Emergency contraceptive pills. Pills and other emergency contraception

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 methods emergency contraception – actual topic 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 different countries use several methods:

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

In Russia, two are most often used latest methods(you can read about other types of contraception in). However, when asked which emergency contraception is better, scientists from the World Health Organization answer that it is an intrauterine contraceptive(), 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 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 further development(although this statement has not been proven, and there is evidence that it is false).

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 probability increases with repeated use 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, use should be minimized. combination drugs, since levonorgestrel very rarely causes such a 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 have a headache or discomfort V mammary glands You should use your usual 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. Normal pregnancy after emergency contraception may occur as early as 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

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, breastfeeding and a woman does not have menstruation, it is possible that she does not need to use protection, since she has not yet ovulated.
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.
If several events have occurred within the last 120 hours unprotected contacts, then one pill will eliminate the possibility of pregnancy. However, it should be taken after the first such sexual intercourse.
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 with 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 not hormonal contraception 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 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, increased body temperature, 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 more powerful, but also more dangerous drug to prevent 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, douching can be done 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 foreign body in the uterine cavity prevents the 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 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 internal form 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 (the names of the drugs will be given below) is used to prevent unwanted pregnancy in cases where other methods of protection were not provided for this. Exist various options, which a woman independently chooses for herself.

Operating principle

Products that belong to this category must be used for a short period of time after the end of sexual intercourse. Before starting intimacy, there is no need to use them, since the desired effect will not be achieved. However, even after the end of sexual intercourse, they should not be frequently abused, as they can cause considerable harm to women’s health.

The main principle of the action of emergency contraception is that the components included in the composition have a significant effect on the body, thereby preventing the egg from attaching to the uterus after fertilization, and as a result, pregnancy simply does not occur.

The final result depends on the time when the woman took the drug. It can give the desired effect within 3 days. In the future, you will not need to use emergency contraceptive pills, since pregnancy will occur and everything will be pointless.

The effectiveness of these funds ranges from 70 to 98%. None of the manufacturers can give a 100% guarantee that pregnancy will not occur. IN medical practice There are cases when, after using the drug, the egg still attached to the uterus and pregnancy occurred. No negative effects of the drug on the fetus have been recorded. Deviations in development in children do not occur due to the fact that a woman used one of the methods of emergency contraception.

Target

Thanks to this method it is possible to help a woman of childbearing age reduce the amount unplanned pregnancies, and ultimately the number of abortions. Of course, it is better to choose the lesser of two evils. And if in the future you have to commit a kind of crime in the form of an abortion, then it is better to avoid pregnancy by all possible means.

There are cases when sexual intercourse occurs under duress, then various drugs Emergency contraception is used as a measure of protection against unwanted fertilization and against the psychological trauma that will be associated with this entire situation.

Therefore, it must be noted that fire protection should only be used in rare cases and after conventional means become ineffective. Thanks to these methods of protection, a woman can be more confident that pregnancy will not occur.

When to use

To many girls reproductive age Emergency contraception may come in handy at any time. It is better to resort to these methods infrequently, but there are cases when you cannot do without them:

1. After voluntary sexual intercourse, in which the partners did not use other means of protection.

2. In moments when standard options contraception fails partners:

condom slipping or breaking;
in case of improper use calendar method to prevent fertilization (it often happens that when making calculations, partners incorrectly determine safe and dangerous days);
the man failed in time, after which the sperm ended up in the vagina;
missing more than three days of using oral contraceptives.

3. In case of involuntary sexual intercourse.

Any woman can use emergency contraception after sex. It is allowed to use these products during breastfeeding (it is necessary to maintain an interval of 8 hours between taking and feeding). It should be noted that hormonal drugs that help prevent pregnancy are not advisable for young girls and adolescents, since their hormonal background.

