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Combination Pill Emergency Contraceptive

Combination Pill – Emergency Contraceptive

What is the Combination Pill emergency contraceptive?

Combination Pill Emergency Contraceptive

Combination Pill Emergency Contraceptive

The “Morning After Pill” is a common name for the most popular type of emergency contraceptive. Emergency contraceptives or emergency birth control (EC) is used to reduce the chance of a woman getting pregnant after she has had sex without using birth control, during the fertile days while using natural family planning, or if the birth control method failed. While some EC methods may be taken as much as 3-5 days after unprotected sex, EC is most effective when taken as soon as possible (i.e. within a few hours).

The Combination Pill (CP) contains a combination of the hormones levonorgestrel (progestin) and ethinyl estradiol (estrogen) found in regular birth control pills. Certain brands of the birth control pill can be used as a CP for emergency contraception. When taken as a back-up oral contraceptive method, CP is to be used as soon as possible, but no more than five days (120 hours), after unprotected sex or contraception failure, to reduce the chance of pregnancy. Emergency contraceptives do not protect against HIV or other sexually transmitted diseases.

In California, women of any age are legally able to purchase the Combination Pill at a pharmacy with a pharmacist consultation but without a prescription. However, as of July 2016, many of the larger pharmacies including CVS and Walgreens are not yet ready to begin this new process. Ask your local San Francisco Bay Area pharmacy if they are able to dispense CP without a prescription.

How does the Combination Pill work?

The Combination Pill is actually a number of regular birth control pills that are taken in multiple doses. The number of pills to take at one time and how many times they are to be taken depends on the type or brand of pill you have. Ask (or consult) with your doctor or a pharmacist to see how to use your combination pill for emergency contraception. When used for emergency contraception, Combination Pills are not as effective as progestin only pills such as Plan B One Step or Next Choice One Dose. Combination Pills are safe for almost any woman to use, even women who are not able to take the birth control pill on a regular basis.

The main function of levonorgestrel and ethinyl estradiol combined is to prevent or delay ovulation (i.e. to stop the egg from releasing), to block fertilization of the egg, or to prevent the egg from attaching (implantation) to the wall of the uterus (womb). The latest scientific research shows that FDA approved ECPs containing levonorgestrel or ulipristal acetate do not inhibit the implantation of a fertilized egg. ECPs stop pregnancy by keeping the egg from leaving the ovary or keeping the sperm from joining the egg. CP will not stop or harm an embryo that has already implanted. If you are already pregnant, emergency contraception will not work. It is not the abortion pill.

The Combination Pill as an emergency contraceptive works before ovulation occurs so if you have unprotected sex after ovulation, taking CP may not stop a pregnancy. If you have unprotected sex in the days or weeks after the use of CP, there is a risk of becoming pregnant.

Is the Combination Pill the same as the birth control pill?

The Combination Pill is the same as the birth control pill. However, it is a common misconception that you can simply double up your birth control pill. The truth is that you need to achieve a certain level of levenorgestrel and ethinyl estradiol to be considered an effective emergency contraceptive. Not all birth control pills can be used as EC. The brands of birth control pills that can be used as emergency contraceptive pills, due to the levels of levonorgestrel and ethinyl estradiol they contain, include: Altavera, Amethia, Camrese, Enpresse, Introvale, Jolessa, Lessina, Levora, Lutera, Nordette, Ogestrel, Portia, Quasense, Seasonale, Sronyx, Trivora, but there are many more brands. Your doctor can inform you of the exact dosage and at what frequency you will need to take the CP based on the brand and hormone levels in your birth control pill.

Are there side effects of the Combination Pill?

Side effects of the emergency contraceptive pill may include nausea and vomiting, abdominal pain or cramps, breast tenderness, headache, dizziness, and fatigue (tiredness). Your period may be delayed, come sooner, be heavier or lighter than normal. These side effects usually do not occur for more than a few days after taking the medication. If vomiting occurs within one hour of taking the pill, contact your doctor to see if you need to repeat the dose. If your period is more than one week late, you may be pregnant.

Important: If you become pregnant or experience severe abdominal pain and/or bleeding 3-5 weeks after taking the emergency contraceptive pill, you may have an ectopic pregnancy (the egg has implanted outside the uterus). Since ectopic pregnancies may be life threatening, you should seek immediate medical attention.

How do I know if I should be concerned?

You should be concerned about an unintended pregnancy if you had sex and your birth control failed (i.e. condom broke, diaphragm not inserted correctly, during the fertile days while using natural family planning, etc.), if you did not use contraception, or if you missed/forgot to take your birth control pill(s). If you had sex and think that you may be at risk of pregnancy, chat with our nurse online or schedule an appointment at one of our three Bay Area Support Circle clinics in Oakland, Redwood City, or San Francisco. We offer free pregnancy tests and same day appointments.

Support Circle provides information about emergency contraceptives but does not prescribe or dispense these medications.

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References:

  1. http://ec.princeton.edu/info/combecp.html
  2. https://www.nlm.nih.gov/medlineplus/druginfo/meds/a601050.html