Morning-after pill: mechanism of action, efficacy, side effects

Morning after pill

The drug known as the “morning-after pill” is actually an emergency contraceptive system, i.e. a product to be taken after complete and unprotected (or in any case not sufficiently protected) sexual intercourse and in the absence of the application of other contraceptive methods. It can also be advised in the event that routine contraceptive systems have proved ineffective, with the intention of avoiding the risk of unwanted pregnancy.

This is obviously a method intended for occasional use, and should in no way be interpreted as a system of habitual contraception. To be effective, the morning after pill must be taken, depending on the product used, in the period between 12 and 120 hours after unprotected sexual intercourse and, as can be easily understood, although it can work as a contraceptive, it offers no protection against sexually transmitted infections and diseases.

On the market there are several pharmaceutical products that perform this function, whose mechanism of action consists in the presence of active ingredients that modify the times of ovulation by intervening on a hormonal level and, consequently, avoiding fertilization.

What is the mechanism of action of the morning after pill

The action of this type of drug varies in relation to the active ingredient contained and the period of time that has already elapsed after sexual intercourse: progestogen-based products, to be effective, should be taken within 12 hours, and in any case no later than 72 hours.

The effect of progestin hormonal preparations, also present in traditional contraceptive pills, is to inhibit the maturation of the egg, blocking the production of luteinizing hormone.

There are also other emergency contraceptives based on substances that interact with progesterone receptors: the mechanism of action is always and in any case that of delaying ovulation, so that it occurs when the spermatozoa have now lost their vital charge . This type of pill can also be useful up to 120 hours after the risky intercourse, for this reason it is also called the “five days after pill”.

Are morning after pills really effective?

There are no contraceptive systems, routine or emergency, which are 100% effective. For both of the aforementioned formulas, the action of this drug is linked to the speed with which it is taken: within 12 hours of intercourse the chances that the contraceptive effect is successful are much higher. Typically, the percentage ranges from 50-55% to 85-90%.

However, one important element must be taken into account: the morning after pills can only work in the phase of the cycle that precedes ovulation, i.e. when a woman is most fertile.

Otherwise, if unprotected sexual intercourse takes place during ovulation or even when the ovum is already implanted in the uterus, these drugs are unable to offer any efficacy: in this case, and if one wishes to avoid pregnancy, it becomes It is necessary to immediately contact a consultant or your trusted gynecologist.

In which cases and situations is the morning after pill recommended?

The use of the morning-after pill is recommended when there is a suspicion that fertilization could take place following sexual intercourse. The most frequent cases concern the non-observance of natural contraceptive methods or an error in calculating the fertile days, the condom breaking or coming out, forgetting to regularly take the contraceptive pill or the transdermal patch coming off.

Often this type of drug is also administered to women who are victims of sexual abuse and violence.

What are the side effects and contraindications

Since it is essentially a relatively large dose of hormones, the emergency contraceptive pill can lead to some side effects, even if they are rather mild disorders, which tend to resolve spontaneously.

The most frequent are headache, nausea, stomach ache and breast pain, as well as menstrual cycle imbalances, which can be delayed or very heavy periods. Therefore, it is not a question of particularly serious ailments, but of a simple annoyance that resolves itself, however, if significant or otherwise unknown symptoms occur, it is recommended to immediately consult your doctor or gynecologist, or to go to an emergency room. .

The situations in which the morning-after pill is not indicated primarily concern cases of allergy, intolerance or sensitization towards the active ingredients or one of the excipients present in the drug formula. The product is also contraindicated for girls who have not yet had their first menstrual cycle .

Women taking other hormonal preparations, who are following any kind of drug therapy or who are breastfeeding, should consult their gynecologist or doctor before resorting to the morning-after pill.

Information and misinformation about the morning-after pill

Post coital contraceptives can be purchased without a prescription by both adult and minor women, however it is mainly younger women who consider their possible use.

Unfortunately, scarce and imprecise information circulates regarding this drug, such as to have on the one hand generated the fear in many women that it is a product potentially harmful to health, and on the other the idea that it can be used as a method of habitual contraception, to be taken after each intercourse, allowing to avoid the other protections.

To avoid misinformation and, consequently, incorrect use of the drug, it is important that every woman, before using it, contact a consultant or her own gynecologist or personal doctor.

The morning-after pill is in fact to be considered a valid tool for emergency contraception, effective up to about five days after intercourse, and represents an aid above all for young women who find themselves having to face the risk of an unsuccessful pregnancy. expected.

However, it is equally important to understand the exceptional nature of this type of contraception, plan your pregnancy with the correct contraceptive method and always use protection during sexual intercourse.

The extraordinary use of the morning-after pill above all allows girls to avoid the practice of abortion which, in addition to being much more invasive, is always a traumatic experience.

Does the morning after pill cause a miscarriage?

Even today, many women are rather skeptical about the use of the emergency contraceptive pill, mistakenly believing that it is an abortifacient drug.

Also in this case this is completely incorrect information, since this type of product can inhibit ovulation but does not cause any effect during a pregnancy.

In reality, the drug is confused with the abortion pill RU-486, completely different both as an active ingredient and as a mechanism of action and method of administration, whose function is precisely that of pharmacological abortion, i.e. to interrupt a pregnancy already in place.

Katherine Johnson, M.D., is a board-certified obstetrician-gynecologist with clinical expertise in general obstetrics and gynecology, family planning, women’s health, and gynecology.

She is affiliated with the Obstetrics and Gynecology division at an undisclosed healthcare institution and the online platform,

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