Hormonal agents with levonorgestrel

Emergency contraceptive pills, which contain a very high dose of progestogen, are taken differently. Some remedies will only need to be taken once, while others will need to be taken several times. This directly depends on the drug that will be used; this scheme will definitely be described in the instructions for use. It often looks like this:

the first pill, which contains a very large amount of the hormone, is drunk within 3 days after the end of sexual intercourse, and the other is not needed at all;
one tablet is taken for 3 days, and the second - half a day after taking the first.

The main representative of this group is familiar to many women - this is “Postinor” ( international name the drug sounds like “Levonorgestrel”). This is completely synthetic agent It perfectly prevents the onset of fertilization, as it causes significant changes in the endometrium, so eventually implantation of the egg becomes impossible. An analogue of "Postinor" is "Escapelle".

Studies have shown that Postinor is effective in 85% of cases. On the first day of use after sexual intercourse, the effectiveness is 95%, if you use the product on the second day, then 85%, and on the third day it is only 58%. Many doctors call this remedy a “medicine of the past”, as it causes very serious consequences.

Mifepristone

This group refers to the best emergency contraception methods. These medications are also hormonal. To prevent fertilization, it is enough to take just one tablet. A woman must fulfill this procedure for three days after the end of the act of intercourse, which was not protected.

A fairly popular example of this category is Ginepristone. It is considered the best because it modern drug safer than the previous one, but there are still side effects and contraindications. The remedy, depending on which phase menstrual cycle it was accepted that it actively inhibits ovulation or prevents the fertilized egg from joining the uterus. Other medications containing mifepristone are Agesta, Zhenale.

Alternative method emergency contraception involves taking several combined oral contraceptive pills in a larger than usual dose.

Their use should be carried out according to the following scheme: within twelve hours from the moment of intercourse, take tablets so that the total amount of ethinyl estradiol is 200 mcg, and levonorgestrel is 1.5 mg.

The main representatives of this category are the drug "Silest" and its main analogues - "Miniziston" and "Rigevidon".

It is not advisable to use this category of emergency contraception when breastfeeding. Women can simply stop this procedure, as the lactation period will be shortened. The product can also significantly deteriorate the quality and reduce the quantity of milk.

Intrauterine contraceptive method - copper-containing device

To prevent unwanted fertilization, you can resort to another option, namely, inserting an intrauterine device. In order to obtain this device, you must consult a doctor, and the procedure must be performed as quickly as possible after sexual intercourse has been completed. Often the period during which this remedy can be used is 5 days.

An intrauterine device is a small device made from copper and plastic. It significantly reduces the lifespan of the egg, and also prevents it from attaching to the lining of the uterus after the fertilization process. The effectiveness of the spiral is 99%.

Myths

It should be noted that there are many entrenched myths about emergency contraception in society:

After unprotected sexual intercourse, you can prevent unnecessary pregnancy using folk remedies. Of course, this is a myth. Any douching, physical exercise or hot baths will not help in solving this problem, since sperm enter the uterus a few minutes after ejaculation. It should be noted that a minimal amount of sperm can be released during sexual intercourse.
After using these drugs, the next time you conceive, the child may be born with developmental abnormalities. This is, of course, fiction. There are many emergency contraceptive medications available, and none of them affect subsequent pregnancies or fetal development.
The drugs cause changes in the figure, as well as weight gain, this is a myth, and minimal weight gain can be caused by long-acting contraceptive methods.
Components in this category are allowed to be taken continuously. This is still not true. These drugs are recommended for occasional use only, as they are not approved for use as long-term protection.
The effect of emergency contraception on periods is deplorable. This statement is not entirely true, since the drugs do not completely disrupt the cycle, but can only cause a slight delay.

It should be noted that what formerly a woman If you use this drug after unprotected sexual intercourse, the higher your chance of not getting pregnant. Experts say that this technique is an excellent backup option only when standard contraceptives have not worked.

Contraindications

Since anyone can purchase emergency contraception without a prescription, you need to know who should not use it, so you must first consult with your doctor. The main contraindications may be:

age under 16 years;
pregnancy;
increased sensitivity, as well as an allergic reaction in a woman to the components that are part of the product;
severe liver failure.

