You may be familiar with the term “emergency contraceptive pills,” commonly referred to as “morning-after pills.” But what precisely do they entail, and are pills the sole option accessible at pharmacies?

Emergency contraception denotes a method employing medication or a device post-sexual intercourse to prevent pregnancy.

When is it appropriate?

It is recommended in scenarios where a pill has been forgotten, a condom has broken or slipped off during intercourse, or when no protection was utilized (including instances of sexual violence). Emergency contraception serves as a safe measure to prevent pregnancy but is not intended for long-term usage.

In such instances, options include pills containing 1.5 milligrams of levonorgestrel (referred to as the “morning-after pill”) or a copper intrauterine device (IUD). Presently, in Estonia, only the levonorgestrel pill is available, which should be ingested promptly post-coitus and preferably within three days. These pills may also exhibit efficacy up to the fourth and fifth day post-intercourse, albeit with diminished effectiveness.

Estonia is expected to soon introduce ulipristal acetate, a non-hormonal medication utilized elsewhere globally, which remains effective for up to five days post-unprotected intercourse. The copper IUD also serves as a viable emergency contraception method and boasts greater efficacy than pills. Its insertion by a medical professional should occur within five days of unprotected intercourse. While the IUD incurs higher costs compared to pills, it presents an optimal solution for individuals seeking effective long-term contraception.

Effectiveness Concerns for Overweight Individuals

Studies suggest that emergency pills may be less effective for overweight women (weighing over 75-80 kilograms). Nonetheless, European and American authorities advocate for their usage, deeming the benefits outweigh the risks. However, in select regions globally, overweight women are advised to opt for copper IUDs. For individuals preferring pills, ulipristal acetate may offer superior efficacy compared to levonorgestrel pills.

The latter are readily available over-the-counter at pharmacies. Contraindications include hypersensitivity to active ingredients or excipients or acute porphyria. Insertion of a copper IUD necessitates a medical appointment, coupled with advisable testing for sexually transmitted infections.

Common side effects associated with emergency pills include nausea and vomiting. In instances of vomiting occurring at least an hour post-pill ingestion, another pill should be taken, or an alternate emergency method should be pursued.

Menstruation typically commences within one week or at the regular time frame following emergency pill ingestion. Some individuals may experience slightly earlier or later menstruation, accompanied by heavier bleeding. While emergency pills often induce menstrual irregularities, they pose no significant risks and do not mandate immediate medical attention. However, if menstruation is delayed by over a week or menstrual flow is notably lighter, a pregnancy test is recommended. In the event of pregnancy despite emergency contraception usage, there is no detrimental impact on the pregnancy.

Emergency contraception does not safeguard against sexually transmitted infections, necessitating testing if deemed necessary. Emergency pills may be employed multiple times within a single cycle; however, this may heighten the likelihood of cycle disturbances.

Emergency contraception may be warranted:

• Within five days post-unprotected intercourse.
• In instances of incorrect usage of regular contraception.
• In situations where regularly employed contraception fails, and unprotected intercourse occurs within five days.

Common reasons for the failure of regular contraception methods include:

• Condom breakage or slippage during intercourse.
• For users of combined hormonal pills, forgetting to take two or more pills.
• For minipill users, forgetting to take the pill, followed by unprotected intercourse within two days, and over 12 hours have elapsed.
• Misplacement or early removal of the contraceptive patch or vaginal ring.
• Spontaneous expulsion of an intrauterine device.