Last Resort: Oral Contraceptives as Emergency Contraception

OCP 2Dear Dr. Mo: What if I needed an emergency contraception and didn’t have it (couldn’t get it) – would a regular pill do the trick?

Dear reader: Even though I don’t recommend this as a contraceptive practice of choice, the answer is Yes.

Any Oral Contraceptive Pill can, in principle, be used as an Emergency Postcoital Contraception (EPC) as long as it contains a certain amount of estrogen hormone; the required amount is 200 μg of ethinyl estradiol (usually 20 – 35 μg of ethinyl estradiol per tablet but it may vary – read the composition label) – take the number of tablets to amount to 200 μg, then repeat in 12 hours.

Note that with any from of EPC, there’s a 2% overall risk of pregnancy.

This last resort method is typically effective within 72 hours of unprotected intercourse but it is best if taken within first 24 hours and there’s limited evidence of benefit up to 5 days, but I wouldn’t test this.

The most common side effect to expect is plain old nausea, which is due to estrogen effect and you may treat this with Gravol if necessary.

After 3 – 4 weeks post-ECP treatment I would suggest you followed up with a pregnancy test if a spontaneous menses didn’t occur.

But really, with so many options around, the ECP should not be required – except maybe this once..

Yours in health,

Dr. Mo

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