Some drugs must be taken with caution if there are problems with the biliary tract, liver, Crohn's disease, chronic heart failure, lactation, and arterial hypertension.

Side effects

Happens in women and bad feeling after taking emergency contraception. What negative symptoms there are are described below:

nausea in 23-50% of cases;
dizziness in 11-17%;
6-9% of girls vomit;
general weakness observed in 17-29% of the fair sex.

Among the most common consequences of emergency contraception, uterine bleeding can also be noted. It may begin within a few days after taking the drug. For certain girls, on the contrary, there may be a delay of 5-7 days.

The reaction of each organism is absolutely individual. Allergic manifestations, soreness of the mammary glands and diarrhea also occur.

Women who decide to use a copper-containing intrauterine device may also experience side symptoms. Mainly, there are pains in the lower abdomen, exacerbations inflammatory diseases uterine appendages and bleeding from the genital tract. It happens that the installation of a spiral is accompanied by perforation of the reproductive organ.

Folk remedies by emergency assistance doesn't exist, so don't even look for them. Hot baths, lemon slices, and decoctions of bay leaves will not help get rid of an unwanted pregnancy.

Before you start using emergency contraception methods, you need to carefully weigh the pros and cons. The funds cannot be called completely safe. Before using them, it is recommended to determine the day of the menstrual cycle. For example, if sex occurred a few days after menstruation or a couple of days before its onset, then such drugs do not need to be used, since, most likely, ovulation simply did not occur. This process occurs approximately in the middle of the cycle, but there are still exceptions.

Flaws

The use of drugs in this category is safe only at the very beginning of egg attachment. It is advisable to take the first dose, according to gynecologists, no later than eight hours after sexual intercourse, although the packaging indicates that there are three whole days for this.
Not all drugs are completely safe for women's health, they have many contraindications, so their use is allowed no more than 2 times a year.

You must first select the time for taking the drug so that it is convenient to take a second dose, if necessary (for example, 21:00 and 9:00).
To prevent unpleasant sensations such as vomiting and nausea, it is recommended to start taking tablets in the evening immediately before bed, during a meal, and wash them down with milk.
During the period that lasts until the next menstruation, you must use barrier methods contraception.
We must not forget that these options are intended for one-time use, and as a permanent contraception, it is recommended to choose a product after consulting with your doctor.
If the expected menstruation occurs a week late, you should definitely contact your doctor to rule out pregnancy.

It happens that during sexual intercourse the condom breaks, so seminal fluid penetrates into the female body. Also, unwanted penetration of sperm can occur during rape. What should a woman do to avoid a deeply unwanted conception, should she really resort to such an unsafe method as abortion. There is a way out, and it’s not so dangerous. There are emergency contraceptive pills that are designed to prevent unnecessary conception and prevent the consequences of unprotected sex. But these drugs can only be taken in truly emergency cases, since frequent use can lead to dangerous complications for woman.

During intimacy, anything can happen - the condom came off, the COC was missed, or the partners simply forgot about protection. What should a woman do in such a situation to still avoid pregnancy?

A woman needs to immediately get out of bed so that the seminal fluid flows out of the vagina without reaching the female cell. But you cannot completely rely on such a method, because it does not guarantee one hundred percent reliability.
Immediately after sexual contact, you must take a bath and wash thoroughly with soap. This should be done in the first 10 minutes after sex. This action will help reduce the chance of conception by 10%. You can also syringe with something sour, for example, lemon or vinegar. aqueous solution. Such means lead to the creation of aggressive conditions for sperm in the vagina, but such douching must be carried out extremely carefully to avoid burn damage to the mucous tissues.
If a lady regularly drinks any contraceptive drug, then you need to carefully study its instructions; usually it contains an algorithm for actions when you miss taking a pill.
If you had sex with an unreliable partner, then the woman needs to treat her genitals and vagina in the very next few minutes with products that prevent the development of STDs. Similar drugs include Miramistin, but the possibility of its use should be discussed with a gynecologist.

When will emergency contraceptives help?

