Thursday, March 30, 2017

Emergency Contraceptives Center

Understanding the Risks of Emergency Contraception

By Dr. Zev Williams, Health Pro Friday, July 15, 2011

While no medication or treatment is without risks, the first and most important thing to know about emergency contraception is that all the risks associated with them are far less than those associated with pregnancy.  In fact, the World Health Organization states that there is no medical condition in which the risks associated with emergency contraception outweigh the benefits.   This includes women who have heart disease, clotting disorders, migraines, liver or kidney disease or who may be breastfeeding.  It is also noteworthy that no deaths or even serious complications have been caused by emergency contraception. 


However, it is still important to understand the risks and the differences in risks with the different forms of emergency contraception.


Hormonal Contraception

The first concern of many women prior to taking emergency contraception is whether it could cause a problem if they are already pregnant. The answer is no. While no randomized studies have been conducted directly measuring the effects of emergency contraceptives in pregnancy, experience from women who unknowingly took emergency contraceptives while pregnant or who took high-dose contraceptives showed no adverse effects.


The second most common concern is the risk that the emergency contraceptive will fail.  Emergency contraceptives are very effective (>98%), but still not 100%.  In addition, the likelihood that the emergency contraceptive will fail increases the longer the delay between unprotected intercourse and taking the emergency contraceptive.


The most common side-effects of emergency contraceptives are nausea and vomiting, irregular vaginal bleeding, dizziness, fatigue and headaches.


Copper Intrauterine Device (IUD)

The copper IUD has the advantage of a lower failure rate (0-0.2%) than hormonal contraceptives and therefore the risk of pregnancy is lower.  Insertion of the IUD is generally a very safe office procedure.   However there are risks associated with it. There  is a risk that any pre-existing infections in the cervix or vagina (such as gonorrhea or Chlamydia) can spread into the uterus and pelvis resulting in pelvic inflammatory disease (PID).  It is felt that this occurs at the time of initial IUD insertion. This risk is limited to the first 3 weeks after the IUD is inserted.  


There is also a risk that while the IUD is being inserted, a puncture can be made into the uterus.  The placement of the IUD can be incorrect and require its removal or adjustment.  It is also possible that the IUD gets expelled from the uterus into the vagina or even into the abdomen.  In these cases, the woman would no longer be protected from pregnancy and, in the case of expulsion into the abdomen, an additional surgery may be required to remove the IUD.  While these complications are serious, they are thankfully very rare.   To help monitor the position of the IUD and aid in its removal, threads attached to the IUD are left inside the vagina.  This allows the woman to feel to make sure the IUD is still present and call be grasped by the physician to remove the IUD.

By Dr. Zev Williams, Health Pro— Last Modified: 08/06/13, First Published: 07/15/11