HEALTH / Common Procedures: Emergency contraception (CORRECTED)

CORRECTION (PUBLISHED 17 JANUARY 1993) APPENDED TO THIS ARTICLE

WHEN a couple first have sex, they are quite likely not to have planned to do so, and may not have used any sort of contraception. Condoms split or come off; women forget to take oral contraceptives. For all sorts of reasons a couple may wake up one morning wondering whether the woman might have become pregnant as a result of sex the previous night. But the outcome does not have to be left to chance.

Treatment with a 'morning-after pill' first came into use in the late 1960s, when it was shown that if large doses of oestrogen were given within 92 hours of unprotected sexual intercourse, pregnancy was usually prevented. The treatment was given for several days and almost invariably made the woman feel sick and vomit. A few years later the Yuzpe method was introduced; this was treatment with a combination of two hormones, an oestrogen and a progestogen. Two doses were given 12 hours apart. Around half the women treated felt sick and a quarter vomited, but the success rate was estimated to be close to 99 per cent.

A newer hormone treatment is now being given in Britain, using the hormone antagonist mifepristone (RU 486), first developed as a medical treatment to induce abortion. Two research studies recently published (one from Edinburgh in the New England Journal of Medicine and one from Manchester in the British Medical Journal) have compared mifepristone with the old Yuzpe method. In both studies the treatment with mifepristone was 100 per cent successful, whereas the Yuzpe method had a few failures - four out of 398 women in Edinburgh and five out of 191 in Manchester. Both drugs caused some side-effects, but fewer women felt sick or vomited while taking mifepristone. Women given the Yuzpe treatment usually knew it had worked because they had some menstrual bleeding within a few days. But in those given mifepristone, the next menstrual period was sometimes delayed, and three became pregnant a couple of weeks after their treatment, having mistakenly believed that it had failed.

Even using mifepristone, postcoital contraception is a clumsy technique with substantial drawbacks, and it should not be used repeatedly. The risks to health of repeated use of high doses of oestrogen are well known - the hormone may cause blood clotting in the veins and arteries - and furthermore the Yuzpe method is not always effective. No one really knows the effects of repeated use of mifepristone, but current thinking is against it. Another possible treatment that is sometimes used is the insertion into the uterus of an intrauterine contraceptive device; this is virtually 100 per cent effective as emergency contraception and also provides continuing protection, but it is not usually recommended for young women who have not had children.

The final reason for discouraging women from psychological reliance on postcoital contraception is that there is no equivalent postcoital method of preventing infection with sexually transmitted virus diseases such as HIV infection (though a woman who has been raped can be protected against some sexually transmitted bacterial diseases by treatment with antibiotics). Safe sex is safe in terms both of contraception and infection.

CORRECTION

The morning-after pill needs to be taken within 72 hours (three days) of intercourse and not 92. The new hormone treatment mifepristone (RU486) is licensed in this country as an alternative method of abortion; it is still only at trial stage as an emergency contraceptive.

Arts and Entertainment
Lionel Richie performs live on the Pyramid stage during the third day of Glastonbury Festival

music
Arts and Entertainment
Buying a stairway to Hubbard: the Scientology centre in Los Angeles
film review Chilling inside views on a secretive church
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment

ebooksNow available in paperback
Arts and Entertainment

ebooks
Arts and Entertainment
Jason Williamson, left, and Andrew Fearn of Sleaford Mods
musicYou are nobody in public life until you have been soundly insulted by Sleaford Mods
Arts and Entertainment
Natalie Dew (Jess) in Bend It Like Beckham The Musical
theatreReview: Bend It Like Beckham hits back of the net on opening night
Arts and Entertainment
The young sea-faring Charles Darwin – seen here in an 1809 portrait – is to be portrayed as an Indiana Jones-style adventurer
film
Arts and Entertainment
The audience aimed thousands of Apple’s product units at Taylor Swift throughout the show
musicReview: On stage her manner is natural, her command of space masterful
Arts and Entertainment
Channel 4 is reviving its Chris Evans-hosted Nineties hit TFI Friday

TV
Arts and Entertainment
Harrison Ford plays Indiana Jones in The Last Crusade (1989)

film
Arts and Entertainment

music
Arts and Entertainment
A Glastonbury reveller hides under an umbrella at the festival last year

