Is Emergency Contraception with Birth Control Pills Safe and Effective?

Is emergency contraception suitable for use as a post-coital contraceptive?

Hello Doctor, I am currently G0P0A0 and have a steady partner.
I do not regularly take any medications.
Recently, after having sexual intercourse with my boyfriend, I discovered that the condom broke.
During the cleaning process, I confirmed that there was ejaculation inside.
Within one hour, I visited a gynecology clinic and requested emergency contraception.
The doctor prescribed me Priliane Gynera, instructing me to take 3 pills initially and then another 3 pills six hours later (a total of six pills).
After returning home, I felt uneasy and contacted the doctor to confirm the medication I was prescribed.
Upon checking the leaflet, I found that it is classified as a contraceptive pill, and I could not find the same dosage instructions.
I am concerned whether taking such a high dosage is appropriate.
(There are no other clinics open during the holiday, so I cannot seek care elsewhere.) I have now taken all six pills, but I am experiencing significant gastrointestinal discomfort as a side effect.
In summary, I would like to consult Dr.
Tsao on whether this prescription is appropriate or if there is anything else I need to be aware of.
Thank you very much.

Ann, 20~29 year old female. Ask Date: 2021/02/28

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, please follow the doctor's instructions.
The effectiveness of emergency contraception is not 100%, so just monitor the situation.
Wishing you good health.

Reply Date: 2021/02/28

More Info

Emergency contraception (EC) using birth control pills can be both safe and effective, but it is important to understand the context and the specific medications involved. In your case, you were prescribed Gynera, which is a combined oral contraceptive pill containing ethinylestradiol and gestodene. This medication is primarily designed for regular use as a contraceptive, but it can also be used off-label for emergency contraception in certain situations.

When a condom breaks and there is a risk of unintended pregnancy, taking emergency contraception as soon as possible is crucial. The effectiveness of emergency contraception is highest when taken within 72 hours after unprotected intercourse, but it can still be effective up to 5 days after. The sooner you take it, the better the chances of preventing pregnancy.

In your situation, the doctor prescribed a higher-than-usual dose of Gynera, instructing you to take three pills initially and then three more six hours later. This method is sometimes referred to as the Yuzpe regimen, which involves taking a higher dose of combined oral contraceptives for emergency contraception. While this approach can be effective, it is not the most common method used today, as there are dedicated emergency contraceptive pills available that are specifically formulated for this purpose, such as levonorgestrel (Plan B) or ulipristal acetate (Ella).

Regarding the side effects you are experiencing, it is not uncommon to have gastrointestinal discomfort, nausea, or other symptoms after taking a high dose of hormonal contraceptives. These side effects are generally temporary and should resolve within a few days. However, if the discomfort persists or worsens, or if you experience severe symptoms such as vomiting, severe abdominal pain, or any signs of an allergic reaction, you should seek medical attention promptly.

In terms of safety, taking a higher dose of birth control pills for emergency contraception is generally considered safe for most individuals. However, it is essential to be aware of any contraindications or personal health conditions that may affect your ability to take hormonal contraceptives. If you have a history of blood clots, certain cancers, or other significant health issues, it is crucial to discuss these with your healthcare provider.

In summary, using Gynera as emergency contraception is a viable option, and while the method you followed is not the most common, it can still be effective. Monitor your symptoms, and if you have any concerns or experience severe side effects, do not hesitate to contact a healthcare professional. Additionally, consider discussing with your doctor about more conventional emergency contraceptive options for future reference, as they may provide a more straightforward approach with potentially fewer side effects.

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