Morning After Pills Malaysia: When Emergency Pills Come Into Plan

Morning After Pills Malaysia

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To prevent an unintended pregnancy after unprotected intercourse, emergency contraception (EC) always comes into our minds. As its name says, emergency contraception needs to be done in an urgent manner following the intercourse for it to work best.

Morning After Pills Malaysia — Image source: cosmopolitan.com

There are a few types of emergency contraception:

Copper-bearing intrauterine device (Cu-IUD)
Morning-after pill, also known as Emergency contraceptive pill (ECP) which contains either:
- Levonorgestrel
- Ulipristal acetate
Combined estrogen-progestogen ECP

We will be focusing on morning-after pill because it is the most common method people are using now.

How Does Emergency Contraceptive Pill Works?

The emergency contraceptive pill works by delaying ovulation in the body. Thus, it prevents the meet of an ovum and sperm. The emergency contraceptive pill can provide protection against pregnancy in females at reproductive age up to 5 days after intercourse.

However, you are advised to take the pill as soon as possible because the effectiveness may drop substantially as time passes. In fact, Ulipristal acetate ECP protects against pregnancy to a greater extent compared to Levonorgestrel-only ECP between 72 hours to 120 hours after unprotected intercourse. Therefore, the duration since the intercourse took place plays a crucial role in deciding which ECP to take.

Levonorgestrel comes in two strengths, 0.75mg and 1.5mg. Levonorgestrel 0.75mg is to be taken twice a day while 1.5mg is to be taken once a day, ideally within 72 hours after intercourse for both types.

Both regimens provide the same effectiveness, however, a single-dose regimen is usually preferred due to compliance issues. You should make sure not to miss the second dose of 0.75mg levonorgestrel.

Ulipristal acetate 30mg is to be taken once also, within 5 days following unprotected intercourse. Please note that these are all one-shot regimen only.

If vomiting occurs within 2 hours after taking the emergency pill, a second dose should be taken as soon as possible.

Benefits of Emergency Contraceptive Pills

This plan B intervention is beneficial in circumstances like:

Missed contraceptive pill (the one to be taken on a daily basis)
Possible contraceptive failure like slip condom
Sexual assault

Downsides of Emergency Contraceptive Pills

Nevertheless, there are shortcomings too:

The emergency pill cannot protect against sexually transmitted diseases (STD) like HIV, herpes infection, syphilis etc (Condom is still one of the best prevention for this)
The emergency contraceptive pill is not 100% effective though, there is still a minimal risk that you might get pregnant even after taking this pill
You might experience some side effects of the pill, for example, nausea, vomiting, headache. The menstrual period might become irregular after taking the pill
Less effective in obese women (BMI >30)

Frequently asked questions (FAQ)

1. Can take this pill frequently?

Not recommended, the incidence of short term side effects might increase. The chance of getting an irregular period is high. There was a review saying that regular taking of morning-after pill has a chance of getting pregnant within 12 months.

Thus, you are advised to use another type of contraceptive method instead of taking this pill regularly. For instance, you can opt for a birth control pill or a condom.

2. Will this pill cause infertility?

No.

3. Will this pill cause an abortion?

No. It will not harm an established pregnancy.

4. Any age limit?

No, as long as the female is at reproductive age.

3. If the female is taking the regular oral contraceptive pill daily, how long should she wait to resume her regular pill after taking the emergency pill?

She can resume immediately after taking the Levonorgestrel emergency pill or on the 6^th day after taking the Ulipristal emergency pill, with extra protection (condom or abstain from intercourse) for 2 days if she is taking the progestogen-containing pill, or 7 days if she is taking the combined oral contraceptive pill.

4. Why need to wait for 5 days to resume oral contraceptive pill after taking Ulipristal emergency pill?

There is drug-drug interaction in this case. Ulipristal and progestogen-containing contraceptive pills will compete for the progesterone receptor to bind with, therefore decrease the effectiveness of either drug.

5. Emergency pill helps in delaying ovulation, what if ovulation has already occurred?

Sadly to say, it is all about timing. The pill does not reverse ovulation, some call it destiny. Cu-IUD works best in this case.

6. Morning-after pill can only be taken in the morning?

No, the soon as you can.

7. You can have more unprotected intercourse after taking an emergency pill?

No. Ovulation is delayed, but not stopped.

The emergency contraceptive pill is not an over-the-counter product. It can only be dispensed or prescribed by a healthcare professional. Correct use and counselling are important to ensure the effectiveness of this plan B.

References:
1. http://apps.who.int/iris/bitstream/handle/10665/252267/9789241565400-eng.pdf;jsessionid=FC47F4437F52AA9CBFD68205A4AEE806?sequence=1
2. https://www.who.int/news-room/fact-sheets/detail/emergency-contraception
3. https://www.medicalnewstoday.com/articles/162762#disease_protection