Though pregnancy is one of the most cherished phases in a woman s life, there are times when it is not desired. This can be due to various reasons ranging from premarital sex to the couple not being ready yet. Whatever the reason, emergency contraceptive measures are available, and I-Pill has become synonymous with that.

Since its introduction, it is widely used to prevent unwanted pregnancies. The easy availability (no prescription required) and low cost have added to its popularity. However, not many realize it has some side-effects and the need to be aware of certain facts when using the I-pill.

It is an emergency contraceptive pill, should be used between 24 to 72 hours after unprotected sex
It is effective in 95% of the women when taking during this time frame
It prevents pregnancy by stopping fertilisation or preventing implantation of the fertilising egg
It stops pregnancy; however, if you conceive before the pill it was taken, it will not have any effect. It is therefore not an abortion pill
So, if you miss the period the next month, test for pregnancy
It does not offer protection against sexually transmitted disease including HIV/AIDS
It is not to be used on a regular basis
If you are on long-term medication, please consult with the doctor before taking the I-pill
It has no long-term consequence. However, there could be some minor symptoms including breast tenderness, nausea, vomiting, headache, and lower abdominal pain (pelvic area),
The next menstrual cycle could be delayed by a couple of days
There could also be spotting before the actual period starts
Women who are allergic to levonorgestrel should not take I-pill.
It can cause skin allergies and reduce libido.
When used repeatedly, it can cause delayed and irregular menstruation
It is ideal for use between the age of 25 and 45. Teenagers should not use it regularly. This needs to be made aware through sex education, as the prevalence of teenage sex and pregnancy is on the rise in India
Repeated usage can cause ovarian damage and severe menstrual issues, so occasional use is the only recommended usage
It is safe to take the pill during lactation. There is no effect on the quality of milk or any other adverse effect on the baby
I-Pill was introduced as an emergency contraceptive method, and not for regular contraceptive purpose. Its correct usage and avoiding complications is largely dependent on sex education which needs to start early and talk about other safe sex measures and avoid using it on a regular basis.


Side-effects of i-Pill Tablets - Every Woman Must Know!! 

It is important that you protect yourself from various types of diseases and infections as much as possible. Female condoms are used to have protected intercourse so as to avoid contact with ejaculatory fluids. These condoms help a person to steer clear of blood, semen and vaginal fluids as well. Female condoms fall under the category of barrier contraceptives. They are considered to be less effective in comparison to male condoms, but are nonetheless good for preventing any kind of infection. Ensuring fine health through safe sex is your due responsibility. Hence, a little knowledge about these contraceptives is helpful if you wish to shun chances of unwanted pregnancy or Sexually Transmitted Diseases. 

What is it like?
A female condom looks like an ill  fitting hollow cylinder. It is a thin sheath with a closed end, that goes inside the vagina and an open end that remains outside the vagina covering other external, genital parts. The covered end has to be inserted into the vagina or into the anus. It is a misconception, that female condoms can only be used by females. It is predominantly used by females, but can also be used by any receptive partner during sexual intercourse. The ends have circular rings to keep the condom in place. 

What are they made of? 
Femidoms are usually made up of polyurethane. This material is expensive, making the product costly. The need for a cost effective product was immediately felt to encourage the use of condoms among females. Thus, the next generation of female condoms were made with synthetic Nitrile. Nitrile proved to be a competent substitute as it did away with the annoying noises polyurethane made during sex. It also reduced condom pricing considerably. Researchers have also come up with natural latex female condoms that retain the feel of a male condom. 

Benefits of using a female condom
It is a great barrier in thwarting the flow of semen into the womb. Thus, they reduce the risk of accidental pregnancy. It also protects you against sexually transmitted infections like gonorrhoea, Syphilis, and HIV. Sex partners should be careful to refrain from any sexual contact before the insertion of a female condom. Only after the condom has been placed properly, the penis should enter the vagina or the anus. Femidoms are available in varied sizes, but the average sized condom fits most females. Large sized condoms can be used by new mothers. It is advised to buy condoms that bear the CE mark on them. The CE mark represents European Safety Standards and thus, leaves you least vulnerable to accidents or diseases.

All About Female Condoms

Emergency is helpful in preventing pregnancies post unprotected sexual activity. It can be used in case of contraceptive failure, in case of sexual assault, incorrect use of contraceptives and unprotected sex.

Emergency contraception can be done by three methods. These are emergency contraceptive pills, combined oral contraceptive pills and copper intrauterine devices.



The copper IUD is considered to be one of the most effective forms of emergency contraception, when it is inserted within 5 days of unprotected sexual activity.

