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Emergency Contraception: America's Best-Kept Secret

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WebMD Feature

Do you watch the television show "ER"? During an episode in 1997, Nurse Hathaway (Carol) offered the option of emergency contraception pills to a young woman who had just been forced to have sex against her will. It's possible that between 5 and 6 million people learned about emergency contraception that day.

According to the Kaiser Family Foundation, almost 3 million unintended pregnancies happen each year in the United States. You can imagine why -- a condom tears, a diaphragm slips out of position, a woman misses two birth control pills in a row. Or, a couple has gotten "swept away" in the momentum of lovemaking and has neglected to use birth control. Perhaps a rape has occurred. Without treatment, eight in 100 women who have had one act of unprotected intercourse during the second or third week of their cycle are likely to become pregnant. With emergency contraception, only two women in 100 would be in the same situation.

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What Is Emergency Contraception?

There are two types of emergency contraception pills (ECPs). One is a combination of estrogen and progestin, and the other is a progestin-only pill. Depending on when they are taken during the menstrual cycle, ECPs can inhibit or delay ovulation; inhibit transport of the egg or sperm; or alter the lining of the uterus to prevent implantation of a fertilized egg.

How Does It Work?

ECPs, sometimes called the morning after pill, must be taken within 72 hours of the unprotected intercourse. The pills are more effective the earlier a woman takes them within the 72-hour time period.

Pills are taken in two doses, with the second dose taken 12 hours after the first. Each dose is one, two, four or five pills, depending on the brand. You need a prescription to get ECPs, although some medical providers are now writing prescriptions in advance.

Preven (levonorgestrel/ethinyl estradiol) is packaged especially for emergency-contraceptive use. It contains both hormones, estrogen and progestin, and reduces the chance of pregnancy by 75 percent. About 50 percent of women who take them feel nauseous and another 20 percent vomit.

Plan B (levonorgestrel) is progestin-only and has been on the market since July of 1999. It's more effective than Preven and has fewer side effects associated with it.

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