Think twice before popping a pill

There is a tremendous change in lifestyle, attitudes and sexual dynamics today and women are often confronting situations in which they are caught unaware. The emergency pill was launched to fulfill this need for protecting against unplanned pregnancy. The emergency contraceptive pill or the morning after pill is to be used by a woman in case of contraceptive failure such as a condom bursting or leaking, forgetting contraceptive pills or in cases of unplanned or forced sex to protect against pregnancy. However, today it is being used or rather misused by many women as a primary method of prevention of pregnancy instead of a backup plan. A prominent concern is that this pill is now readily available, which can encourage irresponsible sexual behaviour, which in turn increases risks of unintended pregnancy and Sexually Transmitted Diseases (STD) such as HIV, Hepatitis B, human papilloma virus (which causes cancer of the cervix), Herpes, Chlamydia, etc. Easy over the counter availability and massive publicity has resulted in women nowadays using this multiple times a month or as a replacement for the low dose contraceptive pills. How does it work? The commonly used emergency pill contains a synthetic hormone called levonorgestrel in a high dose. This prevents the release of the egg from the ovary if taken early in the menstrual cycle, or prevents the embryo from implanting by creating an unsuitable environment in the womb. The pill is available as a single tablet or two tablets to be consumed within 72 hours of unprotected intercourse. Effectiviness The effectiveness of the pill is 90 per cent with the failure rate being upto 10 per cent. The results vary with the time of consumption of pills. The sooner the pill is taken after unprotected sex, the more effective it is. The effectiveness is maximum within 24 hours of intercourse. Side-effects As a high dose of hormone is taken, it disrupts the normal menstrual cycle and the woman may bleed irregularly or have delayed menses in the next cycle. The pill can cause nausea, vomiting, breast discomfort and pain in some users. It is a good idea to take an antiemetic two hours prior to the consumption of the pill. Sometimes a woman may get pregnant despite the pill, but is unaware of it due to the bleeding which occurs, giving her a false sense of security and hence a delay in diagnosis of pregnancy. The resulting pregnancy after failure of the pill is usually safe and free from defects. Unfortunately, along with the huge hype about the emergency contraceptive pill, there has been no spread of information of regular contraceptive methods. As a result, women consider this as the only option. If a woman uses only emergency pills for contraception for an entire year, her chance of becoming pregnant is 20 per cent whereas with the use of regular contraceptive pills the chance is less than 1 per cent and with hormone intra-uterine device it is less than 0.1 per cent. Hence, regular contraceptive methods are much more effective for long term use and emergency contraceptive pills should be used exclusively for an emergency only.