However, the emergency contraceptive pill regimen as per WHO is:

1 dose of levonorgestrel 1.5 mg, or 1 dose of ulipristal 30 mg, taken within 5 days (120 hours) of unprotected intercourse

The Yuzpe regimen which consists of 2 doses of combined oral contraceptive pills

What is Emergency Contraception?

Emergency contraception is usually referred to as the contraception which is used to prevent a pregnancy within the first 5 days after an unprotected sexual activity. It is used post failures of contraception, coerced unprotected sex, rape or misuse of contraception.

Emergency contraception is only effective in the first few days after an intercourse and before the egg has released from the ovary, and before there is fertilization between the egg and the sperm. The emergency contraception can do no harm to an interrupted pregnancy and a developing embryo.

Who needs emergency contraception?

Any girl or woman who is at her reproductive age might need an emergency contraception in case of an unprotected sexual intercourse.

Uses
1 Breakage , slippage or displacement of barrier methods 
2. Three or more missed OCPills for more than 12 hours 
3. Missed Mini pill for more than 3 hours 
4. Missed Desoestrel pills for more than 12 hours 
5. DMPA injections taken more than 2 weeks late 
6. Miscalculated dates of last period and present ovulation side effects 
These are meant only for emergency contraception and NOT AS A REGULAR CONTRACEPTIVE. It involves pumping of a hormone inside your body at levels which are 5 times higher than normal. hence excessive and unnecessary use may cause irregularity in the period cycles and an adverse effect on the menstrual health over a period of time. Ideally it should be taken under guided medical supervision.


In what situations should emergency contraception be used?

Emergency contraception can be used after a sexual intercourse. These include:

In case of no use of contraceptives

If it is a case of rape or coerced sex, where the woman was not protected

When there is a contraceptive failure, like

breakage

incorrect use or slippage

OCPILLS,

mini pills

DMPA

3 or more missed combined oral contraceptives, progestogen-only pill (minipill) taken more than 3 hours late, desogestrel-containing pill 12 hours or more, norethisterone enanthate (NET-EN) progestogen-only injection taken more than 2 weeks late

Delay in placing or dislodgement or early removal of the skin patch or the hormonal ring

Breaking, dislodgement, tearing or early removal of cervical cap or diaphragm

Failure of withdrawal that is ejaculation the external genitalia or vagina

The spermicide tablet failure

Miscalculating the periods, failure from using a barrier on the fertile days

Expulsion of an intrauterine contraceptive device (IUD)

Methods of Emergency Contraception:

There are three emergency contraception methods:

Copper-bearing intrauterine devices (IUDs)

Emergency contraception pills (ECPs)

Combined oral contraceptive pills or the Yuzpe method



Safety of Emergency Contraception

Contraceptives are generally drugs and devices, which are used to prevent pregnancy. A large number of contraceptives are available which allow the couple to enjoy sex without running the risk of unwanted pregnancies. The general categories of contraceptives are explained below:

Barrier Methods:
i. Male Condom: It is one of the most common forms of contraception. They are worn on the penis before sex is initiated. For safety purpose, a new condom should be used every time the person has sex.

ii. Female Condom: Much like male condoms, these are available at over-the-counter pharmacies without prescription. The condoms can be inserted to the vagina anytime within a period of 8 hours prior to sex.

iii. Diaphragm: This should be coated with a spermicide before sex and placed inside a woman's vagina so that the sperms are prevented from entering the uterus.

iv. Cervical Cap: These are used as replacements for diaphragms because some women may develop bladder infections such as cystitis while using it and these caps have lesser contact with the vagina.

Hormonal Methods:
The main implementation of hormonal changes to provide contraception is the pill. This is the most common form of female contraception available. It comes in two forms:
i. Combined contraceptive pill: Contains a combination of hormones such as progestin and oestrogen.
ii. Mini-pill: Contains only progestin: It is available only with the prescription of the doctor and should be used as per the prescription.

Intrauterine Devices
The intrauterine device (IUD) is a long-acting and reversible form of contraception for women. It is of two types: Copper IUD (contains copper) and Hormone-releasing IUDs (progestin hormone is released into the womb slowly). It is a small device that is fitted inside the womb and it provides contraception by facilitating the prevention of fertilization of the egg.

Sterilization
This is a lifelong option that is available for both men and women. In males, the procedure is known as vasectomy which basically ties and cuts off the tubes that carry the sperm.

In women, two forms of sterilization are available; surgical and non-surgical. Surgically, the fallopian tubes are cut and tied using small cuts in the belly so that the ovaries and uterus are not linked. Non-surgically, coils are inserted into the fallopian tubes so the resultant development of scars leads to complete blockage of the tubes.

Other forms of contraceptives include contraceptive patches, vaginal rings, contraceptive injections, spermicides and contraceptive implants.