Any means and categories of such contraception cannot be called completely safe and useful for the female body, and therefore they are resorted to only in extreme situations, when coitus has already occurred, or the woman has been raped, etc. In general, every emergency contraceptive is intended more for women living intimate life quite rare, and also indispensable in unforeseen situations when sex occurred without protection.

Such medications are called post-coital, since they are used after the fact that sperm enters the vaginal environment. If sexual intercourse occurred before the onset of the ovulatory period, then a high dose of hormonal substances will prevent its onset and the woman’s given cycle will be anovulatory. If fertilization occurs, then emergency contraception will prevent the embryo from consolidating. Such medications contain a very high dose of hormonal substances, so such high-dose hormonal drugs should be taken as rarely as possible.

How does emergency contraception work?

The medicinal effect of emergency contraception comes down to such effects as suppressing the maturation of the female cell, preventing the cell from meeting the sperm and preventing its implantation into the uterine wall. Therefore, after taking the drug, a thickening of the cervical secretion occurs in the female body, which does not allow sperm to enter the uterus. Also, at the same time, high dosages of hormonal components prevent ovulation, so the cell does not come out and the sperm die safely.

If the sperm nevertheless penetrated the uterus, reached the cell and fertilized it, then under the influence of the hormonal components of the drug, hypotrophy of the endometrial layer occurs, which does not allow the zygote to gain a foothold on it, therefore, further development of pregnancy does not occur, and the embryo leaves the uterus during the next menstruation together with bloody discharge. The effectiveness of emergency contraceptives reaches fairly high levels, amounting to about 97-99%. But there are also pitfalls here. High contraceptive effect achieved through high content hormonal substances that are not in the best possible way affect the female body.

Types of contraception

Experts distinguish several categories of emergency contraceptives.

How to take emergency contraceptives

To get the proper effect from taking emergency contraception, you need to follow the rules for its use. When taking medications with levonorgestrel as an active ingredient (Postinor, etc.), you need to take into account that they should be taken no later than 72 hours after unprotected intimacy. The first pill must be taken immediately, and the sooner, the higher the contraceptive effect. The second pill is taken after 12-16 hours. If a woman vomits, then she needs to take another Postinor tablet. If we talk about other drugs with levonorgestrel, for example, Eskinor F or Escapel, then they are taken once, one pill, also within a 72-hour period. The effectiveness of such drugs depends on how quickly the drug was taken after sex. Taking every other day or less provides contraceptive effect by 95%, after 25-48 hours - by 85%, and after 2-3 days - by only 58%.

Preparations with gestagen and estrogen are taken according to the Yuspe regimen. This technique involves taking COCs, but in higher dosages. For the first time, take 2-4 pills no later than the third day after intimacy. The second dose of the same number of tablets is taken after 12 hours. Typically, combined oral agents such as Ovidon or Rigevidon, Silesta and Non-ovlon are used as fire contraception. The effectiveness of this method reaches 75-85 percent.

Mifepristone pills like Mifolian and Agesta, Ginepristone or Zhenale are recommended to be taken during the first 3 days. Take just one pill. An important condition is an empty stomach, so you can’t eat a couple of hours before and after taking the pill.

Adverse reactions

Emergency contraception due to a large dose of hormonal substances causes a lot of side effects, which include nausea and vomiting reactions and intermenstrual bleeding, breast tenderness and migraine symptoms. If the patient already has varicose veins, then taking fire contraception can provoke blood clots. Also, adverse reactions often include menstrual irregularities and dizziness. Taking high-dose hormonal drugs often leads to menstrual disorders, when the patient's periods begin to last longer or become heavier.

Also, in response to taking fire contraception, they may develop allergic reactions, painful sensations in the area of the uterus and genital tract. But adverse reactions occur only in a fifth of patients; the rest of the women tolerate the effects of this category of drugs more easily. If the instructions are followed, emergency contraception will help avoid unwanted motherhood.

