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Doo doo doo doo.  Emergency contraception, let's do it!

(Intro)

Welcome to Sexplanations, the sex curious show with your internet sexologist.  I'm Lindsey Doe.  Let's talk about an incredible invention that can prevent pregnancy even if semen with sperm in it gets in or near the vagina.  Emergency contraception!  

We're so excited today.  Oh my gosh, let's do this.

There are four main options.  1) levonorgestral, which you may know of as the morning after pill or Plan B.  It goes by many names.  They're all similar, though.  Typically one 1.5 milligram pill that the person with the vagina swallows within 72 hours of unprotected sex or rape.  72 hours?  That's three days.  

You don't need a prescription to get it, but it's probably much cheaper if you have one.  At the store, Plan B One Step is $45.99.  Try aisle 20 near the feminine hygiene products and prophylactics!

To get the pill for less or even free, as your doctor or Planned Parenthood.  See if you can get a few boxes of them to have on hand for future emergencies, friends, etc.  

A second form of emergency birth control is ulipristal acetate, or (?~1:06).  Same idea.  One pill, except ulipristal usually requires a prescription.  The following states allow pharmacists to prescribe directly so that you don't need a doctor's appointment: Alaska, California, Hawaii, Maine, Massachusetts, New Hampshire, New Mexico, Vermont, and Washington.  Haha, access!  Access!

Ulipristal is slightly more effective than levonorgestral and it can prevent pregnancies up to 120 hours after semen contact.  That's five days instead of three.  

A third option is to take combination pills.  You can do this with regular, everyday for the month birth control pills.  uptodate.com instructs people how to take what's in your pack of birth control to address an emergency situation.  I color coded this chart so it's pretty and easy to follow.  The first column is the type of birth control, the second is the number of pills and their color that you'll want to take as soon as possible within the five day time frame.  The third column is what you'll take 12 hours after the first dose.  Yes, Ovrette is 20 pills.  That's not a typo. 

A note: this option is not as effective as others and it is more likely to cause nausea and vomiting, so pharmacists suggests taking an anti-emetic, 'anti, against, 'emetic', causing vomit, like dramamine.  If you do vomit within a few hours of taking any emergency contraceptive pills, contact a medical provider.  You'll likely be advised to start over, you know, because you puked everything out in the first round.

One more form of emergency contraception and then I'll answer some important questions about all of this.  The fourth option is a copper IUD called paraguard.  'I', intra, inside.  'U', inter the uterus, 'D', device.  This little T-shaped device goes in the open space of the uterus.  You'll have to have it inserted by a medical provider, but if you can get an appointment within the next five day deadline, seven if you're pushing it, it is the most effective form of emergency contraception and you can leave it in there for 10 years to prevent a decade more of pregnancies.  Ahh!  

Copper IUDs work by irritating the space in multiple ways.  First, its position.  Your immune system detects the T as a foreign object and it sends white blood cells to attack.  These warriors may go after sperm which helps, but the big deal is that this battle then causes the uterus to swell and be less favorable for pregnancy.  

Second, the copper coils wrapped around the T react with fluid in the reproductive system, creating an irritant, a toxic environment to sperm and eggs.  I like imagining it as a force field.  Bzz bzz bzz die sperm!

Does it hurt?  Mm.  Your medical provider will probably recommend taking a painkiller an hour or two before the procedure.  When the IUD is being put in, you might experience nausea, dizziness, slight cramping, and low pressure, so some pain.  

For months afterwards, you might also experience longer, heavier periods, spotting, cramps, and achiness.  As for emergency contraceptive pills, those first three options, side effects include tender breasts, headaches, bloating, irregular bleeding, but none of that should last long.  

How do you know if the emergency contraception worked and actually prevented pregnancy?  1-3% of people who take emergency contraceptive pills become pregnant and with the IUD, it's .1% so there is a chance that things don't work, but it's very small.  With pills, your period should show up on schedule or within three weeks of taking the medication, and with any method, you can also take a test to determine if the pregnancy was averted.  It may be helpful to know medications that treat epilepsy, HIV, TB, and stomach acid have been found to decrease the effectiveness of emergency birth control.  Also on the list, St. John's Wort and uncommon antibiotics that I cannot pronounce the names of.

If I take ECP, will it protect me for unprotected sex afterward?  I used to think that Plan B was like a windshield wiper for my uterus and it would just clear me out.  Can't get pregnant now, so why not have more sex until my next cycle?  This is not how it works.  My understanding is that if your risk-taking behavior was on a Monday, emergency contraceptive pills, ECP, can prevent sperm from that encounter leading to a pregnancy for five days afterward.  Sperm can live for up to seven days, though, so if you have sex on Tuesday, the day afterward, thinking, oh, this is fine, I took the pill, you're risking pregnancy on Saturday, Sunday, and the following Monday.  If you want to stay protected after the emergency, the IUD can last for years and years and years after its been installed.

What constitutes an emergency?  No contraception at all or if contraception was used incorrectly or it malfunctioned.  The World Health Organization has a list of examples: the condom breaking, missing a regular birth control pill or taking them late, falling behind on the shot, problems with internal methods, miscalculating ovulation, or ejaculation.  

And it's not an abortion?  Emergency contraceptive pills prevent pregnancies from happening in the first place.  If you are already pregnant and took ECP, it would not abort or affect the pregnancy.

What if I'm not having sperm-egg sex?  Yeah, if you're having sperm-sperm sex or egg-egg sex or vasectomy egg-egg sex, pregnancy is not an option for you or getting pregnant is not an emergency.  I still think it's important to know your options.  I still think it's important to know about ECP.  There are probably hundreds of Sexplanations videos that may not apply directly to your sex life.  Many of you are celibate, asexual, paraphilic in ways that I haven't covered yet.  I still want you to know this information.  To learn how to learn how to learn about sexuality and be a resource for others.  

You might not need Plan B but have one on hand anyway.  Someone you care about might.  And stay curious!

Thank you to everyone on patreon.com/sexplanations who makes this show possible.

(?~6:25) is slightly more effective than loblahhh.  And then a pahapahpah.  My nose is running.  I'm so hot.  Rima-rifa--rifaminizpinspitapuh.