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
Jude Law in Black Sea

film

In Black Seahe is as audiences have never seen him before

Arts and Entertainment
Johnny Depp no longer cares if people criticise his movie flops

film

Arts and Entertainment
Full circle: Wu-Tang’s Method Man Getty

Music review

Arts and Entertainment
When he was king: Muhammad Ali training in 'I Am Ali'
film
Arts and Entertainment
Joel Edgerton, John Turturro and Christian Bale in Exodus: Gods and Kings
film Ridley Scott reveals truth behind casting decisions of Exodus
PROMOTED VIDEO
Arts and Entertainment
Scare tactics: Michael Palin and Jodie Comer in ‘Remember Me’

TVReview: Remember Me, BBC1
Arts and Entertainment
Scare tactics: Michael Palin and Jodie Comer in ‘Remember Me’

TVReview: Remember Me, BBC1
Have you tried new the Independent Digital Edition apps?
Arts and Entertainment

ebooksNow available in paperback
Arts and Entertainment

ebooks
Arts and Entertainment
Carrie Hope Fletcher
booksFirst video bloggers conquered YouTube. Now they want us to buy their books
Arts and Entertainment
Damien Hirst
artCoalition's anti-culture policy and cuts in local authority spending to blame, says academic
Arts and Entertainment
A comedy show alumni who has gone on to be a big star, Jon Stewart
tvRival television sketch shows vie for influential alumni
Arts and Entertainment
Jason goes on a special mission for the queen
tvReview: Everyone loves a CGI Cyclops and the BBC's Saturday night charmer is getting epic
Arts and Entertainment
Image has been released by the BBC
tv
Arts and Entertainment
Will there ever be a Friends reunion?
TV
News
Harry Hill plays the Professor in the show and hopes it will help boost interest in science among young people
arts + ents
Arts and Entertainment
A Van Gogh sold at Sotheby’s earlier this month
art
Arts and Entertainment

MusicThe band accidentally called Londoners the C-word

Arts and Entertainment
It would 'mean a great deal' to Angelina Jolie if she won the best director Oscar for Unbroken

Film 'I've never been comfortable on-screen', she says

Arts and Entertainment
Winnie the Pooh has been branded 'inappropriate' in Poland
books
Arts and Entertainment
Lee Evans is quitting comedy to spend more time with his wife and daughter

comedy
Arts and Entertainment
American singer, acclaimed actor of stage and screen, political activist and civil rights campaigner Paul Robeson (1898 - 1976), rehearses in relaxed mood at the piano.
filmSinger, actor, activist, athlete: Paul Robeson was a cultural giant. But prejudice and intolerance drove him to a miserable death. Now his story is to be told in film...
Arts and Entertainment
Taylor Swift is dominating album and singles charts worldwide

music
Arts and Entertainment
Kieron Richardson plays gay character Ste Hay in Channel 4 soap Hollyoaks

tv
Arts and Entertainment
Midge Ure and Sir Bob Geldof outside the Notting Hill recording studios for Band Aid 30

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.

    Homeless Veterans Christmas Appeal: ‘We give them hope. They come to us when no one else can help’

    Christmas Appeal

    Meet the charity giving homeless veterans hope – and who they turn to when no one else can help
    Should doctors and patients learn to plan humane, happier endings rather than trying to prolong life?

    Is it always right to try to prolong life?

    Most of us would prefer to die in our own beds, with our families beside us. But, as a GP, Margaret McCartney sees too many end their days in a medicalised battle
    Thomas Cook's outgoing boss Harriet Green got by on four hours sleep a night - is that what it takes for women to get to the top?

    What does it take for women to get to the top?

    Thomas Cook's outgoing boss Harriet Green got by on four hours sleep a night and told women they had to do more if they wanted to get on
    Christmas jumper craze: Inside the UK factory behind this year's multicultural must-have

    Knitting pretty: British Christmas Jumpers

    Simmy Richman visits Jack Masters, the company behind this year's multicultural must-have
    French chefs have launched a campaign to end violence in kitchens - should British restaurants follow suit?

    French chefs campaign against bullying

    A group of top chefs signed a manifesto against violence in kitchens following the sacking of a chef at a Paris restaurant for scalding his kitchen assistant with a white-hot spoon
    Radio 4 to broadcast 10-hour War and Peace on New Year's Day as Controller warns of cuts

    Just what you need on a New Year hangover...

    Radio 4 to broadcast 10-hour adaptation of War and Peace on first day of 2015
    Cuba set to stage its first US musical in 50 years

    Cuba to stage first US musical in 50 years

    Claire Allfree finds out if the new production of Rent will hit the right note in Havana
    Christmas 2014: 10 best educational toys

    Learn and play: 10 best educational toys

    Of course you want them to have fun, but even better if they can learn at the same time
    Paul Scholes column: I like Brendan Rodgers as a manager but Liverpool seem to be going backwards not forwards this season

    Paul Scholes column

    I like Brendan Rodgers as a manager but Liverpool seem to be going backwards not forwards this season
    Lewis Moody column: Stuart Lancaster has made all the right calls – now England must deliver

    Lewis Moody: Lancaster has made all the right calls – now England must deliver

    So what must the red-rose do differently? They have to take the points on offer 
    Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

    Cameron, Miliband and Clegg join forces for Homeless Veterans campaign

    It's in all our interests to look after servicemen and women who fall on hard times, say party leaders
    Millionaire Sol Campbell wades into wealthy backlash against Labour's mansion tax

    Sol Campbell cries foul at Labour's mansion tax

    The former England defender joins Myleene Klass, Griff Rhys Jones and Melvyn Bragg in criticising proposals
    Nicolas Sarkozy returns: The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?

    Sarkozy returns

    The ex-President is preparing to fight for the leadership of France's main opposition party – but will he win big enough?
    Is the criticism of Ed Miliband a coded form of anti-Semitism?

    Is the criticism of Miliband anti-Semitic?

    Attacks on the Labour leader have coalesced around a sense that he is different, weird, a man apart. But is the criticism more sinister?
    Ouija boards are the must-have gift this Christmas, fuelled by a schlock horror film

    Ouija boards are the must-have festive gift

    Simon Usborne explores the appeal - and mysteries - of a century-old parlour game