Post-coital drugs, or the pills of tomorrow, are becoming increasingly popular. Women often switch to unreliable methods of birth control, knowing that they can avoid problems by taking the pill if they are in danger of becoming pregnant. But in reality, things are not so rosy. Pills after sexual intercourse cause many problems.
There are different types of emergency contraceptive pills
The content of the article
Schematically, all these tools can be divided into two groups:
- Progestogens
are drugs based on levonorgestrel. These include Escapelle, Exicor-F, Postinor and their analogues. These drugs inhibit ovulation, preventing the egg from being released and connecting with the sperm. That is why it is so important to take them in the first hours after unsuccessful sexual intercourse. - Antigestagens
are drugs that complicate the implantation of the fertilized egg and expel it. The same drugs in other doses are used for medical abortion. Due to the lack of connection with ovulation, their effect depends less on the timing of administration, but still, it is also better to take antigestagens immediately. This group includes Agesta, Mifepristone, Zhenale.
The effectiveness of drugs against unwanted pregnancy
Medical termination of pregnancy is much simpler than surgical termination. However, pills do not always bring results.
The effectiveness of medications depends on the following factors:
- age;
- physical data (weight, height);
- health;
- menstrual cycle.
The most important effect on effectiveness is the amount of time that has passed since sexual intercourse. If you use emergency contraception immediately after contact or after a short time, the effectiveness is 99%. With every hour and day that passes, the percentage of success decreases.
The most effective emergency contraception drugs are those containing mifepristone:
- Mifegin.
- Mytholian.
- Mifeprex.
- Pencrofton.
It is prohibited to use them independently.
If you haven't ovulated yet
The dangerous period during which a woman can become pregnant begins a few days before ovulation. This is due to the fact that sperm retain their fertility for 2-3 days, being in the female body and waiting for the release of the egg. During this period, any contraceptive medications will be effective. They will slow down ovulation and prevent the embryo from settling in the uterus.
However, taking the drug late after sexual intercourse causes ovulation to start, the embryo to be fertilized and pregnancy to occur. Therefore, the effectiveness of drugs based on the Escapelle type drops from 98% to 58% in three days. This is where the 88% data provided by the manufacturer comes from.
Levonorgestrel drugs act more mildly than antigestagens, and pregnancy, if it does occur, can be maintained without fear for the baby’s health. Therefore, during this period it is preferable to take gestagens. Due to its toxicity and frequent complications, the outdated Postinor can be used only in extreme cases.
How do the pills work?
As mentioned above, there are 2 types of emergency contraceptive pills, both of which are hormonal-containing drugs:
- a group of drugs that include levonorgestrel (progestogen)
- tablets containing mifepristone (antigestagen)
Levonorgestrel
The mechanism of action of pills whose active substance is levonorgestrel (the names of birth control pills after the act are Postinor, Escapelle, Eskinor F) consists of three points:
- Delayed or blocked ovulation. By acting on the ovaries, levonorgestrel prevents the release of the egg from the main follicle (when taking the drug on the eve of ovulation), since it suppresses the influence of gonadotropic hormones (FSH and LH).
- The composition of cervical mucus changes. Among other things, levonorgestrel increases the viscosity of cervical mucus. It becomes thick and slows down the process of sperm penetration into the uterus.
- Inadmissibility of implantation of a fertilized egg. There are 2 mechanisms that prevent the egg from implanting into the uterine mucosa. The first is that the structure of the endometrium changes, since levonorgestrel causes a reverse development of proliferative processes in the endometrium, which eliminates the possibility of its transition to the secretory phase, which is so necessary for full ovulation. Thus, Postinor and other drugs containing levonorgestrel have a mild abortifacient effect. In addition, levonorgestrel affects the peristalsis of the fallopian tubes, their contractions decrease, which disrupts the delivery (in time) of the fertilized egg to the uterine cavity for implantation.
