Emergency Contraceptive Pills: Effectiveness After Unprotected Intercourse - Obstetrics and Gynecology

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Emergency contraceptive pills (ECPs) are designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. The effectiveness of ECPs depends on several factors, including the timing of administration relative to the unprotected intercourse and the type of emergency contraceptive used.

In your case, you mentioned that you took the emergency contraceptive pill within two hours after the first instance of unprotected intercourse when the condom broke. This is a critical factor because ECPs are most effective when taken as soon as possible after unprotected intercourse. The sooner you take the pill, the higher the chance of preventing ovulation and, consequently, pregnancy.
Most ECPs, such as those containing levonorgestrel (Plan B One-Step) or ulipristal acetate (Ella), can reduce the risk of pregnancy significantly if taken within 72 hours (3 days) after unprotected intercourse. Levonorgestrel is most effective within the first 24 hours, while ulipristal acetate can be effective up to 120 hours (5 days) after intercourse.
However, since you mentioned that you had another instance of unprotected intercourse two hours after taking the emergency contraceptive, it is important to note that the ECP you took will not be effective against any sperm that may have been present during that second encounter. Sperm can live inside the female reproductive tract for up to five days, so if ovulation occurs during that time, there is a possibility of pregnancy.

To summarize, while taking the emergency contraceptive pill within two hours of the first unprotected intercourse significantly reduces the risk of pregnancy from that event, the subsequent unprotected intercourse two hours later poses a risk of pregnancy since the ECP will not prevent fertilization from that encounter.
If you are concerned about the possibility of pregnancy, it may be advisable to take a pregnancy test if your period is late or to consult with a healthcare provider for further guidance. Additionally, consider discussing long-term contraceptive options to prevent similar situations in the future, as regular contraceptive methods can provide more reliable protection against unintended pregnancies.
In conclusion, while the ECP you took is likely to reduce the risk of pregnancy from the first incident, the second instance of unprotected intercourse does increase the risk of pregnancy. It is essential to be proactive about your reproductive health and consult with a healthcare professional for personalized advice and options.