Postcoital contraception (emergency contraception, further EC) is shrouded in a host of horror stories about its extreme harm to the body. And indeed, the first thing that any gynecologist says when starting a conversation on this topic is that this is an extreme measure that in no case can be used constantly, and that, resorting to it, one must consult a doctor. The words “extreme measure” are so strongly sometimes fixed in the subconscious that the brain generally puts a taboo on this tool, perceiving it as so harmful that it is simply unacceptable. Forgetting that a tool called “maybe” is much worse, more harmful, more dangerous and unacceptable.Gynecologists of three medical centers told SHE what to do if there was an unprotected sexual intercourse.
Postinor, contrary to the opinion of the majority, is not synonymous with emergency contraception. Although to him, according to doctors and statistics of purchases of pharmacies, resorted most often. Alla Teplitskaya, the head doctor of the Zdravitsa MC, said that this remedy is popular among young people, who, as a rule, simply go to the pharmacy without resorting to the advice of doctors. Just like Postinor, the “maybe” tool is also popular: “People simply do not know about the possibilities of such contraception and rely on the odd,” commented gynecologist Endocrinologist Professor Pasman Alla Dudareva.
Where to run
According to the website vapteke.ru, in July 2010, 125 Novosibirsk pharmacies were purchased for the sale of 1670 packages of Postinor, 310 Eskapela, 16 Ginepristone, 31 spirals of the intrauterine device Multiload and 5 spirals of Mirena. Despite the low popularity, the most safe means gynecologists consider the recently appeared “Ginepriston” (or “Agest”) – 156-176 rubles. The cheapest remedy is the intrauterine device (Yunona, Vector – from 60-80 rubles), the most expensive is also the intrauterine spirals (the hormone Mirena – 10 000-11 500 rubles and more popular “Multiload” and ” Nova 1700-3300 rub.). The permanent leader of sales “Postinor” costs from 208 to 273 rubles. for two tablets.
The recommended time of application of all EC instruments is 72 hours from the moment of unprotected sexual intercourse, “Ginepristone” and intrauterine device is worth using for five days (120 hours), although the efficiency after traditional 3 days is already decreasing.
The mechanism of action of all hormonal drugs is based on a sharp change in the hormonal background. “The goal is to break the cycle at the level of ovulation, implantation or transportation of the amniotic egg. After taking the drug after 2-3 days, menstrual bleeding occurs, “- says Alla Dudareva.
The consequence may be a violation of the menstrual cycle, the restoration of which sometimes takes up to six months. Therefore, it is not recommended to use such drugs more than once every six months or a year.
Contraindication, even for a single admission are pronounced violations of the liver, because it is a serious blow to it, and it is contraindicated to protect it from this stroke. “There is no point in checking with supporting drugs. There is a double-edged sword: any drugs to improve liver function act as sorbents, collect this drug (emergency contraception – ZK) and thereby reduce its effectiveness – there is no logic in it, “the obstetrician-gynecologist MC “Avicenna” Elena Loginova.
How much to hang in grams?
When everything has happened, there are only two alternatives to emergency contraception. Perhaps, and abortion – and for the first, as a rule, stealthily creeps up the second.
Gynecologists are unanimous in the opinion: when abortion and EC tablet are on two scales, you need to choose the second without hesitation – abortion clearly outweighs the risk and unfavorable prospects.
“Abortion is a trauma to the uterus, cervix and a hormonal storm. The organism is already working in a certain rhythm, is set up for pregnancy, and we once – and all this was taken from him, – says Elena Loginova.
– Inflammation, obstruction of the tubes, functional cysts in the ovaries – abortions without complications do not happen. These can all be hidden consequences, but they will be necessary. “
There is a softer, as it is called – “velvet abortion”, medicamentous. For this, the drug “Mifegin” is used, which is taken at the gestation period up to 8 weeks and only under the supervision of a doctor. First, it is important to exclude ectopic pregnancy, and, secondly, after receiving it, you may still need an abortion (medical or vacuum). “The underwater stone is whether the uterus will reject the fetal egg. Pushed – great. If not – are forced to still use the tools of the egg from there. Abortion in any case – it’s a disaster, “- says the gynecologist” Avicenna. “
When choosing “avosya” many hope for the so-called “safe days”. It is believed that the “dangerous”, that is, favorable for conception – three days before ovulation and three after. Ovulation, as a rule, falls on the middle of the cycle, while it can fluctuate from the 11th to the 15th day, that is, potentially dangerous are the 9-17th days of the cycle. However, this rule can be applied only if you have a clear, as scheduled, 28-day cycle without delays and failures, otherwise rely on these calculations – is highly doubtful. “There are cases when ovulation occurs against a backdrop of some kind of stress, so it’s hard to say exactly when it’s a safe period,” warns Alla Dudareva.
It is possible that even after using postcoital contraception, pregnancy will still come – the effectiveness of emergency contraceptive methods fluctuates around 99%. According to the recognition of Novosibirsk gynecologists, 1% of cases in their practice were. “There are studies that suggest that there is no damaging effect of these pills on the fetus. A woman can bear, if she wants, “- observes Alla Dudareva.
However, whatever happens, no matter which method of contraception you choose, you must clearly follow the timely start of the next cycle. With a delay of 1-2 days, you can donate blood for quantitative HCG (human chorionic gonadotropin), a pregnancy test can be positive after 3-5 days of delay, and with a delay of 7-10 days you can already make ultrasound. In any case, if the pregnancy is still there, it is important to learn about it as soon as possible – regardless of whether you are going to give birth or not.