The best emergency contraceptives

Doctors identify several popular fire contraception drugs that are most often used to prevent unwanted conception:

Contraindications for use

But such high-dose hormonal contraception has a number of specific contraindications, which include long experience nicotine addiction and mature age after 35, the presence of a hereditary tendency to thromboembolism. In addition, patients suffering from severe migraine pain, a predisposition to uterine bleeding or advanced hepatic, biliary pathologies. Also, the use of such contraception is not recommended for young girls (under 16), pregnant women, and lactating patients.

If girls of puberty age who are not yet fully formed take such contraceptives, then they will experience serious violations cycle, and in some cases irreversible infertility may develop. Also, fire contraception is not recommended for lactose intolerance, Crohn's disease, unstable and irregular menstrual cycle, and hormonal-dependent reproductive problems. tumor processes, as well as women who have had cases in the past ectopic pregnancy.

Emergency contraception is a fairly serious category of drugs that are unsafe to take on your own, therefore a gynecological prescription and strict adherence to the rules of administration are necessary, then unwanted conception and further abortion can be avoided.

Many have heard the concept of emergency contraception, but not everyone has delved into this topic. In fact, girls who care about their health should know the main advantages and disadvantages of existing methods, as well as the features of their application.

Emergency contraception - indications

Methods and means that prevent the fertilization of an egg, which are used after sexual intercourse, are called emergency contraception. They are used once, and they cannot be a replacement for planned contraceptives. Emergency contraception is recommended in the following cases:

unprotected sex or abuse occurred;
the barrier agent has slipped or been damaged;
Missed scheduled hormonal medications three times.

After using emergency contraception, you should be guided by the following information:

Before the start of your next menstruation, it is recommended to consult a doctor to get tested for. Be sure to tell your doctor what medications you took.
In most cases, menstruation fails, which may begin earlier or later than usual.
Discharge during menstruation may be heavier than before. In this case, it is recommended to consult a doctor.
If, three weeks after taking emergency contraception, menstruation has not begun, or symptoms characteristic of pregnancy occur, then you should immediately consult a doctor.
It is worth visiting a gynecologist if after a while you feel pain in the lower abdomen.

Emergency contraception - how often can it be used?

Since these products contain a large amount of hormones and other biologically active substances, they have a serious impact on the hormonal balance of the female body. Because of this, doctors do not recommend frequently resorting to emergency contraception. It is best to use such methods once every 4-6 months, but more is acceptable. frequent use. As often as possible, emergency contraception at home can be used no more than four times during one menstrual cycle.

Emergency contraception - pros and cons

This group of funds has its own advantages and disadvantages, which you should familiarize yourself with first. The main benefit of contraception is that it helps to avoid more serious stress on the body associated with. Emergency contraception is not without its disadvantages, which are associated with the presence large quantity contraindications and side effects. Doctors indicate that they should be used only as a last resort.

Emergency contraception - effectiveness

The effectiveness of such measures depends on correct reception, so, such contraception should be taken no later than 72 hours after sexual intercourse. In this case, emergency protection will be 95% effective. If more than three days have passed, the percentage is significantly reduced, since during this time the fertilized egg can attach to the lining of the uterus and begin to develop. It is worth noting that emergency contraception is considered less effective than other contraceptives, which is associated with their improper use.

Emergency contraception - harm

Although such products have been researched and developed taking into account the characteristics of the female body, harm cannot be completely excluded. If used frequently, emergency contraception methods can cause various gynecological diseases and subsequent problems with conception. Before using the chosen product, it is recommended that you familiarize yourself with the list of contraindications that are indicated in the instructions, here are just a few of them:

kidney and liver diseases;
joint problems;
age up to 16 years;
uterine bleeding;
anemia and poor blood clotting;
pregnancy;
serious chronic diseases;
individual intolerance.

Side effects of emergency contraception

Since these drugs contain a large dose of hormonal substances, it is understandable that many experience a number of adverse reactions. These include nausea, vomiting, intermenstrual bleeding, chest pain and headaches. Contraception after sexual intercourse in girls with varicose veins can cause blood clots. Refers to side effects disruptions in the menstrual cycle, dizziness and even allergic reactions. According to statistics, adverse reactions occur only in a fifth of patients.

