Reports of women becoming serial users of the emergency contraceptive pill have raised questions about the effects on their health and long-term fertility.
For the past 17 years the morning-after pill has brought relief to millions of women whose regular contraception has failed, or who have had unprotected sex they regret or against their will. But pharmacists report that a growing number of women are using it multiple times, treating it casually as a back-to front “contraception method” after having unprotected sex.
“Many women use it more than they should,” says Clicks pharmacist Waheed Abdurahman. One young woman in the UK is on record as using it 60 times over five years. “I’m on the contraceptive pill but I’m just really bad at remembering,” she told The Daily Mail. “I know I can just nip to the chemist and get the morning-after pill, so it’s not a problem.”
How safe is the morning-after pill, and how often can you use it?
It’s intended only as back-up contraception for use in emergencies, says Abdurahman. It contains doses of hormones that prevent pregnancy by preventing or delaying ovulation, fertilisation, or implantation of the fertilised egg in the uterus, depending where you are in your menstrual cycle. And it must be taken within 72 hours of sex – the sooner the better.
It is entirely different to the abortion pill, RU-486, which is designed to terminate an established pregnancy, where the fertilised egg has implanted and begun to develop. Morning-after pills sold in South Africa contain levonorgestrel (marketed as Norlevo, Escapelle or Plan B), and can have side effects, though these are uncommon and usually short-lived, Abdurahman says. They include nausea, headaches, tiredness, dizziness, breast tenderness, lower abdominal pain and unexpected bleeding. In a study published in The Lancet, 20% of women reported headaches,13-14% painful periods, and 11-12% nausea.
Olga van den Akker, Professor of Health Psychology at Middlesex University in the UK, suggests that in theory, prolonged frequent use of levonorgestrel might affect fertility, as it interferes with the body’s menstrual cycle.
But the US Association of Reproductive Health Professionals says the morning-after pill has no long-term or serious side effects. It claims: “You can safely use the morning-after pill even if your healthcare provider recommends against using the birth control pills (usually because you are at risk of cardiovascular problems)”.
The World Health Organisation says there is no medical condition where the risks of morning-after pills outweigh their benefits as emergency contraception, and that “drugs used for emergency contraception do not harm future fertility. There is no delay in the return to fertility after taking them.”
There are no official guidelines on how often the morning-after pill can be taken, but pharmacists advise they be used as little as possible. “If there’s a need for regular use, rather start on a regular contraceptive,” says Abdurahman. He notes that there is no evidence of detrimental effects on long-term health, but that morning-after pills are less effective than regular methods of contraception, and cost more.
Morning-after pills prevent pregnancy 85-89% of the time, while the efficacy of implants is 99.9%, injectables 99.8%, vaginal rings 99.3%, patches 99%, IUDs 99%, birth control pills 91-99%, and condoms 98% (male condoms) and 95% (female condoms). Condoms also protect against STIs.
For advice, talk to your Clicks pharmacist or Clicks clinic nurse.
To make a booking at your nearest Clicks clinic, call 0860 254 257 or book an appointment online.
ARTICLE IMAGE CREDIT: Getty Images
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