1 tablet of Postinor contains a huge dose of the hormone, after taking which a serious hormonal imbalance occurs in a woman’s body. WHO does not recommend the use of such contraceptives at all; the instructions for the drug indicate that even a healthy woman should not take it more than 4 times a year and no more than 1 time per menstrual cycle. However, some women (unknowingly) use levonorgestrel uncontrollably, sometimes even several times per cycle - which is unacceptable and very dangerous.
When taking Postinor, ovarian function is impaired, and even with a one-time dose of the drug, the body needs a certain time to restore their function, and in each case this is individual (see in detail about the harm and side effects of Postinor).
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Mifepristone
The effect of drugs from the second group of emergency contraceptive pills (containing mifepristone - Zhenale, Mifegin, Pencrofton, Miropriston) approximately corresponds to that of pills containing levonorgestrel:
- inhibition of ovulation;
- structural changes in the endometrium (mifepristone, the active component of drugs in this group, has antigestagenic activity, it blocks receptors in the uterine mucosa that respond to progesterone, the pregnancy hormone, as a result the endometrium does not undergo changes necessary for implantation);
- increased contractile activity of the uterus, which promotes the expulsion of a fertilized egg that has not attached to the uterine mucosa from its cavity.
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If ovulation should already begin
If a condom breaks or other unplanned situations occur on the most dangerous day, there is no point in taking drugs that inhibit ovulation - you may not have time. According to scientific research, the effectiveness of levonorgestrel-based products these days does not exceed 68%. Therefore, it is better to take a drug based on antigestagens - Agesta or Zhenale.
But here lies another danger. Drugs in this group cause disruption of fetal development, so the resulting pregnancy is terminated. Another disadvantage of drugs in this group is frequent delays in the onset of menstruation.
Advantages and disadvantages of 24 hour tablets
Regardless of the type, the pill used within 24 hours of intercourse to prevent unplanned pregnancy has certain advantages and disadvantages that should be considered before using postcoital contraception. The advantages of these drugs include:
- The ability to quickly prevent unplanned conception, provided that unprotected sexual intercourse took place.
- Ease of use. In order to prevent unplanned conception, it is enough to take one quick-acting birth control pill.
In addition, this type of contraception can help women who have been sexually assaulted .
The disadvantages of postcoital contraception used during the first day after unprotected sexual intercourse include:
- Serious impact on a woman’s reproductive function in general, and hormonal levels in particular.
- High risk of complications after using postcoital contraception.
- Inability to use on an ongoing basis to protect against unplanned pregnancy.
In addition, this group of drugs is not able to protect sexual partners from infection with sexually transmitted diseases.
If pills after intercourse do not help and pregnancy occurs
This happens, because not a single pill taken after sexual intercourse is 100% effective. If your period does not come on time and the test is positive, it means that pregnancy occurred before suspicious sexual intercourse or the medications did not work.
During this period, taking any pills after sexual intercourse is useless or even dangerous. A case of an attempt to terminate a pregnancy using the drug Postinor, which led to the death of the patient, is described. Due to a sharp jump in hormone levels, the woman developed blood clots that disrupted the functioning of the liver, kidneys and heart.
In this case, you need to contact a gynecologist to confirm the pregnancy and the possibility of terminating it with medication or a mini-abortion.
Which contraceptives are the safest?
The Yuzpe method is considered to be the safest emergency contraception. Low-dose medications have minimal side effects. If you follow the conditions for taking the pills, the effectiveness of this method is 90%.
These contraceptives can be purchased without a prescription.
It should be noted that vaginal contraceptives are not suitable for emergency contraception due to their low effectiveness.
Table: Comparison of the effectiveness and side effects of birth control pills after unprotected intercourse
Other problems with the drugs of tomorrow
Ineffectiveness of action caused by the patient's excess weight. In obese women, the effectiveness of drugs in this group is significantly reduced. Some manufacturers even indicate this in the annotations for the drug. The dose of hormones contained in the tablet is simply not enough.
Sometimes vomiting occurs when taking medications. In this case, it is recommended to take the tablet again. But sometimes the woman vomits again. Under such conditions, it is impossible to determine how much of the substance entered the body.
