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When a woman has had intercourse and she is concerned that there is a chance of pregnancy she can use one of 2 approaches to emergency contraception. She can take emergency contraceptive pills.  She has about 5 days from her most recent unprotected intercourse to do this. Then her risk of pregnancy from one unprotected act of intercourse falls to about 1 in 100. If she uses Plan B she should take them as soon as possible and take both Plan B tabs at once.

A more effective approach would be to have a copper IUD inserted.  If she does this, the chance of pregnancy is just 1 in 1,000 AND SHE WILL THEN HAVE IN HER UTERUS AN EXTREMELY EFFECTIVE CONTRACEPTIVE AND A FULLY REVERSIBLE CONTRACEPTIVE THAT SHE CAN USE FOR 10 OR MORE YEARS.

Below are 2 examples of emergency copper T 380 A insertions (ParaGard insertions) for women who have had recent unprotected intercourse.  They are the 80th and 81st insertions by the same nurse practitioner in Charlotte, North Carolina: 

Case #80: A 22 year-old, who has been pregnant once, having had an abortion (G-1 P-0 A-1). She had the termination on 2-1-08. The clinic did not start her on a birth control method after the procedure because her blood pressure was "too high". She had used Depo-Provera injections in the past but gained too much weight. Her BMI is 34 (very overweight!) Her BP yesterday was 118/84. She was contemplating using the NuvaRing. She had unprotected sex 3/15/08 and did not know about emergency contraception. She also had had unprotected sex prior to 3/15 with no bleeding after the 2-3 wks of bleeding from the procedure. Her pregnancy test was negative. She informed us that she "never wanted to be pregnant". On exam, she had an apical pulse of 64/m and a very irregular heart beat without murmur or extra sounds. She had no prior history of heart problems. When I questioned her about activity she admitted that sometimes she got dizzy if she stood for awhile and if she climbed steps. No history of syncope on exertion. I reviewed the range of birth control options, Emergency Contraception with Plan B and emergency contraception using a ParaGard IUD. She wanted Emergency Contraception and an ongoing birth control method that would protect her after leaving the clinic. She chose ParaGard. I referred her to an ambulatory care clinic where they will follow up on the arrhythmia. Happy Camper # 80!

Case #81: 23 yr old presented to our family planning clinic for initial exam on March 20, 2008. She had been pregnant 4 times, having had 3 abortions and she has on living child (G-4 A-3 L-1). Her last normal menstrual period was on March 10, 2008. She was not using a contraceptive method and was considering Depo-Provera injections or an IUD. Her last unprotected sex was March 18 (2 days previously). She did not know about Emergency Contraception. After reviewing her options for both Emergency Contraception and ongoing birth control she chose the ParaGard IUD. Happy Camper # 81!

Are you thinking of using either approach to emergency contraception?

Her reply on 11-16: “Thank you for your prompt reply!  My partner definitely did not ejaculate.  I was on birth control on and off for 14 years and will absolutely not go back on it.  I finally have a normal libido and lost 18 pounds after it was out of my system.  Do you have any suggestions to increase my libido if I were to go back on birth control?  Thanks!”

Several possibilities for you:

·        No estrogen pills (progestin-only pills, also called mini-pills)

·        20 microgram combined pills

·        Mirena IUD that has many non-contraceptive benefits and is an extremely low progestin contraceptive

·        ParaGard IUD has no hormones at all (the copper IUD)

Good luck!

Key Words:  condom, inside vagina, drunk sex, no birth control protection, ovulating, intercourse, ejaculate, pre-ejaculate fluid, alcohol, pregnant, sperm, low risk, emergency contraception, insertion, IUD, Mirena, ParaGard, libido, estrogen pills, progestin-only pills, mini-pills 

Posted 11-20-2008, Updated 11-25-2008, Updated 12-2-2008