Emergency Contraception: Types and Window Period

Patient: Hi there I had a early abortion 6 weeks pregnant on wednesday and foolishly had unprotected sex on the Thursday do I need the morning after pill is there chance I could be pregnant again. Also how soon can I start taking my contraception again

Doctor: Yes, you may take the morning after pill. It is most effective when used within 24 hours from sexual intercourse. There are 2 types of emergency contraception. One is a method using hormones (estrogen or progesterone) and the other one is IUD. IUD insertion within 7 days of unprotected sex may prevent implantation; the sooner the better. It has a ~1% failure rate though. However, it also has its pros and cons, pros being the effect may last for 5 years and cons are bleeding in between periods, headaches, uterine wall perforation, ectopic pregnancy, etc. In general, any birth control pill (BCP) with a total dose of 200ug ethinyl estradiol (divided evrey 12 hours ergo, 100ug 12 hours apart) may be used as emergency contraception. For example, Yaz (brand of BCP with 20ug ethinyl estradiol per active pink pill) may be used. So 5 active pills (5 x 20ug=100ug) may be taken at once then take another 5 active pills 12 hours after. Ovral has 50ug ethinyl estradiol. So 2 tabs may be taken then take another 2 tabs 12 hours after. Plan B is the more convenient morning after pill. It has a progesterone-like hormone; 2 tabs are needed, each taken 12 hours apart or at once. Nausea and vomiting is a very common side effect of morning after pill, especially if 2 tabs are taken at once, so anti-nausea (gravol) may be taken ahead. The morning after pill is effective within 72 hours from unprotected intercourse, it is most effective in the 1st 24 hours. Since you already had unprotected sexual intercourse, yes, there is a chance you will get pregnant again. You may start the contraception right away, it is okay. If you are planning to take the morning after pill, I suggest you wait for your period first (may be late or advanced) then start back on the contraception. I also strongly suggest to please avoid unprotected intercourse or withdrawal method. You may use a contraceptive patch, depo or implant if you find the pill too inconvenient. I do hope this helps. Take care.