woman's health

Morning-after pill: contraindications and side effects

Important introduction

It would be wrong, senseless and unreasonable to consider the morning-after pill as a habitual contraceptive model to remedy potential risk situations or continuous and repeated "accidents". Although the morning-after pill does not present particular contraindications of use, nor numerous side effects, it certainly does not mean that it can be used normally and lightly, nor even consider it a method of contraception of excellence (as, unfortunately, happens for many young women girls).

The contraindications and the side effects deriving from the emergency contraception are not particularly heavy, since the morning-after pill consists only of the levonorgestrel, progestin hormone: it seems, in fact, that the progestins (unlike estrogen) are not the main responsible neither of the side effects, nor of the contraindications of use. However, this does not mean that the woman must make appropriate use of it, without abusing it.

Contraindications for use

As anticipated, there are no particular contraindications for using the morning-after pill; however, emergency contraception is contraindicated in cases of proven or suspected pregnancy, not because it is harmful to the embryo, but because the use of the morning-after pill would be ineffective and would unnecessarily weigh down the liver. As repeatedly stated, after 72 hours of potentially at-risk sexual intercourse, emergency contraception would be useless, because the chances of a successful morning-after pill are very low. It has been shown, in fact, that levonorgestrel, at doses 20-30 times higher than the common estroprogestinica contraceptive pill, guarantees maximum effectiveness (99.5%) when taken within 12 hours immediately following unprotected sexual intercourse, and a 85% effectiveness within 24 hours. The longer the time interval between the sexual relationship at risk of pregnancy and the time of taking the morning-after pill, the more likely it is to have no effect.

Furthermore, emergency contraception does not provide contraindications neither for breast-feeding women nor for extrauterine ectopic pregnancy. The morning-after pill is not contraindicated even for smokers, for women who suffer from hypertension, cardiovascular diseases, angina pectoris, breast cancer, diabetes, high cholesterol, thyroid dysfunction, endometriosis, uterine fibroids or migraine: all another, it seems that the benefits that come from using the morning-after pill far outweigh any risks. Despite what has been said, this should not be an expedient for an excessive use of the post-coital pill.

Much attention must be paid in case of concomitant intake of the morning-after pill with particular medicinal specialties, as these could reduce or even cancel the post-coital contraceptive efficacy: consequently, the administration of NorLevo® or Levonelle® is contraindicated (commercial name of the morning-after pill) along with anticonvulsant, antibiotic or antiepileptic drugs.

In this regard, it is always necessary to inform the doctor.

Contraindications pill the day after

  • It does not present particular contraindications, given the absence of estrogens in the pharmaceutical formulation
  • It is contraindicated in cases of proven or suspected pregnancy
  • The use of the post-coital contraceptive pill is contraindicated in the case of concomitant use with particular medicinal specialties such as: anticonvulsant drugs, antibiotics or antiepileptics

Side effects

Although the side effects derived from the administration of the morning-after pill are almost minimal, these could still occur especially in particularly sensitive women.

Among the most famous possible side effects are acne, headache, weakness, nausea and, more infrequently, vomiting. When vomiting occurs in the 2 hours immediately following the administration of the morning-after pill, the woman should take another tablet, without allowing too much time. However, statistics reveal that vomiting is a rather sporadic condition.

The morning-after pill could generate side effects in subsequent menstrual cycles:

  1. More abundant menstrual flow (hypermenorrhea)
  2. Menses in advance (polymenorrhea)
  3. Intermenstrual spotting
  4. Whites

No effects of acute toxicity were recorded following the administration of more pills the following day.

Morning-after pill: side effects

  • Acne, headache, weakness, nausea (most known side effects)
  • Vomiting (sporadic side effect)
  • In case of vomiting before 2 hours from the first administration: take another tablet
  • More abundant menstrual flow (hypermenorrhea)
  • Menses in advance (polymenorrhea)
  • Intermenstrual spotting
  • Whites
  • Liver toxicity (following frequent use of the morning-after pill)

Liver toxicity

The morning-after pill should not be used inappropriately or frequently: if, on the one hand, the administration of more tablets does not generate acute toxicity, on the other hand it could favor chronic liver intoxication.

The liver is a gland responsible for detoxifying the body from waste and harmful substances (not surprisingly, it is one of the organs most prone to damage): the morning-after pill, as indeed most drugs do, provides hepatic metabolism. It is clear that, when repeatedly used, the morning-after pill may require excessive metabolic effort on the part of the liver, thus causing severe chronic liver toxicity.

Morning after pill and venereal diseases

As with all hormonal contraceptive methods (trans vaginal ring, estroprogestinic pill, hormonal spiral, transdermal patch), even emergency contraception does not protect against sexually transmitted diseases (AIDS / HIV, vaginal herpes, Candida albicans etc.). The only contraceptive method that protects against the transmission of venereal diseases is a condom.

In conclusion, it is right to reiterate that the morning-after pill should not be considered a routine contraceptive model: despite the few contraindications of use, and the relatively modest side effects that follow, emergency contraception can and should be used only in absolutely occasional and unexpected situations.