Gynaecology
In most cases, no. But although it’s deemed safe, an emergency contraception pill shouldn’t be used in place of more sustainable contraceptive methods, experts say.
Despite its name, the morning-after pill can be taken up to 72 hours (and in some cases up to seven days) after unprotected sex and is said to be 90% effective in reducing the chance of an unwanted pregnancy if taken within 24 hours.
‘Currently, overwhelming evidence supports that the morning-after pill works primarily by delaying ovulation,’ says Dr Deon van Zyl, an obstetrician and gynaecologist at Mediclinic Panorama.
This type of emergency contraception (a copper intrauterine device – IUD – is another option) is packed with levonorgestrel, the same progestin hormone found in regular birth control pills like Nordette and Triphasil.
As Dr van Zyl cautions, the morning-after pill does not terminate a pregnancy – and although it is very safe medication – it may not work as effectively if used more than once in the same menstrual cycle.
The two most common morning-after pills include Norlevo (two tablets once off), Plan B (two tablets once off) and Escapelle (one tablet once off). All of these are available without a prescription and need to be taken within 72 hours to be effective. Mifegyne is only available on prescription, but can be taken up to seven days after intercourse. It is significantly more expensive than the other options (approximately R600 vs approximately R70).
‘One of the main causes for concern when it comes to repeated use of the morning-after pill is that it suggests numerous bouts of unprotected sex,’ says Dr van Zyl. ‘This means condoms aren’t being used – which means a greater risk of sexually-transmitted diseases (STD’s) and HIV infection.’
Dr van Zyl strongly advises those who aren’t in a stable, committed relationship be tested for HIV and STD’s if they’re going to get the morning-after pill.
‘If you vomit up to an hour after taking the morning-after pill, it’s best to take some anti-nausea medication and then repeat the dose to ensure your body has a chance to absorb all the necessary medication,’ says Dr van Zyl.
Side effects you may experience after taking the morning-after pill include nausea, dizziness, tiredness, headaches, breast tenderness and lower abdominal pain or cramps.
Taking such high doses of levonorgestrel can also cause heavier or irregular menstrual bleeding and can throw your cycle off-kilter for a couple of months.
‘As you won’t know when you’re ovulating, this is a good reason to consider taking additional precautions (like using condoms) if you’re sexually active after taking the morning-after pill,’ says Dr van Zyl.
Some antibiotics, epilepsy medication, HIV medication and St John’s wort might render the morning-after pill ineffective – and women with porphyria, Crohn’s disease and certain other medical conditions that preclude hormonal contraception should consider a copper IUD as long-term contraception, or as emergency contraception should the need arise.