Taking a closer look at this type of emergency contraception, which is packed with levonorgestrel, the same progestin hormone found in regular birth control pills, Dr van Zyl cautioned that the morning-after pill does not terminate a pregnancy – and although it’s a very safe medication – it may not work as effectively if used more than once in the same menstrual cycle.
Most levonorgestrel emergency contraceptive medications are available without a prescription and are dispensed as either two tablets once off, or one tablet once off depending on the dosage.
“One of the main causes for concern when it comes to repeated use of the morning-after pill is that it suggests numerous bouts of unprotected sex,” said Dr van Zyl. “This means condoms aren’t being used, which means a greater risk of sexually transmitted diseases (STD’s) and HIV infection.
Dr van Zyl recommends you strongly advise patients who aren’t in a stable, committed relationship be tested for HIV and STD’s if they’re going to get the morning-after pill.
He also said it was important to explain to patients that if they vomit up to an hour after taking the morning-after pill, it’s best to take some anti-nausea medication and then repeat the dose to ensure their body has a chance to absorb all the necessary medication.
Patients should also be aware that taking such high doses of levonorgestrel can cause heavier or irregular menstrual bleeding and can throw their cycle off-kilter for a couple of months.
“As you won’t know, when patients are ovulating, it’s a good reason to consider taking additional precautions, like using condoms, if they’re sexually active after taking the morning-after pill,” said Dr Van Zyl.
Some antibiotics, epilepsy medication, HIV medication and St John’s wort might render the morning-after pill ineffective. Women with porphyria, Crohn’s disease, and certain other medical conditions that preclude hormonal contraception should consider a copper IUD as long-term contraception, or as emergency contraception should the need arise.