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

Feature
Regular Contraception
Emergency Contraception (EC)

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


Medically reviewed by

References
  1. WHO. (2018). Emergency Contraception Fact Sheet https://www.who.int/news-room/fact-sheets/detail/emergency-contraceptive

  2. Atkins K, Kennedy CE, Yeh PT, Narasimhan M. Over-the-counter provision of emergency contraceptive pills: a systematic review. BMJ open. 2022 Mar 1;12(3):e054122.

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