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| |    Four Types of Emergency Contraception by Marjorie Greenfield, M.D. reviewed by Marjorie Greenfield, M.D. Four general methods of emergency contraception are currently available in the United States: the morning-after pill, in both estrogen-progestin and progestin-only formulas; the IUD; and RU486. This article explains how each method works and their various side effects. For more information, including how to obtain emergency contraception, see our article How to Prevent Pregnancy after Having Unprotected Sex. High dose of estrogen-progestin pill The classic morning-after pill is really a high-dose combination of estrogen and progestin that's taken twice in a 12-hour period. While the doses can be made up by taking a number of standard oral contraceptive pills, a kit called Preven, designed specifically for emergency contraception, is now available by prescription in the U.S. Most practitioners recommend running a pregnancy test (included in the kit) before using the medication. You should be aware that the morning-after pill is intended to prevent conception from taking place, not to abort an established pregnancy. If this sounds a little confusing, don't hesitate to talk to your practitioner--she can help you figure out if you are in the right part of the cycle for taking this medication. The most common side effect of the morning-after pill is nausea and vomiting--which can be severe--so many physicians will prescribe antinausea medication to be taken an hour before starting the contraceptive regimen. If vomiting occurs less than an hour after taking the first dose of contraceptive pills, the dose should be repeated. The nausea usually subsides within 24 hours after starting the pills. It's important to know that high-dose estrogen regimens are not suitable for everyone. Women with an increased risk of blood clots or other serious complications from oral contraceptive pills should use a different form of emergency contraception. This protocol reduces the chances of getting pregnant by 75 percent. If 100 couples have one act of unprotected intercourse and then use this method, only two will end up pregnant instead of the expected number of seven or eight. High-dose progestin-only pill A high-dose, progestin-only morning-after pill is also available by prescription in the U.S. Under the brand name Plan B, these pills also come packaged in a kit with detailed instructions and a home pregnancy test. This regimen causes much less nausea than the estrogen-containing regimen, and it appears to be at least as effective, so many people prefer it to the estrogen-containing method. IUD insertion A copper-containing IUD inserted within five days of unprotected intercourse can prevent implantation of a fertilized egg in the uterus, as well as provide long-term contraception from that time forth. A downside of this method is that some people who have unprotected sex are at risk for sexually transmitted disease, and the IUD is not recommended for women with gonorrhea or chlamydia. This method has the lowest failure rate: About 1 woman in 1,000 who uses the IUD as emergency contraception becomes pregnant. RU486 RU486, recently released onto the U.S. market under the brand name Mifepristone, is a medication that counteracts the natural female hormone progesterone. Taken for four days any time between ovulation and when the period is due, RU486 prevents implantation of a fertilized egg. Despite its presence on the market, RU486 is not as widely available as the aforementioned methods are. The pros and cons of emergency contraception Advantages
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