Emergency Contraceptive Pills: Usage and Timing Explained - Obstetrics and Gynecology

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Emergency contraceptive pills (ECPs) are a crucial option for preventing unintended pregnancies after unprotected intercourse or contraceptive failure. Understanding their usage and timing is essential for effective prevention.
ECPs, often referred to as "morning-after pills," are most effective when taken as soon as possible after unprotected sex. There are two primary types of ECPs: those containing levonorgestrel (Plan B One-Step) and those containing ulipristal acetate (ella). Levonorgestrel is effective within 72 hours (3 days) after unprotected intercourse, while ulipristal acetate can be effective up to 120 hours (5 days) after. However, the sooner they are taken, the more effective they are.

In your girlfriend's case, she started taking a 21-day oral contraceptive pill regimen, which is typically designed to prevent ovulation and regulate menstrual cycles. The standard recommendation is to begin taking these pills at least seven days before engaging in unprotected intercourse to ensure maximum effectiveness. Since she started taking the pills a week before her expected period, it is likely that she is still within the window of effective contraception, assuming she continues to take the pills as directed.

Regarding whether she should continue taking the pills after her period starts, the answer is yes. She should continue taking the oral contraceptive pills as prescribed, even if her menstrual cycle begins. The 21-day regimen is designed to be taken continuously, and stopping the pills prematurely can disrupt her hormonal balance and increase the risk of unintended pregnancy.

As for the timing of her next dose, she should take her next pill at the same time each day, following the prescribed schedule. If she has any concerns about missed doses or irregularities in her cycle, it is advisable for her to consult with her healthcare provider for personalized guidance.

It is also important to note that while ECPs are effective for preventing pregnancy after unprotected intercourse, they do not protect against sexually transmitted infections (STIs). Therefore, using condoms in conjunction with hormonal contraceptives is recommended for additional protection.

In summary, your girlfriend should continue taking her oral contraceptive pills as prescribed, even if her period has started. She should maintain a consistent schedule for taking her pills and consult her healthcare provider if she has any concerns or questions about her contraceptive method. Understanding the proper use of ECPs and regular contraceptive pills is essential for effective pregnancy prevention and reproductive health.