Taking postcoital contraceptives, causing hormonal disruption, often leads to bleeding. This complication occurs especially often when taking an outdated postinor. All tablets in this group cause menstrual dysfunction. After taking them, the timing of the onset of critical days can “dance” for several months.
It’s not for nothing that doctors call this contraception “firefighting.” Taking such medications should be a rare measure, and not an “insurance policy.” You should not rely only on the pills of tomorrow, which is often done by women who do not have a regular sex life.
It is much more effective and safer to consult a doctor and select other contraceptive measures. An intrauterine device (IUD) can be placed immediately after questionable sexual intercourse, permanently solving the problem of the possibility of unwanted pregnancy.
Which drug should I choose?
First of all, the selection of the drug should be carried out by a doctor. Many factors are taken into account: age, hormonal levels, diseases, pregnancies in the past and present. If you compare drugs with mifepristone and levonorgestrel in terms of their sparing effect, you can obtain the following data:
| Mifepristone (usually 10 mg dosage) | Levonorgestrel (usually 1.5 mg dosage) | |
| Pregnancy does not occur | in 98-99% |
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| Time of use after NPA | 72 hours | 72 hours |
| Risks of developing an ectopic pregnancy | 0,8% | 1,6% |
| Changing your menstrual calendar | 26% | 43% |
| Number of respondents who reported pain in the chest | 8% | 8% |
| Number of respondents who noted pain in the uterus and ovaries | 14% | 15% |
| Percentage of patients with bleeding | 19% | 31% |
| Age restrictions | Can be used in adolescence | Contraindicated under 16 years of age |
Where to pick up contraceptive pills and have an abortion in St. Petersburg, prices
This can be done by contacting the St. Petersburg gynecological clinic Diana. Experienced gynecologists will diagnose and select safe contraceptive measures. And if an unwanted pregnancy does happen, you can get a medical abortion here for only 3,500 rubles. The price includes an appointment with a gynecologist, pills and a pelvic ultrasound, which is necessary to identify contraindications and confirm the duration of pregnancy.
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Cost of emergency contraceptives
How much do pills that prevent unwanted pregnancy cost? Consider the list of tablets and their average cost:
| A drug | Price, rub |
| Postinor | 410 |
| Escapelle | 480 |
| Gynepristone | 380 |
| Genale | 300 |
| Agesta | 290 |
| Marvelon | 1450 |
| Microgenone | 350 |
| Regulon | 420 |
| Rigevidon | 340 |
| Miniziston | 440 |
| Novinet | 480 |
| Logest | 810 |
Please note that the prices for drugs are average. Depending on the region of residence, the cost may vary.
Precautionary measures: what a teenager needs to know
A gynecologist should select a COC after a visual examination of the girl and based on test results. Usually, blood donation is prescribed and an ultrasound (ultrasound) examination of the pelvic organs is performed. An acceptable remedy will be prescribed after identifying contraindications.
Among them:
- liver dysfunction;
- diabetes;
- obesity;
- pathologies of the heart and blood vessels;
- smoking.
The prescribed remedy will have a positive effect only if you follow the doctor’s recommendations. There is no reason to worry about vomiting, nausea and mild bleeding. At the beginning of treatment, dizziness and engorgement of the mammary glands may occur. After the adaptation period is completed, the symptoms will disappear on their own. There is no need to stop taking the medication.
Sometimes weight gain is observed. If you have a tendency to be overweight, you should immediately stick to a low-calorie diet.
When can you start having sex?
Girls should not have sexual intercourse before the age of 18-19. It is at this age that the menstrual cycle stabilizes. Experts do not recommend starting sexual activity at an early age, since negative consequences for reproductive and general health cannot be ruled out. For boys, the same indicators remain, although they reach puberty earlier. From the age of 11-14, a girl’s ovaries begin to form full-fledged eggs, which are required for conception. Unplanned pregnancy can occur as early as this age.
Can I use hormonal pills?
Hormonal pills can be taken only after establishing a regular menstrual cycle. Medicines are dangerous because they can have a negative impact on the further sexual development of a girl. The contraceptive will be effective if a woman has only one partner and regular sexual intercourse.
