Just yesterday one of my patients asked me about the effectiveness of the morning-after pill in a woman like herself, who was overweight. I knew that obesity could be associated with a decrease in the effectiveness of the birth control pill and the morning-after pill, but I could not give her better information.
Recently, there were a few review articles showing that studies are limited. Let me give you some questions to ask your health care provider about this situation, especially since about 25% of women in the childbearing age group are considered to be obese based on their BMI:
- How effective is the birth control pill in overweight women?
- Being overweight, is there a pill that could be more effective?
- Could a vaginal ring or IUD be a better consideration?
- Is the risk of blood clots increased with the pill?
- Does bariatric surgery have any effects with the use of the pill?
I hope these questions will open the door for a good discussion so that the best medical treatment plan can be established.
The side effects of these treatments include nausea and vomiting along with irregular vaginal bleeding. Some patients will complain of breast tenderness, abdominal pain, dizziness, and headaches.
These types of emergency contraception have been used successfully when initiated up to 72 hours after intercourse. This was the findings with the initial studies. However, more recent findings indicate that they are still moderately effective when used up to 5 days after intercourse.
Lastly, we should mention the use of the copper IUD for emergency contraception. This has been used since 1976 (when inserted within 5 days after unprotected intercourse). One advantage of this treatment is that the IUD can be left in and serve as a long-term treatment for contraception. Sometimes this treatment may not be as easily available to the patient, and the placement of the IUD may not be easily accomplished in a patient who is young and has not had a baby before.
…..Let us get back to our discussion of emergency contraception. The research on emergency contraception began in the 1960s, and the first treatment protocols arrived in 1974.
…..The two most common protocols are the progesterone only pill (Plan B) and the estrogen and progesterone pills. Plan B consists of only one pill, and the second regime of estrogen and progesterone is a two-dose treatment 12 hours apart. Both of these treatments are available over-the-counter for women 17 or older. For women under 17, a prescription is necessary.
…..There is no clear reason for how the emergency contraception works. A few explanations have been promulgated:
- Inhibition or delay of ovulation
- Interference with sperm transport or penetration of the egg
- Thickening of cervical mucous
- Impairment of ovarian hormone production
…..Remember that emergency contraception is effective only before a pregnancy has occurred. If a pregnancy has already been established, studies have shown that the emergency contraception does not harm the developing fetus nor increase risks to the ongoing pregnancy.
…..To be continued!!!!!!
With the mornings crisp and clear, it is certain that fall is in full swing. As I have mentioned before, since my life has always revolved around the school year, this is my time for new projects. Our anti-aging/bio-identical hormone program is being updated, and the new treatment options are becoming available for our practice family. I promise to keep you informed.
Today I want to begin to update you on emergency contraception. This is a therapy to prevent pregnancy after unprotected or not totally protected intercourse. It is not an abortion, and it does not cause an abortion if you are already pregnant. Most people call this treatment the Morning After Pill or Plan B, but regrettably, these phrases are not known or used as much as they should be.
With half of all pregnancies unintended and 40% of these pregnancies ending in abortion, it is imperative that this treatment is more known. Women seeking this treatment are typically under 25, and the common indication is a broken condom, missed oral contraceptive pills, or a failure to use any birth control at all. It should not replace our normal contraceptive methods, but should be available and used when necessary to prevent an unintended pregnancy.