Effectiveness of Emergency Contraceptive Pills During Ovulation and Treatment

The contraceptive effectiveness of birth control pills?

Hello Doctor: I started treatment for Candida albicans last Thursday.
On the first day, I took three pills prescribed by my gynecologist, and since then, I have been using the suppositories and topical medication for the vulvar area as directed by my gynecologist.
The day before yesterday, I had sexual intercourse with my boyfriend and later discovered that the condom had a hole.
I immediately took one dose of Ulipristal acetate 30 mg as an emergency contraceptive.
Coincidentally, that day was my ovulation day.
Is it still effective to take emergency contraception on the day of ovulation? Additionally, will the suppositories and medications I am using for the Candida treatment affect the efficacy of the emergency contraception? Thank you.

Ching, 20~29 year old female. Ask Date: 2019/03/25

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effectiveness of emergency contraceptive pills taken within 72 hours after intercourse is about 97%, but it is not 100%, with a failure rate of approximately 3%.
Early pregnancy may not present specific symptoms, and subjective symptoms cannot be used to make a judgment.
It is recommended to check for pregnancy if menstruation is more than a week late.

Medications that may interact with oral contraceptives include:
1.
Antibiotics (Penicillin, Cephalosporins, Erythromycin, Sulfonamides, Bactrim, Chloramphenicol) - may reduce the gut flora that aids absorption, thereby decreasing the effectiveness of contraceptives.
2.
Sedatives (Barbiturates) - increase the metabolism of contraceptives, reducing their effectiveness.
3.
Antiepileptic drugs (Primidone, Phenytoin, Carbamazepine) - increase the metabolism of contraceptives, reducing their effectiveness.
4.
Tuberculosis medications (Rifampicin, Isoniazid).
5.
Antidiabetic medications (Rosiglitazone).
6.
Acetaminophen and Ascorbic acid - may inhibit the metabolism of estrogen, leading to increased concentrations and a higher incidence of side effects.
7.
Oral contraceptives can affect the action of anticoagulants.
8.
Smoking - increases the metabolism of contraceptives, reducing their effectiveness.
Thank you! Wishing you peace and health.
Dr.
Zhang.

Reply Date: 2019/03/25

More Info

Emergency contraceptive pills (ECPs), such as Ulipristal acetate, are designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. The effectiveness of these pills is influenced by the timing of administration in relation to the ovulation cycle.
Ulipristal acetate is most effective when taken during the luteal phase of the menstrual cycle, which is after ovulation has occurred. However, it can still be effective if taken during ovulation, although the efficacy may be reduced. Studies indicate that Ulipristal acetate can delay or inhibit ovulation, but if ovulation has already occurred, its ability to prevent fertilization or implantation is less certain. Therefore, taking Ulipristal acetate on the day of ovulation may still offer some level of protection, but it is not guaranteed.

Regarding your treatment for Candida (yeast) infection, the medications you are using—whether they are topical antifungals or suppositories—should not affect the efficacy of Ulipristal acetate. ECPs work primarily by altering hormonal pathways to prevent ovulation, and antifungal treatments do not interfere with this mechanism. However, it is always advisable to inform your healthcare provider about all medications you are taking, as they can provide personalized advice based on your specific situation.

In summary, while taking Ulipristal acetate during ovulation may not be as effective as taking it before ovulation, it still provides some level of protection. The antifungal treatment for your yeast infection should not impact the effectiveness of the emergency contraceptive pill. If you have further concerns or experience any unusual symptoms, it is best to consult with your healthcare provider for tailored guidance.

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