovral supplies an especially high dose of the progestin norgestrel. This hormone is also found in other brands, including Lo/Ovral, Nordette, Levlen, Triphasil, and Tri-Levlen, but in significantly lower doses. If you are currently taking any of these pills, you can use them in an emergency, but you'll have to take twice the amount you would of Ovral. This means you will need to take four tablets within 72 hours, and then another four tablets 12 hours later. If you use the triphasic pills (Triphasil or Tri-Levlen), make sure you take only the pills designated for the last week. These are the ones with the right dose. Again, be sure to consult your physician before using OCs in this way.
Studies have now shown that progestin-only pills containing levonorgestrel are more effective and less likely to produce nausea and vomiting than combined oral contraceptives, and in 1999 a progestin-only emergency contraceptive was released under the brand name "Plan B." The Plan B package contains two tablets of levonorgestrel. Like other emergency contraceptives, the first pill must be taken within 72 hours of unprotected sex; the second pill 12 hours later.