Emergency contraception

1. It is not a permanent contraceptive, to be taken only as an “emergency”! 
2. Does not protect against sexually transmitted infections!
3. Preferably take within 24 hours, and no later than the recommended time of taking! 
4. Read the instructions in detail! 
5. After taking emergency contraception, it is safest not to have intercourse until the next menstruation or to use barrier methods (condoms) until the end of the cycle! 
6. Do not take emergency contraception multiple times a month! 
7. In case of side effects described in the package, contact your doctor! 
8. In case of vomiting within 3 hours of taking emergency contraception, the dose should be repeated! 
9. In case of delayed menstruation or scanty or heavy menstruation, contact a gynaecologist to confirm or rule out pregnancy!

Emergency contraception or post-coital or morning-after pill are the names for contraception used if pregnancy protection has not been used during sexual intercourse or there has been an error in the use of contraception such as a ruptured or slipped condom, or the girl/woman forgot to take two birth control pills. Emergency contraception is used only as an “emergency” and should not be used as a regular method of protection against pregnancy. 

Post-coital contraception works by delaying ovulation, it does not prevent implantation, nor does it have an abortive effect. Emergency contraception does not work if the fertilized egg is implanted in the uterus, thus it does not have an abortive effect. The effectiveness of post-coital contraception is thought to be greater the earlier it is administered after unprotected intercourse, and is recommended within 24 hours.

After taking hormonal emergency contraception, side effects may occur: headache, nausea, painful next menstruation, fatigue, dizziness, abdominal pain, back pain, premature menstruation or delayed menstruation. The effectiveness of each method is described below. Emergency hormonal contraception can be purchased in pharmacies, with a prescription, and recently the European Medicines Agency issued a recommendation for EU countries to change the regime of issuing hormonal emergency contraception ellaOne, so that it can now be purchased without a prescription. 

There are several methods of post-coital protection, but the most commonly used is hormonal method, so this contraception method will be elaborated together with other types of hormonal emergency contraception that are approved for use in Croatia. 

Hormonal methods of emergency contraception

1. Conventional or Yuzpe method. This method uses the same combination of the hormones oestrogen and progesterone as with the contraceptive pill, but in higher doses. As soon as possible, and no later than 72 hours after unprotected intercourse, take two birth control pills or four if the pills are low in hormones and the same dose is repeated after 12 hours. This method can be accompanied by side effects, such as nausea, vomiting, so the pills should be taken with food, and if vomiting occurs within 3 hours of taking the pills, the dose should be repeated. Due to a lesser effectiveness and frequent side effects, this method is no longer used in European countries and has been replaced by new methods of hormonal emergency contraception. 
2. Hormonal contraception only with progestogen, levonorgestrel (on the market called Escapelle and Vikela), in one pill contains 1.5 mg of levonorgestrel. This method prevents approximately 84% of pregnancies if taken within 72 hours of unprotected sex. The pill is more effective if taken as soon as possible after an unprotected intercourse, preferably within 24 hours. Side effects that may occur after taking the pill include nausea, and in case of vomiting within 3 hours of taking the pill, the dose should be repeated. In most women, the next menstruation comes at the expected time, but it can also be late or come earlier. If it is more than 7 days late or is unusually scanty or heavy, you should contact your doctor.