So, as you may have heard, the morning-after pill is available as of today, over the counter, to the collective cheers of triumph of the pro-choicers and groans of despair of the pro-lifers.
Does this mean that an era of unbridled orgies can commence, with scant regard for any consequences? Erm, no. Here are some things you need to know about the morning-after pill before you race to the chemist to book your year’s supply.
1. There’s 2 of them
There are two types of morning after pills available, and both are incorrectly named, since they can be used beyond the “morning after” time period. These are pills containing levonogestrel (Levonelle®) and pills containing ullipristal acetate (ellaOne®).
Levonelle® should be taken within 72 hours of unprotected sexual intercourse (the apt acronym is UPSI), whereas ellaOne® can be taken up to 120 hours after UPSI. That’s a pretty long morning…
2. Can anyone take it?
Almost. Many comments board experts were horrified to learn that it would be available over the counter, claiming that its many contraindications and side effects would massacre thousands. The truth is, it’s a very safe drug, with very few side-effects.
It may cause your period regularity to go a bit wonky and women with serious liver problems should probably check with their doctor before taking it. Men should probably not take it either, since that’s about 35 Euro down the drain. Other than that, its main problem is that it may not actually work
3. What do you mean? It’s 100% effective, right?!
Wrong. No contraceptive method is 100% effective, and the morning-after pill is actually not a particularly good contraceptive when compared to other methods. Levonelle® is anything from 52-94% effective at preventing pregnancy, whereas ellaOne® has been quoted as being up to 98% effective (if taken up to 72 hours post-UPSI…just love that acronym).
Which means that anything from 2 to 48 times out of a hundred, the morning-after pill just won’t work. Also, in ladies who are overweight, the morning-after pill may be less likely to work. If you vomit straight after taking it, then it might not work either. If you’re on some types of medication, that may decrease its efficacy too.
4. So why shouldn’t I use it as a regular contraceptive?
There are many reasons why you shouldn’t. As we’ve said, it may mess up your cycle (for a short while, don’t panic). Also, it’s not the best contraceptive there is when it comes to efficacy at preventing pregnancy. It provides no protection at all against sexually transmitted infections.
It’s bloody expensive, when compared to other methods of contraception. It’s only effective at the time of taking, so basically if you have an UPSI, take the pill, then have another UPSI in one or two days, you’ll probably have to take it again. And if you’re on another type of contraceptive pill, then the morning-after pill might mess that up for you, and you have to use other methods of contraception (like condoms) for about a week after taking it. Need any more reasons?
5. So why is it available if not for regular use?
The morning-after pill is a form of emergency contraception. It is meant to be taken by people who are in need of contraception following an UPSI, either because they weren’t on another type of contraceptive, or because they had a contraceptive failure (torn condom, missed pill kind of thing).
Ok, so what can I use as regular contraception?
These are the options easily available in Malta:
Condoms: the only real protection against infections, including HIV, hepatitis and HPV which causes cancer of the cervix. All these can kill you.
Combined oral contraceptive: Take a pill every day, with or without a break depending on the brand. Should be avoided by older women who smoke, obese women and women who suffer from migraines or have had a thrombosis.
Vaginal ring: Same as the combined pill, except you insert a small plastic ring in your vagina for three weeks and remove for one week.
Progesterone only pill: Recently introduced in Malta (but has been around for ages elsewhere), it is taken daily and has fewer contraindications than the combined pill.
Intra-uterine system: Commonly known as “the coil”. The ones commonly available in Malta are hormonal ones, which last for 3 or 5 years. They sit inside the uterus and provide very good contraception. Their main advantage is the fact that they require zero input on a day to day basis, making them relatively foolproof (although not infallible).
This article is not meant in any way to be a substitute for advice from your doctor, but rather just aims to clear up some possible misconceptions. When in doubt, always seek advice from a pharmacist, family doctor or gynaecologist. (The Salott is neither of the above.)