Emergency Contraceptive Pills: Side Effects and Efficacy - Obstetrics and Gynecology

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Emergency contraceptive pills (ECPs) are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They are most effective when taken as soon as possible after the event, ideally within 72 hours, although some types can be taken up to 5 days later. The two main types of ECPs are those containing levonorgestrel (Plan B One-Step) and those containing ulipristal acetate (ella).

Side Effects of Emergency Contraceptive Pills
Common side effects of ECPs can include:
1. Nausea and Vomiting: Many women report feeling nauseous after taking ECPs. This is a common side effect due to the high doses of hormones in these pills. If vomiting occurs within two hours of taking the pill, it may reduce the effectiveness of the medication, as the body may not have absorbed it fully.

2. Fatigue: Some women may feel tired or fatigued after taking ECPs.

3. Headaches: Hormonal changes can lead to headaches in some users.

4. Breast Tenderness: Hormonal fluctuations can cause breast tenderness.

5. Changes in Menstrual Cycle: ECPs can cause your next period to be earlier, later, or heavier than usual.


Efficacy After Vomiting
In your girlfriend's case, since she vomited after taking the second pill, it is important to consider the timing. If she vomited within two hours of taking the pill, there is a possibility that the pill did not get fully absorbed into her system, which could potentially reduce its effectiveness. In such cases, it is often recommended to take another dose, but this should be discussed with a healthcare provider for personalized advice.


What to Do Next
1. Consult a Healthcare Provider: It is crucial for your girlfriend to speak with a healthcare professional. They can provide guidance on whether she should take another dose of the ECP or consider other options.

2. Monitor for Side Effects: If she continues to feel nauseous or experiences other concerning symptoms, she should seek medical attention.

3. Follow Up on Menstrual Cycle: After taking ECPs, it’s important to monitor her menstrual cycle. If her period is more than a week late, she should take a pregnancy test.


Conclusion
Emergency contraceptive pills are generally safe and effective, but they can come with side effects, including nausea and vomiting. If vomiting occurs shortly after taking the pill, it may impact its efficacy. It is always best to consult with a healthcare provider for advice tailored to her specific situation. They can help determine the next steps and ensure that she receives the appropriate care.