Types of emergency contraception

IN modern medicine There are several methods that can be used to effectively prevent pregnancy after unprotected sex. Gynecologists say that all girls should know existing classification, as well as the main advantages and disadvantages of each option, to understand which safe emergency contraception is more acceptable. It is impossible to ignore and folk methods, which have existed for decades.

Postcoital contraception intrauterine devices

This group of non-drug methods includes only one contraceptive option - installation of an intrauterine device. A gynecologist inserts a mechanical device into the vagina, and this must be done no later than five days after unprotected sexual intercourse. All methods of contraception after sexual intercourse have disadvantages, and the spiral has a preliminary medical examination. It is worth pointing out that this protection option is not suitable for teenagers, nulliparous women and girls who have been raped.

Emergency hormonal contraception

There are several hormonal drugs that are divided into specific groups.

Gestagens. Active ingredient These drugs contain progestin hormones that suppress the secretion of gonadotropin, which prevents the ovulatory period from occurring. These substances also prevent cell invasion into the uterus. If this emergency contraception was taken in the first three days, the risk of conception will decrease by 60%.
Estrogen agents. They are highly effective, but at the same time provoke side reactions. In addition, such emergency protection from unwanted pregnancy is dangerous for the fetus; if conception does occur, then an abortion will have to be performed.
Combined products. These drugs contain several active ingredients, for example, gestagen and estrogen. They are the most popular among patients. Their dosage regimen provides 75% effectiveness. Adverse reactions are not excluded.

Separately, we should highlight emergency contraception, which is non-hormonal. It is safer, but its effectiveness is lower than that of the first group:

Antiprogestins. The active substance in these drugs is mifepristone. It is used for drug interruption pregnancy. This substance delays ovulation and causes endometrial atrophy, so the egg is not capable of implantation. Adverse reactions are not excluded, but they are more easily tolerated.
Antigonadotropin contraception. Active substances production of these products is blocked gonadotropic hormones, which are important for ovulation. Adverse reactions may occur when taken.

Emergency contraception during breastfeeding

Most pregnancy protection products that are used after sexual intercourse are contraindicated for breastfeeding mothers. This is explained by the fact that they contain many substances that affect the composition of milk. Emergency contraception during breastfeeding should be selected with a doctor, and there are three days during which the drug can still work. Postinor, which contains a large dose of gestagen, is considered relatively safe.

Emergency contraception - folk methods

In addition to traditional methods, there are also folk remedies, but you should know that they do not provide a guaranteed effect. Doctors, answering the question regarding which emergency contraception is best, do not consider prescriptions from traditional medicine, considering them hazardous to health. In most cases, women use them when they do not have the opportunity to purchase medications.

Lemon juice. For this method it is better to have . Mix 200 ml of boiled water with the juice of a large lemon. Rinse your vagina thoroughly with the prepared solution. At the end of the procedure, wash the area with clean water so that the acid contained in the citrus does not disturb the vaginal microflora.
Potassium permangantsovka. It is believed that such emergency contraception is effective in 60% of cases, since potassium permanganate is a strong oxidizing agent that can deprive sperm of activity. At the same time, we cannot exclude the risk that improper processing may harm the internal genital organs. Prepare a solution in a ratio of 1:18, and then douche with it. The procedure should be completed with genital hygiene using gentle soap.
Laundry soap. A risky method that involves unprotected sex Place a piece of soap the size of a matchbox into your vagina. It should stay there for 15-20 seconds. After this, be sure to rinse the mucous membranes. In addition, it is recommended to use a moisturizer intimate area. Please note that this method can only give results if you use it no later than 10 minutes later. after unprotected sexual intercourse.