Low-dose and virtually safe drugs are becoming increasingly accepted among young people.
Monophasic tablets are considered the most suitable:
- Logest;
- Lindinet 20;
- Novinet.
They contain minimal dosages of hormones, but the gynecologist must select the remedy. You need to take the medications at the same time every day; skipping them can lead to an unwanted pregnancy. In addition, body weight may increase rapidly. The best option is to combine taking the pill and using condoms to protect against sexually transmitted infections.
Review of contraceptive drugs 24 hours
Below we will present and characterize the previously mentioned contraceptive pills 24 hours after an act of unprotected intimacy.
Postinor
This type of postcoital contraception refers to medications that include levonorgestrel.
This medication has a powerful and aggressive effect on the female reproductive organs, and is one of the most effective tablets used in the first 24 hours against unplanned pregnancy after intimacy without a barrier protection. The postcoital contraceptive contains 0.75 mg of the active ingredient, which is an order of magnitude higher than alternative contraceptive options in this category. When using Postinor in accordance with the annotation, its effectiveness is at least 95%. The maximum level of effectiveness is observed if the product was used on the first day after unprotected sexual intercourse. The cost of packaging the product is 370 rubles.
Mifepristone
The medication allows not only to prevent conception, but also to terminate an existing pregnancy in the early stages. The maximum gestational age at which Mifepristone can be effective is 6 weeks. Mifepristone tablets contain 200 mg of the active substance of the same name, which affects the mucous membrane of the uterine cavity. If this drug is used for medical abortion, then for a period of 4-6 weeks the woman should be under the supervision of a gynecologist in a gynecological hospital. The cost of packaging the product is 780 rubles.
Escapelle
After unprotected sexual intercourse, one Escapel tablet is enough against unplanned pregnancy, since the drug contains a loading dosage of levonorgestrel. Before using this contraception option, it is recommended to consult your gynecologist. Escapelle cannot be used in cases of diagnosed Crohn's disease and certain diseases of the hepatobiliary system, accompanied by impaired bilirubin metabolism. The cost of packaging the product is 450 rubles.
Genale
This drug is produced by the Russian company Izvarino Pharma. The effect of the medication is due to the content of mifepristone. In order to prevent the onset of unplanned conception, it is enough to drink 1 tablet of the drug 2 hours before eating, during the first day. The cost of packaging the product is 420 rubles.
Side effects of postcoital contraceptives
The incidence of side effects is not that high, but some patients report the following symptoms:
- pain in the lower abdomen (pulling or aching);
- scant bloody discharge (“bleeding”);
- irregularity of the menstrual cycle;
- mastalgia (pain in the mammary glands);
- breast swelling;
- headaches, migraine;
- nausea and vomiting;
- allergic reactions in the form of skin itching and rash;
- sudden mood swings.
The appearance of these symptoms requires consultation with a gynecologist.
Precautions for contraception 24 hours
When using postcoital contraception, you must strictly adhere to the recommended dosage and do not combine drugs with alcohol or other hormonal drugs. In addition, the more time has passed from the end of intimacy to the moment of taking a contraceptive, the lower the degree of its effectiveness.
After using this type of protective equipment, a woman may experience serious hormonal imbalances. Recovery may take from 2 to 3 months.
The best birth control medications
Correspondence of oral contraceptives to female phenotypes:
- Predominance of estrogens. Phenotype: femininity, dry skin and hair, short stature, prolonged menstruation. If estrogen predominates, protective agents with a high content of hormones are recommended: Rigevidon, Triziston, Milvane.
- Balanced composition of estrogens and androgens. Phenotype – femininity, medium-sized developed mammary glands, oily skin, normal hair, absence of PMS, menstrual cycle 30 days. Optimal choice of contraception: Microgynon, Silest, Femoden, Marvelon, Lindinet-30.
- Increased content of androgens (gestagens). Phenotype – high growth, poor development of the mammary glands, oily skin and hair, PMS in the form of depression, pain in the lower abdomen, lower back, scanty menstruation, cycles of 28 days. The preferred choice of drugs is: Jess, Janine, Yarina, Diane-35.
