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April 19, 2005

Regarding Emergency Contraception...

As I mentioned in my previous post about Wal-Mart pharmacists refusing to dispense birth control, Attack of the Tiny Purple Elephant quoted the form letter from Wal-Mart on the subject, which included this statement: "Wal-Mart does not carry emergency contraceptives."

Actually, Wal-Mart probably does, but it doesn't know it. I know "emergency contraception" is referring to things like RU-486, but you can use regular birth control pills as emergency contraception. Of course, the problem with Wal-Mart is that its pharmacists probably won't fill the prescriptions.

I have posted about emergency contraception before, and I thought this was a good time to repeat that post.

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It's about time women learned how to use emergency contraception.

In light of the huge backlash against a woman's right to decide when and if she will bear children, I decided it was a good time to dig this information out of my archive and post it here. Please feel free to spread this information far and wide.

According to the Emergency Contraception Website, "both the contraceptives approved by the FDA for emergency contraception and those used for ordinary birth control can legally be used for emergency contraception. Any clinician authorized to provide prescriptions may prescribe an approved drug for an unlabeled purpose; the most common example is prescribing oral contraceptives to regulate menstrual periods, or to reduce menstrual cramps. The FDA has explicitly declared ECPs to be safe and effective. If widely used, emergency contraceptives could substantially reduce unintended pregnancy and the need for induced abortion."

Using birth control pills in this manner eliminates the middle man. A woman may take these pills in the privacy of her own home, thereby placing her out of the range of the picketers and the men with hard-ons for a woman's private medical records. She of course should keep in touch with her physician. Despite the ability for pills to be used in this manner, most women and most clinicians don't know about it. It wasn't until recently that pharmaceutical companies even marketed or advertised about emergency contraception. I suspect that emergency contraception and the privacy it gives women may be one big reason that those who are against abortion are also against the use of birth control pills. Some of them know that the pills may be used as abortifacients, and they don't like it.

That's why I'm posting the information here for women to read and use when necessary.

Here is the link to Princeton's Emergency Contraception Page. It includes a directory of providers and a FAQ.

Here are instructions for using progestin-only emergency contraception pills.

Reproduced here in full are instructions for using combined emergency contraception pills.

[Note: One of the birth control pills mentioned below, Preven, is now off the market. Thanks to Ema from The Well-Timed Period for the update, in my comments.]

Instructions for Using Combined Emergency Contraceptive Pills

There are several choices for combined ECPs listed below. You need to take only one type of pill, not all of them. For example, if you use Ovral, you do not need Nordette. If you are getting your ECPs from a regular pack of birth control pills containing 28 pills (one for every day), remember that the last seven pills do not contain any hormones. In a 28-pill pack of Ovral, Ogestrel, Alesse, Levlite, Lo/Ovral, Low-Ogestrel, Nordette, Levlen, or Levora, any of the first 21 pills can be used as ECPs. If you are using Triphasil or Tri-Levlen, the first 21 pills have three different colors, but only the yellow pills can be used as ECPs. If you are using Trivora, the first 21 pills have three different colors, but only the pink pills can be used as ECPs.

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Brand of Pill
Click on brand names to see illustration of pills.

* Preven (blue pills)
* Swallow 2 pills as soon as possible
* Swallow 2 more pills 12 hours later

* Ovral (white pills only), Ogestrel (white pills only)
* Swallow 2 pills as soon as possible
* Swallow 2 more pills 12 hours later

* Lo/Ovral (white pills only), Low-Ogestrel (white pills only), Nordette (light-orange pills only), Levlen (light-orange pills only), Levora (white pills only), Triphasil (yellow pills only), Tri-Levlen (yellow pills only), or Trivora (pink pills only)

* Swallow 4 pills as soon as possible

* Swallow 4 more pills 12 hours later

* Alesse (pink pills only), Aviane (orange pills only), Levlite (pink pills only)
* Swallow 5 pills as soon as possible
* Swallow 5 more pills 12 hours later

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1. Swallow the first dose as soon as possible. ECPs are more effective the sooner after unprotected sex they are started.