Pregnancy after emergency contraception

There is no reliable data in medical practice that confirms that emergency funds contraception, if it is ineffective, is Negative influence on the fetus and its development. At the same time, the risk that anomalies may develop cannot be completely excluded. If contraception after unprotected act did not work, the pregnancy has occurred, and the woman has decided to keep the child, then she must certainly undergo thorough examination at the doctor's. Using an ultrasound, you can determine where the fetus is, since taking such drugs can cause an ectopic pregnancy.

Emergency contraceptives were designed specifically for emergencies. It doesn’t matter what happened - whether the condom broke, she forgot to take a pill, or intimate intimacy was unwanted for the woman. One thing is important: if for some reason sex was unprotected and pregnancy was unwanted, you should think about protective measures right now, in the next three days - before it’s too late. 72 hours - this is the period given for using emergency contraceptive pills. How to use such drugs correctly and what should you know about their mechanism of action?

Is it possible to get pregnant if the condom breaks?

The answer to this question depends on what day of the cycle the unplanned sexual intercourse occurred:

Intimacy in the first 7 days of the cycle is unlikely to lead to an unwanted pregnancy. During this period, the lining of the uterus is shed and monthly bleeding occurs. The maturation of the follicles has not yet begun, and sperm live in the woman’s genital tract for no more than 7 days. With a standard 28-day cycle, the risks are minimal. The shorter the total duration of the cycle (21-27 days), the higher the likelihood of conceiving a child during intimacy on these days.
Sex close to ovulation (7-14 days) is highly likely to lead to the conception of a child. During this period, follicle maturation and ovulation occur. The egg released from the ovary has every chance of meeting a sperm and fertilization will occur.
Sexual intercourse in the second phase of the menstrual cycle (14-28 days) does not threaten the unwanted conception of a child. The egg dies 24 hours after leaving the ovary. After the death of the egg, a corpus luteum. Conceiving a child during this period is impossible.

Does this mean that after unprotected sex in the second phase of the cycle you can not drink and not worry about possible pregnancy? Yes, but only if the woman is absolutely sure: ovulation has already occurred, and more than 24 hours have passed since then. Women who use it probably know the date of ovulation. natural ways contraception (fertility detection method). In other situations, it is quite difficult to catch the moment the egg leaves the ovary. Any cycle failure can lead to ovulation being postponed indefinitely, and all calendar calculations will be incorrect.

If in doubt, it is better to take an emergency contraceptive pill than to have an abortion if you are pregnant.

How often can I take emergency contraceptive pills?

The instructions for drugs for postcoital contraception indicate that such drugs can be taken no more than once a month. Practicing gynecologists point out that such recommendations are incorrect. Emergency contraception is first aid in case of emergency, and not a routine method of protection against unwanted pregnancy. Experienced doctors do not advise their patients to get carried away with such drugs, which cause significant harm to reproductive health.

One gynecologist, when asked “How often can you take post-coital pills?” answered categorically: “Once in a lifetime!” There is some truth in this, because the more often a woman drinks similar drugs, the higher the risk of developing complications in the form of menstrual irregularities.

When should you take emergency contraception?

Unprotected sexual intercourse when no contraceptives were used at all.
Cases of sexual violence where a woman was unable to protect herself from an unwanted pregnancy.
Situations in which there is reason to believe that the contraceptives used were ineffective.

Regarding the last point, they particularly highlight:

Missing a dose more than two times in a row.
Pass for more than 3 hours.
Delayed administration (timing depends on the specific drug).
Loss or .
Displacement or damage to the diaphragm or cap on the cervix.
Rupture or slippage.
An attempt at interrupted sexual intercourse, resulting in ejaculation into the vagina or external genitalia.
Incomplete dissolution of spermicide before sexual intercourse.
Wrong definition safe days using natural methods contraception.

When is it not too late?

Emergency contraception should be taken no later than 72 hours after unprotected sex. The optimal effect is achieved if the tablet is taken on the first day after intimacy. There is evidence that postcoital contraceptives remain effective for 120 hours, but drug manufacturers do not guarantee the desired result.

To protect yourself from unwanted pregnancy, you need to take the pills strictly according to the instructions.

When can I take the postcoital pill again?

