Unprotected sexual intercourse, a broken condom, or an error when using regular contraception do not always mean that pregnancy can no longer be prevented. Emergency contraception is available for such situations. Depending on the method chosen, it can be used within five days after unprotected sexual intercourse; however, it is important not to delay its use.
What Methods of Emergency Contraception Are Available?
The classic and most extensively studied intrauterine method of emergency contraception is the copper intrauterine device (IUD). It can be inserted within 5 days after unprotected sexual intercourse and is one of the most effective methods of emergency contraception. After insertion, the IUD can be left in place and used as a long-term contraceptive method.
Can Mirena Be Used as Emergency Contraception?
Mirena contains 52 mg of levonorgestrel and is a hormonal intrauterine system. Previously, recommendations for intrauterine emergency contraception referred only to the copper IUD. However, modern studies have shown that a 52 mg levonorgestrel-releasing intrauterine system can also be used for emergency contraception when inserted within 5 days after unprotected sexual intercourse. In a randomized study, it was found to be no less effective than a copper IUD; the Society of Family Planning includes the 52 mg LNG-IUD among the options for emergency contraception. After insertion, Mirena can be continued as a long-term contraceptive method. In addition, it may help reduce menstrual bleeding and the severity of menstrual pain.
What Emergency Contraceptive Pills Are Available?
The main oral methods are ulipristal acetate 30 mg and levonorgestrel 1.5 mg. Ulipristal can be taken within 120 hours — five days — after unprotected intercourse. Levonorgestrel should also be taken as soon as possible; its effectiveness gradually decreases as more time passes after intercourse. According to the CDC, during the first 3 days, the effectiveness of ulipristal and levonorgestrel is comparable, while on days 3–5, ulipristal is more effective.
What Is Available in Georgia?
In practice, among oral emergency contraceptive methods, levonorgestrel 1.5 mg is available in Georgia, whereas ulipristal acetate is currently unavailable through regular pharmacy sales in Georgia. Therefore, for patients in Georgia, levonorgestrel is the main available oral option. Since medication availability may change, it is advisable to additionally check availability at local pharmacies when needed.
Is Emergency Contraception an Abortion?
No. Emergency contraception does not terminate an existing pregnancy and is not a medical abortion. The main mechanism of action of emergency contraceptive pills is related to preventing or delaying ovulation.
What Happens to Your Period After Taking the Pill?
After emergency contraception, the next menstrual period may start slightly earlier or later than usual. Spotting or irregular bleeding may also occur. If the expected period does not occur after using emergency contraception, pregnancy should be ruled out. The CDC recommends taking a pregnancy test if expected bleeding does not occur within three weeks after emergency contraception.
The Main Point
After unprotected sex, do not assume that nothing can be done after 72 hours: some methods of emergency contraception can be used within 5 days. In Georgia, levonorgestrel is the most readily available oral option. If a woman also wants to choose a long-term contraceptive method, insertion of an intrauterine system can be discussed: Mirena 52 mg has evidence supporting its effectiveness as emergency contraception when inserted within the appropriate time frame.