Things to know about morning-after pills

At Maya we understand that the topic of sex education can be considered a taboo by many, and therefore discussing morning-after pills is likely to be even more complex, or may even be seen as controversial.
Through our Q&A tool, “Maya Apa Ki Bolen”, over 50 per cent of questions we receive are to do with pregnancy, family planning and sex education. As a result we feel it is highly important that the women out there, many of whom are considerably young, have more information about morning-after pills, commonly referred to as “i-pills”.
Whether socially and culturally different forms of sexual activities are acceptable or not, men and women will engage in sexual behaviours.
For people to make the right decisions about their bodies, whether it is to practise abstinence or have multiple sexual partners, it is imperative especially for young adults to have information about their bodies. Especially in the Bangladeshi context where we have the paradox of being over-populated yet shy away from conversation on sex education in our households, it is important to use print and online platforms to provide these much needed information.  
Many of us have memories of parents changing channels when i-pills commercials came up as if to avoid is the best strategy! But the truth is, everyone knows of these products and usually the ways in which they find out about contraception are not well-researched or thought out.
From our own research we have seen that due to a lack of basic knowledge about pregnancy, sexual health and contraception, many young women use emergency pills without understanding the risks associated. Our goal is to highlight some of these risks and share information on alternatives to the morning-after method.
What you need to know about the morning-after pill
    Morning-after pills contains levonorgestrel which is a synthetic version of the progesterone hormone. Regular birth control pills contain levonorgestrel but in much lower doses. This pill works by keeping your progesterone level artificially high, thus delaying or stopping ovulation and preventing implantation of the fertilised egg in your womb lining.
    It is meant for women between 25-45 years of age but nowadays younger individuals are using it because it is so easily available, without prescription.
Enough studies are not available that prove there are no side effects of this hormone in young users. Taking high doses of this hormone is, however, not recommended for a developing reproductive system. Although there are no major, long-term side effects of this drug, when taken too often, it can disrupt your normal cycle. Remember there is a reason why the hormones rise and fall throughout your menstrual cycle!
    Morning-after pills can be taken more than once during a menstrual cycle but it's not a logical choice because frequent overuse can cause irregular menstrual cycle which in turn can affect your fertility. If a woman uses only emergency pills for contraception for an entire year, her chance of becoming pregnant is 20 per cent whereas with the use of regular contraceptive pills the chance is less than 1 per cent and with hormonal intrauterine device it is less than 0.1 per cent. It doesn't cause abortion if you are already pregnant.
    It is not recommended as a regular method of contraception because of its very high failure rate. When taken within 24 hours of unprotected sex it is 95 per cent effective in preventing pregnancy, when taken within 25-48 hours its 85 per cent effective and when taken within 49-72 hours the effectiveness is only 58 per cent.
    Morning-after pills can be taken as a backup method when there is a contraceptive failure, such as torn condom or missed pills, unprotected or forced sex.
    Some common side effects are nausea, vomiting, headaches, lower abdominal pain and breast tenderness. It is a good idea to take an anti-emetic (medicine that prevents vomiting) two hours before you take the pill. There are may be unexpected vaginal bleeding. Your period may come early or may be delayed. But if your period is delayed by more than a week, a pregnancy test must be done.
    Emergency contraceptive pills do not cause abortion. If you have a missed period, repeating doses will not help. But if the pregnancy is continued, no birth defects have been reported so far.
    Many think that overuse of post-coital pills causes infertility but studies done so far have failed to prove any such side-effect.
 
By Dr Kazi Mashfia Fardeen, Medical Expert, maya.com.bd