The regimen of use depends on the chosen drug:

Postinor should be taken twice. The second tablet should be taken 12 hours after the first.
Escapelle and Mifepristone are prescribed once. Repeated administration of the drug is not necessary.
According to the Yuzpe method, COCs are used as emergency contraception. The first dose is taken 72 hours after unprotected intercourse. The second dose is prescribed 12 hours after the first dose of tablets.

Regarding the interval between reuse of emergency contraception, then the opinion of doctors is clear: the more, the better. There should be at least a month between taking post-coital pills.

Which emergency contraceptive pills are best?

All postcoital medications are effective in their own way if you take them on time and strictly follow the instructions for use. IN Lately in gynecology they are moving away from Postinor, giving priority to new drugs - Escapel and Mifepristone. These drugs need to be taken once, and thus eliminate the risk of insufficient effect from forgotten second pills.

All of these products have a large number side effects, so it’s quite difficult to single out a safe one among them.

How much do pills cost after unprotected sex?

The price of the drug depends on its type and manufacturer:

The average cost of Postinor and Escapel is 300-500 rubles.
Mifepristone-based drugs will cost 350-600 rubles.

Can COCs be used for emergency contraception?

This scheme was developed in 1977, but it is not very popular. According to the Yuzpe method:

Take the first dose of the drug within 72 hours after sexual intercourse.
Take the second dose 12 hours after the first.

For emergency contraception, 8 tablets of a low-dose COC (containing 30-35 mcg ethinyl estradiol and levonorgestrel) taken in two doses (4 tablets of the drug) are used at once. The following products are suitable: Microgynon, Rigevidon.

This type of scheme is not popular in Russia, as there are more convenient and affordable means.

Do emergency contraceptive pills protect against sexually transmitted infections?

No, such drugs only protect against pregnancy, but do not provide protection against infections. Pathogenic microorganisms penetrate the woman's genital tract without any problems and cause dangerous diseases. The following measures will help slightly reduce the risk of infection:

Hexicon (candles).
Betadine (suppositories).
Miramistin (spray).

Antiseptics should be used in the first hours after unprotected sexual intercourse. These drugs do not provide 100% protection and practically do not protect against the penetration of HIV infection and viral hepatitis.

What happens if you get pregnant while on emergency birth control pills?

Women using Mifepristone for postcoital contraception should know that if there is no effect, they should consider terminating the pregnancy. During the use of the drug, it is noted high risk appearance birth defects development in the fetus.

Levonorgestrel-based drugs (Escapelle and Postinor) are contraindicated during pregnancy, but there is no evidence of an adverse effect of the drugs on the fetus.

Can breastfeeding mothers take emergency contraceptive pills?

According to the instructions, drugs for postcoital use penetrate into breast milk and are considered unsafe for children. Nursing mothers are prohibited from drinking such products. If there is an urgent need to take a contraceptive, you need to interrupt breastfeeding:

for 24 hours for drugs based on levonorgesterl (Escapelle, Postinor);
for 14 days for Mifepristone.

Do emergency contraceptive pills have an abortifacient effect?

The answer to this question depends on when the drug was taken:

In the first phase of the cycle, postcoital contraceptives inhibit ovulation and interfere with the release of the egg. Conception in this case becomes impossible, and there is no talk about the abortive effect.
In the second phase of the cycle, the tablets prevent the implantation of the fertilized egg into the uterine cavity. In this situation, a miscarriage occurs within 7 days. This is considered to be the abortifacient effect of the drug.

Important! After implantation occurs, emergency contraception methods are not used.

The effectiveness of drugs used after unprotected sexual intercourse is 85-95%. Despite all possible disadvantages, such funds are considered the best alternative abortions. Even if the drug leads to termination of pregnancy as a result of impaired implantation of the fertilized egg, this will be the best outcome for the woman. In this situation, abortion will occur at very early and will pass with minimal consequences for reproductive health. On the contrary, termination of pregnancy at more later(after a delay in menstruation) threatens serious health problems, including infertility.

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