Emergency Contraception
What Is Emergency Contraception?
Emergency contraception (EC) refers to methods used after unprotected sex or contraceptive failure (e.g., condom break, missed pills) to prevent pregnancy. It is not intended for routine use and does not terminate an existing pregnancy.
It is needed in the following situations:
Unprotected intercourse
Contraceptive failure (e.g., condom slippage, missed pills)
Sexual assault
Delayed or missed contraception initiation (e.g., starting pills late)
What Are the Types of Emergency Contraception?
Emergency Contraceptive Pills (ECPs)
Levonorgestrel (LNG) pill
Dose: 1.5 mg single dose of synthetic progesterone called levonorgestrel (e.g., Unwanted-72, i-Pill)
Time window: Most effective within 72 hours
Efficacy: ~85% if taken within 72 hours
Availability: OTC in India
Cost: ₹50–100
Ulipristal Acetate (UPA)
What: It is a selective progesterone receptor modulator but not widely available in India
Time window: Up to 120 hours (5 days)
Efficacy: More effective than LNG, especially closer to ovulation
Copper Intrauterine Device (Cu-IUD)
Copper Intrauterine Device (Cu-IUD)
What: When inserted intrauterine, it prevents fertilization and implantation; also serves as long-term contraception (up to 10 years)
Insertion time: Within 5 days of unprotected sex
Efficacy: >99% (most effective EC method)
Availability: Requires insertion by trained provider
Cost: Free in government facilities; ₹300–500 privately
What Are the Side Effects of Emergency Contraception Pills?
Side effects are mainly due to high dose of progesterone. They include:
Nausea, headache, fatigue, breast tenderness
Menstrual changes: early, delayed, or irregular bleeding
Generally mild and self-limited
Safety and Limitations of Emergency Contraception Pills
Safe for all women, including adolescents
No effect on future fertility
Should not be used as a regular contraceptive method as they can cause repeated side-effects which bring down the quality of life and if used repeated can cause hormonal imbalance
Less effective in women >75 kg with LNG pills (UPA or IUD preferred)
Emergency Contraception in India
Government-approved brands: Unwanted-72, i-Pill, Preventol
Available OTC without prescription
Copper-T available free under National Family Planning Programme
Contraceptive vs Emergency Contraceptive: Detailed Comparison
Purpose
To prevent pregnancy continuously with consistent use
To prevent pregnancy after unprotected sex or contraceptive failure
Timing
Used before or during sex, regularly (daily, weekly, monthly, or per act)
Used after sex, typically within 72–120 hours
Methods
Pills, condoms, IUDs, injectables, implants, sterilization
EC pills (Levonorgestrel, Ulipristal), Copper IUD
Mechanism
Inhibits ovulation, fertilization, implantation or sperm transport depending on method
Delays ovulation (pills) or prevents fertilization/implantation (IUD)
Efficacy
High with proper use (IUDs & implants >99%, pills ~91%, condoms ~85%)
EC pills: ~85% (within 72h); Copper IUD: >99%
Duration of Protection
Varies: daily (pills), monthly (injectables), 5–10 years (IUDs), permanent (sterilization)
One-time use only, no ongoing protection
Side Effects
Depends on method: hormonal changes, irregular bleeding, cramps (IUD)
Nausea, breast tenderness, delayed or early periods (temporary)
STI Protection
Only condoms offer protection
No STI protection
Accessibility in India
Widely available: free in government and private options
EC pills OTC; Copper IUD through trained providers
Examples in India
Mala-D, DMPA (Antara), Copper-T, condoms, Mirena, implants
Unwanted-72, i-Pill (pills); Copper-T (as EC)
Cost
₹0 (public) to ₹1000+ depending on method
EC pills: ₹50–100; Copper IUD: ₹300–500 privately
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