Next Day Pill

What is the morning-after pill?

The morning-after pill is a progestin-based pharmaceutical preparation useful in emergency contraception: this can be taken following a sexual relationship potentially at risk of pregnancy.

The woman, after a non-repeatable medical prescription, can take the morning-after pill no later than 72 hours immediately following unprotected sexual intercourse.

Before proceeding with the disquisition, it should be pointed out that the morning-after pill is not an abortive method, since it has no effect on the embryo implantation and does not prevent the sperm from entering the egg. Therefore, the abortion pill (known as RU-486) has nothing to do with the morning-after pill: the latter does not interrupt the pregnancy, but prevents it, consequently, it cannot be considered abortive.

Pharmaceutical composition

The morning-after pill can only be used as an emergency contraceptive method, so it should not be confused with the estroprogestinica contraceptive pill.

There are two different types of morning-after pill, which differ substantially in the hormonal composition:

Levonorgestrel, hormonal composition of excellence for the morning-after pill. It is a progestin used at high doses: the pack contains two pills, each 0.75 milligrams: the first pill should be taken as soon as possible, the other after 12 hours. To remedy a possible forgetfulness, it is generally recommended to administer the two pills at the same time. In Italy, this morning-after pill is known as NorLevo® or Levonelle®.
Levonorgestrel is a progestin-based active ingredient that is found in many birth control pills, often associated with estrogen: in the specific case of the morning-after pill, the dosage of Levonorgestrel is approximately 20/30 times higher than common contraceptive pills.
Yuzpe method (named after the Canadian inventor): released on the market in 1974, the very high dose of estrogens and progestins in a double dose at 12 hours of interval guarantees a relatively effective emergency contraception (100 micrograms of ethinyl estradiol in association with 0.5 milligrams of levonorgestrel per dose). This morning-after pill is almost no longer in use, given its low reliability and effectiveness, and the more serious side effects compared to the Levonorgestrel-based morning-after pill.

Even the copper IUD spiral can be considered an emergency contraceptive method, when inserted into the uterus no later than 7 days after a risky sexual relationship.

Action mechanism

The operation of the morning-after pill is not at all simple, far from it: the mechanism of action appears rather complex and articulated. First of all, the morning-after pill is able to stop ovulation, in case it has not yet occurred. Secondly, the emergency contraceptive is able to hinder the passage of the spermatozoa towards the uterus and the tubes, and altering their functionality. Last but certainly not least, the morning-after pill prevents the fertilization of an already released egg: in similar situations, the meeting between the spermatozoon and the egg cell is denied.

Once again. it is right to point out that this is not an abortion pill, given the ineffectiveness of the morning-after pill, following the implantation of the zygote.

However, once the morning after pill is taken too late (therefore, after 72 hours from the risk ratio), this does not in any way hinder the growth and correct development of the embryo ; not only that, being a progestin, Levonorgestrel does not generate any type of embryo malformation.

Safety and effectiveness

The effectiveness of post-coital contraception is directly proportional to the timeliness with which it is administered following a potentially risky sexual relationship.

Let's see the data that emerge from the statistics:

maximum effectiveness of the morning-after pill (99.5%) if it is taken within 12 hours immediately following the unprotected sex
85% effectiveness, after 24 hours
when the woman lets more than 24 hours pass (with a maximum of 72) following the consumption of a risky relationship, the guarantee of preventing pregnancy, given by emergency contraception, drastically drops to 58% (after 3 hours days)

Therefore, for the prescription of the morning-after pill, it is advisable to consult a doctor or a consultation center as soon as possible: in this way, urgent contraception guarantees a successful outcome.

Contraindications

First of all, it should be pointed out that emergency contraception should not be exploited lightly: the morning-after pill cannot and should not be used whenever a risk of pregnancy is suspected. The dose of administration of Levonorgestrel is particularly high, consequently the repeated use of the drug could overload the hepatic metabolism, increasing the risk of poisoning the liver.

Ideally, all sexually mature women could resort to the morning-after pill in the event of a potentially risky relationship.

Relationship to risk of pregnancy

There is talk of a sexual relationship at risk of pregnancy when a woman suspects that the relationship has potentially established fertilization: typical post-relationship fear is represented by the failure of natural contraceptive methods (interrupted coitus, Ogino-Knaus method, thermo-thermal method, Billings method, etc.). ) ... also the accidental breakage of the condom, the non-observance of the correct frequency of taking the estroprogestinica pill, the detachment of the transdermal contraceptive patch (not worrying about applying a new one) and an error in calculating the potentially not fertile days.

Violence and sexual abuse can also generate unexpected pregnancies, as well as causing the possible transmission of sexually transmitted diseases (eg HIV / AIDS, etc.).

In all these cases, the woman could use the morning-after pill.