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17. Emergency Contraception
Hi guys I am back with another video , in this video we will talk about the emergency contraceptive .
Now what is emergency contraceptive?
Emergency contraceptive is the contraception which is given within 72 hours of unprotected intercourse .
Implantation of the embryo takes places within the 6th day after intercourse . So abortion is not preferred in this case because it is too early . Abortion is not a method of emergency contraception .
Now let us talk about the most proffered drug , most preferred drug is levonorgestrel which contains progesterone and the brand name is I pill. This is the drug of choice . It has the least side effects and it can be taken as a single pill which does not interfere with the menstrual cycle . The dosage is 0.75 * 2 tablets . One if taken right now will be taken after 12 hours. Now let us understand the mechanism of action of these drugs: patient is having intercourse on day 11 and the patient comes to you on day 12. The sperm can live upto day 14, so you give progesterone and there will be less secretion of LH. So if there is a less secretion of LH, there will be less secretion and there will be no pregnancy . If the patient comes on day 14 after intercourse the embryo is already formed . So what happens in this case that the progesterone is given and after the progesterone is given, the endometrium becomes so fluffy and it gets out of the phase , it prevents the embryo from getting implanted into the uterus . Now the most important thing is thickening of cervical mucus. This cannot be used , the Sperms have already crossed the cervix after intercourse .
Now, let us come to know about the other options of emergency contraceptives: The first one is Yuzpe regimen , A 50 mcg estradiol is used , 2 pills are given in the morning , another 2 pills are given after 12 hours , Mechanism Of Action : it reduces ovulation , it reduces the chances of implantation by altering the endometrium, side effect is vomiting .
The second one is mifepristone or anti progestin . This is anti progestin , the mode of action is it reduces implantation , it doesn’t affect the ovulation , the dosage is 10 to 50 mg for emergency contraception
The third one is Centchroman Saheli . This is a SERM (Selective Estrogen Receptor Modulator ) , dosage is 60 mg 2 tablets , tablet is taken twice in 24 hours , it prevents pregnancy upto 99 percent of the cases.
The fourth one is ulipristal acetate It is a selective progesterone receptor modulator
The dosage is 30 mg one tablet, the brand name is ELLA , better than levonorgestrel , delays or suppresses ovulation , reduces implantation , but it is not the drug of choice of emergency contraception as in India it’s not approved.
The fifth one is intrauterine contraceptive device which is IUCD , it reduces implantation , it is useful upto 5 days , it is uniformly effective upto 5. Days .
We need to remember both of these information :
The dose of mifepristone for abortion is 100 to 600 mg .
IUCD is the most effective method for dealing with emergency contraception but it is not preferred . The criteria for the DOC are : available all over the counters , prescription isn’t required, easy to use .
This is all about this topic , see you again , thank you !
