Morning-after Pill Types Of Morning after Pills Use As A Birth

The morning-after pill, however, operates in a manner different from that of abortifacient pills such as RU-486.

1 Types of morning-after pills

Emergency hormonal contraception is available in two main forms; the original version is the combined or Yuzpe Regimen which uses large doses of both estrogen and progesterone taken as two doses at 12 hour intervals. This technique is believed to be approximately 75% effective when taken within 24 hours of unprotected intercourse. Examples of Yuzpe Regimen emergency contraceptive pills include Preven ( USA), Schering PC4 ( UK) and Tetragynon ( France). This regimen is known to be associated with severe side effects, especially nausea and vomiting, and has largely been superceded by the progesterone-only method. The progesterone-only method usually uses the progesterone levonorgestrel in a dose of 1.5 mgMg or mg or MG may stand for: machine gun Madagascar, ISO country code magnesium Mg MG the car company milligram mg megagram Mg or Ton Lists of two-letter combinations., either as two 750 microgramThe microgram (symbol g sometimes mcg is an SI unit of mass. It is defined as: 1 µg 10−9 kg 1/1,000,000 of a gram. See 1 E-9 kg for comparisons. nanogram << microgram << milligram SI derived units of mass. doses 12 hours apart, or more recently, as a single dose. This method is now known to be more effective (up to 95% if taken soon enough), safer and better tolerated than the Yupze method, and is available in the USA and CanadaCanada historically the Dominion of Canada is the second-largest, and northernmost, country in the world. It is a decentralized federation of 10 provinces and 3 territories, governed as a constitutional monarchy, and formed in 1867 through an act of Confe as Plan B, in the UK as Levonelle and in France as NorLevo.

Products such as Preven, Plan B and Levonelle are specifically designed and marketed as emergency contraceptive pills. It is also possible to obtain the same dosage of hormones, and therefore the same effect, by taking a number of normal birth control pills; see Yuzpe Regimen for some examples. Note: Preven is no longer in production as it is less effective and has more intense side effects than other emergency contraceptive pills.

2 Use as a birth control method

The morning-after pill cannot be recommended as the main means of birth control because of its strong side effects and relatively low reliability. It also does not protect against sexually transmitted diseases. However, it is used by some as a back-up when other means of contraception have failed—for example, if one has forgotten to take the Pill or when a condom is torn during sex.

An alternative to the morning-after pill is the intrauterine device which can be used up to 5 days (In some cases 7 days [1]) after unprotected intercourse.

3 Morning-after pills and abortion

For those who hold that pregnancy begins at implantation, the morning-after pill prevents pregnancy. Those who hold that pregnancy begins at conception classify this prevention of implantion as an abortion in cases where fertilization has already occurred. Medically, the morning-after pill is not classified as an abortifacient, since medically that term relates only to an established pregnancy where implantation has already occurred.

Emergency contraception's only proven mechanism is preventing ovulation. Other possible ways that the pills work are by preventing the released egg from being fertilized, or by preventing the implantation of the fertilized egg in the uterus, but these have not been shown scientifically or reliably. Theoretically, the predominant mechanism would vary according to the stage of the menstrual cycle.

The morning-after pill is somewhat controversial: opponents, often social or religious conservatives, object to it since it may prevent the implantation of an already fertilized egg, which they consider to be an abortion. Others hold that it is emergency contraception which reduces the number of unwanted pregnancies and surgical abortions, and is therefore beneficial. They have no moral objection to preventing the implantation of a fertilized egg.

The morning-after pill is not to be confused with RU-486, an actual abortifacient which ends a pregnancy by inducing a chemical abortion of an implanted embryo.

4 International availability

In January 2000, France decided to dispense morning-after pills in junior and high schools by school nurses without prescription, because of high rates of undesired pregnancies among teenaged girls; after strong opposition from the Catholic Church, and much debate around the fact the teenager could later suffer from the doubt of not knowing whether fertilization had occurred or not, the decision was overruled by a court in July 2000. The French parliament changed the relevant law in October 2000 and now school nurses are again able to dispense the drugs. The pill NorLevo is now available in France without prescription, without parent authorization and for free for teenagers under the age of 18 since the 9th of January 2002 to insure urgency contraception.

As of early 2001, women of age 16 and higher may obtain the morning-after pill in the United Kingdom without prescription. This was challenged by an anti-abortion group, but the High Court let the rule stand in April 2002.

In the United States, the American Medical Association issued a non-binding recommendation in 2000 that morning-after pills be available over the counter without prescription in the U.S. On December 16, 2003, an advisory committee to the Food and Drug Administration (FDA) recommended that the pill be made available over the counter. [2] The committee voted 23 to 4 that the drug should be sold over the counter and 27 to 0 that the drug could be safely sold as an over-the-counter medication. However, in May of 2004 the FDA went against this strong recommendation and prohibited over-the-counter sale. the FDA claimed that this was due to limited experimental data on the effects of such pills on girls under 16 years of age, but critics have accused the FDA of basing the decision on political pressure. [3]

The American retailer Wal-Mart announced in May 1999 that it would not sell morning-after pills in its 2,400 pharmacies; it fills prescriptions for regular birth control pills to be used as emergency contraceptives but does not stock Preven nor Plan B. Many smaller pharmacies in the United States have also followed suit.

At about the same time (May 2004) Canada's Health Minister announced that Plan B would soon become available from pharmacists in all provinces without a prescription, although it has yet to occur. It is currently available without a prescription in Québec, British Columbia and Saskatchewan. The new system would still require the person to buy the pills directly from the pharmacist.

Emergency contraception is available without prescription in Albania, Belgium, Denmark, Finland, Israel, Morocco, Norway, Portugal, South Africa, and Sweden.

5 External links

Planned Parenthood information on emergency contraception: http://www.plannedparenthood.org/ec/
Princeton website with information on emergency contraception: http://ec.princeton.edu
Information on morning-after-pill in Germany: http://www.profamilia.de/pille_danach_englisch.html

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