2. Take the second dose 12 hours later. It is not even known what is the optimal timing between doses, much less whether the second dose is even necessary. All research on the efficacy of emergency contraceptive pills has used the 12 hour time frame, but it may not need to be so rigid. Taking the second dose a little early or late (+/- two hours, for example) will probably not make a difference in how effective the pills are, but we really do not know for sure.

Do not swallow any extra ECPs. More pills will probably not decrease the risk of pregnancy any further. More pills will increase the risk of nausea and vomiting.

If you have nausea, it is usually mild and should stop in a day or so. If you vomit within one hour after taking a dose, call your clinician. You may need to repeat a dose. You may need some anti-nausea medicine.

Watch for pill danger signals for the next couple of weeks. See your clinician at once if you have:

* severe pain in your leg (calf or thigh)
* severe abdominal pain
* chest pain or cough or shortness of breath
* severe headaches, dizziness, weakness, or numbness
* blurred vision, loss of vision, or trouble speaking
* jaundice (yellowish discoloration of the whites of the eyes, skin, and mucus membranes)

7. Your next period may start a few days earlier or later than usual. If your period doesn't start within three weeks, see your clinician for an exam and pregnancy test. If you think that you may be pregnant, see your clinician at once, whether or not you plan to continue the pregnancy. ECPs may not prevent an ectopic pregnancy (in the tubes or abdomen). Ectopic pregnancy is a medical emergency.

8. Get started as soon as you possibly can with a method of birth control you will be able to use every time you have sex. ECPs are meant for one-time, emergency protection. ECPs are not as effective as other forms of birth control. If you want to resume use of birth control pills after taking ECPs, consult your clinician. Protect yourself from AIDS and other sexual infections as well as pregnancy. Use condoms every time you have sex if you think you may be at risk.

Preven has been approved by the U.S. Food and Drug Administration (FDA) for use for emergency contraception. Ovral, Lo/Ovral, Ogestrel, Low-Ogestrel, Nordette, Aviane, Levlen, Levlite, Triphasil, Tri-Levlen, Levora, Trivora and Alesse have been approved by the FDA as regular birth control pills. These products have not been submitted to the FDA for use as ECPs, but clinical research studies have shown that ECPs are safe and effective. The FDA has explicitly declared all brands of birth control pills listed above to be safe and effective for use as emergency contraceptives.

The accompanying table has more details about the brands of oral contraceptives that can be used as emergency contraception in the United States.

Doses of the brands of oral contraceptives that can be used for emergency contraception.

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If you have questions about emergency contraception, please visit our page on frequently asked questions.

Posted on April 19, 2005 at 07:02 AM | Permalink

Comments

Preven is off the market.

Posted by: ema at Apr 20, 2005 1:20:57 AM

cyclen is good too.

2 pills immediately
2 pills 12 hours later

Posted by: marlo_girl at May 3, 2005 2:52:38 AM

Great post! This is so important. I have a similar post on my blog, not having seen yours.

I worry these days, unfortunately, that I should stockpile birth control pills. Isn't that horrible?

Posted by: Jami at May 11, 2005 7:09:45 PM

i have read from several medical reports that there are a lot of side effects to these birth control pills, i was wondering, what brand produces lesser side effects? or are these effects on a ratio per individual?

thank God for ECP....

Posted by: Rachel at Jun 7, 2005 3:05:10 AM

i have read from several medical reports that there are a lot of side effects from these birth control pills, i was wondering, what brand produces lesser side effects? or are these effects on a ratio per individual?

thank God for ECP....

Posted by: Rachel at Jun 7, 2005 3:06:04 AM

Speaking from personal experience, I just cannot take a regular full-time contraceptive pill. Tried every brand in the book and they just made me feel miserable and tired and not "me" any more. ECP however I've taken several times and although I did feel a little queezy, that didn't last very long at all and wasn't nearly so bad as having to spend the next four weeks worrying I might be pregnant...

Posted by: Cruella at Jun 7, 2005 4:43:11 AM