Dr. Shah Tushar Arvind

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:

1. Copper-bearing intrauterine devices (IUDs)

2. Emergency contraception pills (ECPs)

3. Combined oral contraceptive pills or the Yuzpe method

Premature ejaculation is a kind of sexual dysfunction. Almost 1 out of 3 men experience this problem at some point. Premature ejaculation is an uncontrollable ejaculation that occurs shortly after sexual intercourse. It may result in unsatisfactory sex for both partners. This can increase the anxiety that may add to the problem.

Premature ejaculation is the inability to delay ejaculation for more than one minute after penetration. It can be classified in two types – lifelong and acquired. Lifelong premature ejaculation occurs all or nearly all of the time beginning with your first sexual encounters. Acquired premature ejaculation develops after you’ve had previous sexual experiences without ejaculatory problems.

Causes

Premature ejaculation

The exact cause of this condition isn’t known. However, there are certain causes that are believed to cause this problem.

Psychological causes:

Psychological factors that might play a role include:

• Early sexual experiences
• Sexual abuse
• Depression
• Worrying about premature ejaculation
• Feeling guilty
• Biological causes
• A number of biological factors might contribute to this such as:
• Abnormal hormone levels
• Abnormal levels neurotransmitters
• Inflammation and infection of the prostate or urethra
• Inherited traits

Other factors

1. Erectile dysfunction

Premature ejaculation can be at higher risk in you if you have erectile dysfunction or if you have fear of losing your erection that may also cause you to consciously or unconsciously hurry through sexual encounters resulting premature ejaculation.

2. Anxiety

Anxiety is also one of the causes of this problem. Many men with this problem may have anxiety either specifically about sexual performance or related to other issues.

How to overcome premature ejaculation?

Ejaculation can be considered premature when it occurs 30 seconds to 4 minutes into sex. However, it seems that most tend to agree that any sexual intercourse lasting less than 2 minutes can be considered premature ejaculation. There are some ways to overcome premature ejaculation.

1. Behavioral techniques

Behavioral techniques can help you delay orgasm. It involves stimulating the penis and stopping just before you feel you are about to ejaculate. Stop this for 30-60 seconds and restart. Repeat this process up to 4-5 times unless you decide to delay orgasm. It also involves squeezing the penis in the area between the shaft and the glans before you are about to ejaculate.

2. Other tips

Use a thick condom to help decrease sensation. Take a deep breath. This can decrease anxiety and help you gain better control over your ejaculation. Have sex with your partner on top and take breaks during sex and distract your mind by thinking about something boring.

3. Medication

If these techniques are not helpful medications are recommended to treat this problem. These medicines are basically antidepressants. These pills may have side effects such as nausea, headache and delaying ejaculation.