Glastonbury
Arts and Entertainment

music
Arts and Entertainment
Miles Morales is to replace Peter Parker as the new Spider-Man

comics
Arts and Entertainment
The sequel to 1993's Jurassic Park, Jurassic World, has stormed into the global record books to score the highest worldwide opening weekend in history.

film
Arts and Entertainment
Odi (Will Tudor)
tvReview: Humans, episode 2
Arts and Entertainment
Can't cope with a Port-A-loo? We've got the solution for you

FestivalsFive ways to avoid the portable toilets

Arts and Entertainment
Some zookeepers have been braver than others in the #jurassiczoo trend

Jurassic WorldThe results are completely brilliant

Arts and Entertainment
An original Miffy illustration
art
Arts and Entertainment
Man of mystery: Ian McKellen as an ageing Sherlock Holmes
film review
Arts and Entertainment
Kitchen set: Yvette Fielding, Patricia Potter, Chesney Hawkes, Sarah Harding and Sheree Murphy
TV review
Arts and Entertainment
Chris Evans has been confirmed as the new host of Top Gear
TV
Arts and Entertainment
Top of the class: Iggy Azalea and the catchy ‘Fancy’
music
Arts and Entertainment
Dave Grohl of the Foo Fighters performs at Suncorp Stadium on February 24, 2015 in Brisbane, Australia.

music
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    How to stop an asteroid hitting Earth: Would people co-operate to face down a global peril?

    How to stop an asteroid hitting Earth

    Would people cooperate to face a global peril?
    Just one day to find €1.6bn: Greece edges nearer euro exit

    One day to find €1.6bn

    Greece is edging inexorably towards an exit from the euro
    New 'Iron Man' augmented reality technology could help surgeons and firefighters, say scientists

    'Iron Man' augmented reality technology could become reality

    Holographic projections would provide extra information on objects in a person's visual field in real time
    Sugary drinks 'are killing 184,000 adults around the world every year'

    Sugary drinks are killing 184,000 adults around the world every year

    The drinks that should be eliminated from people's diets
    Pride of Place: Historians map out untold LGBT histories of locations throughout UK

    Historians map out untold LGBT histories

    Public are being asked to help improve the map
    Lionel, Patti, Burt and The Who rock Glasto

    Lionel, Patti, Burt and The Who rock Glasto

    This was the year of 24-carat Golden Oldies
    Paris Fashion Week

    Paris Fashion Week

    Thom Browne's scarecrows offer a rare beacon in commercial offerings
    A year of the caliphate:

    Isis, a year of the caliphate

    Who can defeat the so-called 'Islamic State' – and how?
    Marks and Spencer: Can a new team of designers put the spark back into the high-street brand?

    Marks and Spencer

    Can a new team of designers put the spark back into the high-street brand?
    'We haven't invaded France': Italy's Prime Minister 'reclaims' Europe's highest peak

    'We haven't invaded France'

    Italy's Prime Minister 'reclaims' Europe's highest peak
    Isis in Kobani: Why we ignore the worst of the massacres

    Why do we ignore the worst of the massacres?

    The West’s determination not to offend its Sunni allies helps Isis and puts us all at risk, says Patrick Cockburn
    7/7 bombings 10 years on: Four emergency workers who saved lives recall the shocking day that 52 people were killed

    Remembering 7/7 ten years on

    Four emergency workers recall their memories of that day – and reveal how it's affected them ever since
    Humans: Are the scientists developing robots in danger of replicating the hit Channel 4 drama?

    They’re here to help

    We want robots to do our drudge work, and to look enough like us for comfort. But are the scientists developing artificial intelligence in danger of replicating the TV drama Humans?
    Time to lay these myths about the Deep South to rest

    Time to lay these myths about the Deep South to rest

    'Heritage' is a loaded word in the Dixie, but the Charleston killings show how dangerous it is to cling to a deadly past, says Rupert Cornwell
    What exactly does 'one' mean? Court of Appeal passes judgement on thorny mathematical issue

    What exactly does 'one' mean?

    Court of Appeal passes judgement on thorny mathematical issue