What to expect during your consultation for emergency contraceptives

Sometimes, accidents can happen no matter how safe we are, and that’s alright. There’s no need to panic! This is where emergency contraceptives, like the morning-after pill, can feel like a lifesaver.

We know the moments when you may need emergency contraceptives can be a little anxiety-inducing, especially since access to information and resources is sometimes limited. Please don't fret, we’re here to make the process easier.

Firstly, one must recognize that the only form of emergency contraception is the ‘morning after pill’ and it is not to be confused with the birth control pill. Here’s a short guide on what you can expect when consulting a doctor for emergency contraceptives; as well as possible questions that you may have about the morning-after pill if you don’t have the chance to ask your friendly GP during the consultation.

DURING THE CONSULTATION: QUESTIONS YOUR DOCTOR MAY ASK YOU

Your doctor may have to ask you a few questions about your lifestyle and medical history before they are able to prescribe you the morning-after pill. Common questions asked would be around the topics of:

• The date of your last period and when you had unprotected sexual intercourse

• If you have any trouble with your period (such as heavy flow or bad menstrual cramps)

• Diagnosis of chronic health conditions and/or are taking any other types of medication

• History of smoking

This would help them assess your suitability for the morning-after pill, as well as determine which type they should prescribe you.

TYPES OF EMERGENCY CONTRACEPTIVES

In Malaysia, there are three main types of emergency contraceptives that you’ll be prescribed.

Ulipristal acetate (also known as Ella)

• Recommended to be taken within 24 hours of unprotected sex, but can be effective for up to 120 hours after unprotected sex

• Lowers your chances of pregnancy by 98% throughout this period

Levonorgestrel (also known as Postinor-2)

• Recommended to be taken within 24 hours of unprotected sex, but can be effective for up to 72 hours

• Lowers your chances of pregnancy by up to 95% if within 24 hours; 85% if taken between 24 – 48 hours; or 58% if taken 48 – 72 hours

• Mood changes

HOW TO TAKE THE MORNING-AFTER PILL

Ideally, you should take the morning-after pill as soon as possible after unprotected sex has occurred. This maximizes the effectiveness of the pill and reduces the risk of an unwanted pregnancy from happening.

The emergency contraceptive is a concentrated dose of the regular monthly birth control pill. Depending on the brand, you may have to take them at different frequencies:

• Ulipristal acetate: you will only need to take one pill for the full dose

• Levonorgestrel: you will need to take two pills for the full dose

YOUR QUESTIONS ON EMERGENCY CONTRACEPTIVES: ANSWERED

During the doctor’s consultation, you should feel comfortable asking any questions about your prescription. However, if some questions have slipped your mind, here’s a list of common queries about the morning-after pill.

Is the emergency contraceptive an abortion pill?

No, the emergency contraceptive prevents pregnancy from taking place. This is through preventing or delaying the release of the egg (ovulation), hence preventing any sperm from fertilizing an egg, or preventing a fertilized egg from implanting itself in the uterine lining. If ovulation has already taken place, no emergency contraceptive pill will be effective.

If you are pregnant when you are taking an emergency contraceptive, there is no evidence that the morning-after pill will terminate or interrupt an existing pregnancy. You can do a pregnancy test before taking the emergency contraceptive if you’re unsure; and you should let your doctor know if you do become pregnant, after taking the morning-after pill.

What are the possible side effects of the morning-after pill?

The most common side effects are nausea and vomiting. Other side effects may include:

• Headache

• Dizziness

• Tiredness

• Breast tenderness

• Lower abdominal pain

• Mood changes

In some cases, emergency contraception can also lead to an irregular menstrual cycle. If these side effects persist for a prolonged period of time, do speak to your doctor for a more thorough check-up.

How effective is the emergency contraceptive pill?

The pill can be effective up to 98%, depending on which brand and when you take it — the earlier, the better. Depending on the brand, it can be effective between 3 – 5 days.

Can I take emergency contraceptives more than once in the same cycle?

Although there are technically no restrictions on how often you can consume the morning-after pill, a woman is generally not advised to take it more than once during the same menstrual cycle.

This is because the pill can create a disturbance to your cycle. As such, it is not recommended that you rely on the emergency contraceptive pill as your regular form of birth control. As its name suggests, it should only be used as a backup, in the event of an emergency.

Can emergency contraception protect me from sexually transmitted diseases (STDs)?

No, the emergency contraceptive pill is not designed for that. The only way to protect yourself from STDs is to wear a condom properly during sexual intercourse.

WHERE TO GET EMERGENCY CONTRACEPTION?

Here's how you can get emergency contraception in Malaysia:

1. Speak to a friendly GP anytime on the Doctor Anywhere app, from the comfort of your home; and receive your pills delivered to your doorstep within hours.

2. Make an appointment to see a doctor at a clinic or private hospital (emergency contraception is not available in government hospitals)

3. You may purchase them over the counter at a pharmacy.

An emergency pill typically contains hormones and is considered a Group C poison, therefore you would be required to get a doctor to prescribe them or register your purchase at your local pharmacy.

What’s most important is to speak to a healthcare professional before starting any type of birth control or emergency contraception. They would best be able to guide you on what is most suitable for you, and if there are any serious risks or side effects you need to be aware of, before consumption.

Here are some key points to note:

• If you have never used EC before or are unsure of whether it suits you, it is best to seek professional advice.

• It should never be a choice of contraception for regular use.

• EC is not the same as abortion, and will not terminate an existing pregnancy. Have questions about emergency contraception?

Finally, remember that emergency contraception is a vital part of sexual and reproductive health care. In addition to being an effective method of contraception, it can also help to prevent unwanted pregnancies and abortions. Your healthcare provider is always the best source of reference when unsure about anything.