Different Types of Contraceptives and Its Uses

There are two methods by which abortion can be done:

Medical Abortion - Non-surgical abortion in which medicines are used to induce abortion

Surgical Abortion - Use of transcervical procedures for terminating a pregnancy, including vacuum aspiration, and dilatation and evacuation (D and E).

Surgical or Medical Abortion for Unwanted Pregnancy

If pregnancy is lesser than = 7 weeks; medical method with Mifepristone with Misoprostol is favorable as the success rate is as high as 97%.

If pregnancy is between 7-12 weeks; surgical abortion is the only option.

If pregnancy is beyond 12 weeks - 20 weeks, then the woman needs to be hospitalized and will be given either Mifepristone followed by Misoprostol tablet or only Misoprostol tablets and woman will then abort like a miscarriage in the hospital. If any products are remaining, then it will be evacuated surgically.

Surgical abortion is preferred if patient desires concurrent tubal ligation or IUCD (CuT) insertion.

If a woman fulfills the criteria for selecting either method i.e. before 7 weeks, final choice has to be given to the woman.

Summary of choice between Surgical or Medical abortion in India

lesser than = 7 weeks - Medical method or surgical method

7-12 weeks - Surgical abortion

12 - 20 weeks - Medicines with or without surgical procedure in hospital

Advantages of Medical Abortion

Avoid surgery

Controlled by the woman and may take place at home

No need for admission to the hospital

Usually, well tolerated by women, if properly counselled and motivated

No need to take leave from work, as bleeding can be managed with menstrual pads even while in the office or at work.

Disadvantages of medical abortion

Takes time (hours to days) to complete abortion, and the timing may not be predictable. Women experience bleeding and cramping, and potentially some other side-effects (nausea, vomiting, fever, and shivering). May require more clinic visits than surgical abortion.

Advantages of Surgical Abortion

Quick procedure

Complete abortion easily verified by evaluation of aspirated products of conception

Takes place in a hospital so Sterilization or placement of an intrauterine device (IUD) may be performed at the same time as the procedure. It can be performed under local anaesthesia if woman is properly motivated and counselled

Disadvantages of surgical abortion

Requires instrumentation of the uterus

Small risk of uterine or cervical injury

Timing of abortion controlled by the doctor and hospital

Anaesthesia needs to be administered. Most doctors perform this procedure under short general anaesthesia. A woman needs to be in the hospital for at least 6 hours. Effect of sedation will be there throughout the day.

Methods of Abortion for Unwanted Pregnancy

Use of contraceptives is really important to avoid unwanted pregnancy. Countries like China and India, facing the problem of population explosion lay more stress on the use of contraceptives. However, you must always use or take oral and barrier contraceptives following the advice of a medical practitioner unless it is absolutely necessary to go ahead without consultation. The reason behind medical assistance is your own health. Contraceptive methods do have a vast range of side effects that can result in health hazards. There are various kinds of contraceptives; each having its own set of advantages and disadvantages. Being acquainted with the side effects of some contraceptive methods can help you choose wisely in times of need.

Possible side-effects of using condoms: Some men are allergic to latex. Using condoms can lead to heightened sensitivity. It can also lead to rashes in your genitals. Condoms are not foolproof. They do not provide total protection against sexually transmitted infections, HPV or against Syphilis and Herpes. These diseases can be contracted by coming in contact with genital skin that is not covered by a condom.
Possible side-effects of a Contraceptive Film: A contraceptive film might act as an interruption in your sexual activities if it is not placed properly, that is to say it must come in contact with the cervix to be effective. Using the film nonoxynol- very frequently can make you susceptible to life threatening diseases like HIV and other STIs.
Possible side-effects of a Cervical Cap: A cervical cap has to be inserted by a clinician and requires immense care to be fitted in later. Some of its side - effects can be of serious concern. If it is left inside for more than forty eight hours, it can result in toxic shock syndrome. Toxic shock syndrome is an infection that mars your overall health. It is also known to increase the chances of inflammation of the surface of your cervix.
Possible side-effects of Progestin only pills: Progestin only pills or mini pills can subject you to long- lasting depression. It can make you feel bloated and can actually increase your weight to a great extent if used on a regular basis. Minipills lead to irregularities in your menstrual cycle and might also make bleeding during menstruation scanty.
Possible side-effects of combined oral contraceptives: If this is your first month on combined oral contraceptives, you might feel nauseous and they can give you a terrible headache. Women taking these pills have a higher chance of developing cervical dysplasia. If you wish to discuss about any specific problem, you can consult a gynaecologist and ask a free question.

Side Effects of Different Contraceptive Methods

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