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The Morning-After Pill: Efficacy, Safety & Important Facts For Emergency Contraception

What is emergency contraception?

Used promptly, emergency contraception (ED) aims to prevent an unwanted pregnancy after unprotected or inadequately protected sexual intercourse. The term “emergency” emphasizes that this form of contraception must represent an occasional measure and not replace a regular contraceptive method. It is not, in fact, a pill that can be taken after each sexual relationship.

Hormonal EC is improperly called a “morning-after pill” or “Plan B”. It is a tablet to be taken as soon as possible, after a relationship to the risk of unwanted pregnancy and, in any case, no more than 72 or 120 hours depending on the hormonal formulations.

The hormonal EC does not protect against pregnancy, if other risky relationships occur during the same cycle and does not protect against sexually transmitted diseases.

The currently available methods are:

  • progestin-containing oral preparations containing levonorgestrel: the packs on sale contain 1 tablet of 1.5 mg to be taken in a single administration
  • oral preparations containing ulipristal acetate: the packs on sale contain 1 tablet of 30 mg to be taken in a single administration

the morning-after pill

Mode of use

Preparations for oral use must be taken as soon as possible. The effectiveness is maximum (95%) if they are taken in the first 24 hours, in which the effectiveness of the ulipristal is 3 times higher than that of levonorgestrel. Levonorgestrel-containing oral preparations should be taken within 72 hours of unprotected intercourse. Preparations containing ulipristal acetate must be taken within 120 hours of unprotected intercourse. It is necessary to use another contraceptive method of support (for example the condom) until the onset of menstruation and then return to using the usual one.

Precautions

  • If the intercourse took place in the hours or days preceding ovulation, levonorgestrel and ulipristal acetate prevent fertilization (the union of the spermatozoon with the egg).
  • If the relationship has taken place when the process leading to ovulation has already begun, levonorgestrel has no effect, while ulipristal acetate is able to postpone ovulation for a few days.
  • If the implantation process has already begun (even if recently) the drug is not effective.
  • For patients aged 18 or over, these drugs are not subject to medical prescription.
  • For patients under age, the medical prescription remains mandatory.

Side effects and drawbacks

  • Headache, asthenia and pelvic pain may be rarely seen
  • Hormonal EC cannot be used regularly or at short intervals

Contraindications

Levonorgestrel and ulipristal acetate in general are considered to be free of serious contraindications, since the time taken for taking them is very short.