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Source: Preven --By Lisa Ann Kaufman |
The condom broke. You got caught up in the moment. You were drunk. You forgot about protection. Someone raped you. What can you do to prevent an unintended pregnancy?
Emergency conception, or EC, has been used for over 25 years as a last resort to prevent pregnancy. Commonly known as the "morning after pill," EC can prevent pregnancy if taken within 72 hours of sexual intercourse.
The gynecology department at the Elson Student Health Center introduced Plan B two weeks ago -- a new EC produced by Women's Capital Corporation, a Seattle-based women's health product developer. The FDA approved the drug this fall.
"Condoms break; that is the most frequent thing we see at Student Health," said Dr. Christine M. Peterson, associate director for gynecology.
Peterson cites "getting carried away," forgetfulness and alcohol as additional reasons for requesting EC prescriptions. EC also is given to rape victims in emergency rooms.
Plan B is a new form of EC that uses 0.75 mg of levonorgestrel, a progestin or synthetic form of progesterone. This female sex hormone secreted by the ovaries induces changes in the lining of the uterus essential for the implantation of a fertilized egg. Plan B prevents or delays ovulation, the release of an egg from the ovaries.
The period of delay for ovulation is at least five days -- the time it takes sperm to die in the female body. But, researchers have not yet determined the exact duration of the ovulation delay. The pill also may prevent fertilization of the egg by sperm and may prevent implantation of a fertilized egg on the uterine wall.
Progestin circulates through the bloodstream, reaching the hypothalamus and the pituitary gland. The presence of progestin tricks the glands into believing that the ovaries already have released progesterone with an egg. As a result, the glands turn off the secretion of their hormones. The ovaries do not receive a command to ovulate and do not release an egg, Peterson explained.
The lining of the uterus is stimulated directly by estrogen and progesterone. If ovarian hormones do not prepare the uterus, the egg will not implant.
According to Peterson, if 100 couples had unprotected sex during a woman's mid-cycle, roughly 20 women would become pregnant. If all 20 women used Plan B, only four would become pregnant.
Women take one dose within 72 hours of sex and a second dose 12 hours after the first treatment. Plan B is most effective within the first 24 hours after intercourse.
Plan B can be prescribed to women anticipating a sexual encounter to ensure they have quick access to the treatment. Students can call the Gynecology Clinic at the Student Health Center or Planned Parenthood for information or an appointment.
Peterson estimates the gynecology department at Student Health prescribes at least one dose of Plan B per day. The Yezbe regimen is a previous group of EC that contains estrogen and progestin and includes the popular EC Preven. Between July 1, 1998 and June 30, 1999, doctors made 130 Yezbe regimen prescriptions.
Plan B treatment costs $9.20 at Student Health.
Plan B is intended as a last resort and not as a primary source of birth control. While there are no medicinal limits to how often the drug can be taken, excess use can result in extremely irregular menstrual cycles.
Regular contraceptives "are all going to be better than trying to take emergency contraception every time you have sex," Peterson said. "Mainly we don't want people to think that this is good enough. It's not good enough to use time after time after time."
Because Plan B does not carry estrogen, patients experience fewer side effects than from the Yezbe regimen, such as nausea and vomiting, she said.
She added that patients may experience some minor side effects such as headache or fatigue and the timing and heaviness of their period may be affected slightly.
Plan B is an ideal EC because almost all women can take the drug, Peterson said.
But, she stressed that some exceptions are women who already are pregnant, or who have tumors responsive to hormones such as breast or uterine cancer, active liver disease, hepatitis or mononucleosis.
No direct studies have been made on the effects of Plan B or other EC treatments on fetuses, she added.
EC treatments are composed of the same compounds as birth control pills. Researchers have investigated cases in which women did not know that they were pregnant and continued to take birth control for a period of time. No increased risks were noted, Peterson said.
The pill has sparked some controversy among anti-abortion activists who believe that human life begins at fertilization. This is one reason doctors explain the process to patients who may have religious or moral oppositions to this form of birth control.
Plan B cannot stop a pregnancy already in process. Plan B does not work like RU-486, the European abortion pill which terminates an existing pregnancy, Peterson said.
The gynecology department seeks to educate women about birth control options through the Student Health Center Web site. Peer Health Educators give presentations on contraception to students and highlight EC. Resident Advisors also are educated about EC.
"We learned about it as part of a broader presentation by Student Health about resources for students," Resident Life Co-Chair Esther Adams said.
Currently, Plan B is being marketed specifically to student health centers and family planning clinics across the country, Peterson said.
She said the treatment will not be available for private practice doctors to prescribe for a few more months.
"With the introduction of Preven and Plan B with approval by the FDA and increased publicity, the number of women seeking emergency contraception has gone up dramatically," said David Nova, president and CEO of Planned Parenthood of the Blue Ridge.
"In our estimation, emergency contraceptive has led to a significant decrease in the number of unintended pregnancies and abortions in our area," Nova said.
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