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Postcoital Emergency Contraception


Postcoital emergency contraception is often needed as a result of the Billings method that failed. This is what every walk-in-clinic physician witnesses, a couple that has sex first and thinks about the consequences later.

This is the opposite from being disciplined. In the past this was often the first step in a sequence that would lead to a referral for an abortion. Now there is the “postcoital contraception”, which is not really a regularly established method, but more of an “emergency method”.

Using a shot gun hormone blast of 2 Ovral pills immediately and again 12 hours later will prevent implantation of a fertilized egg or the first cell divisions into the uterine wall in about 85% of cases. The problem is that the clotting mechanism of the liver can also get activated from this estrogen blast increasing the likelihood of heart attacks and strokes.

As these are younger individuals, this danger is offset by the relative immunity of this patient group to such cardiovascular events. Deep vein thrombosis (=clots in the deep veins of the legs) and pulmonary emboli (=blood clots in the lungs), however, can occasionally be inadvertently caused and would have to be treated immediately with blood thinners.

Another class of emergency contraception, which has been popularized in the press, is the use of methotrexate. However, the bone marrow suppressive side effect can be so life threatening that many jurisdictions rightly have outlawed this method.


These emergency situations arose out of an ignorance and lack of education in the field of contraception.

The solution is not another magic pill, but application of what works for a couple or two partners.

These methods should be applied consistently, in which case there is no need for emergency contraception or abortion. Should the need for abortion arise in the case of a rape or incest, this procedure should be done by an experienced gynecologist where monitoring for choriocarcinoma and moles is done. In a certain percentage of abortions a piece of placenta may be left behind and this can develop into this type of cancer in the subsequent weeks.



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Last modified: August 15, 2014

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatment stays in the hands of your doctor and you.