What Is Levonorgestrel?
- Levonorgestrel is a hormonal medication used as emergency contraception.
- Commonly known as the “morning-after pill”.
- Available over-the-counter without a prescription in many countries.
- Does not terminate an existing pregnancy; it prevents pregnancy after unprotected sex or contraceptive failure.
How Does Levonorgestrel Work?
- Prevents or delays ovulation (release of an egg from the ovary).
- May prevent fertilization of the egg or attachment of a fertilized egg to the uterine lining.
- Does not work if ovulation has already occurred and fertilization/implantation has taken place.
Uses of Levonorgestrel
- Emergency Contraception: Prevents pregnancy when taken within 72 hours (3 days) after:
- Unprotected sexual intercourse.
- Contraceptive failure (e.g., condom breakage, missed birth control pills).
Who Should Use Levonorgestrel?
- Women seeking emergency contraception after unprotected intercourse.
- Not suitable for routine contraception; intended for occasional use only.
Dosage and Administration
- Standard Dose:
- One tablet containing 1.5 mg of levonorgestrel, taken as a single dose.
- Alternatively, two doses of 0.75 mg, taken 12 hours apart.
- Timing:
- Most effective when taken as soon as possible, ideally within 12 hours.
- Can be taken up to 72 hours after unprotected sex, but effectiveness decreases over time.
- Administration Tips:
- Take with or without food.
- If vomiting occurs within 2 hours of taking the pill, a replacement dose may be needed.
Effectiveness
- Reduces the risk of pregnancy by 87% when taken within 72 hours.
- Most effective within the first 12-24 hours.
- Less effective in women with a higher body mass index (BMI > 30).
Precautions Before Taking Levonorgestrel
- Medical History: Inform your doctor if you have:
- History of ectopic pregnancy.
- Severe liver disease.
- Unexplained vaginal bleeding.
- Pregnancy:
- Not effective if you are already pregnant.
- Does not harm an existing pregnancy.
- Breastfeeding: Safe to use during breastfeeding, but consider feeding the baby before taking the pill to minimize hormone transfer.
Possible Side Effects
Common Side Effects:
- Nausea or vomiting.
- Irregular menstrual bleeding.
- Fatigue.
- Headache.
- Breast tenderness.
Less Common but Serious Side Effects:
- Severe abdominal pain (may indicate ectopic pregnancy).
- Prolonged or heavy bleeding.
What to Do If You Experience Side Effects?
- Mild symptoms typically resolve within a few days.
- Seek medical attention if severe abdominal pain or heavy bleeding occurs.
Drug Interactions
- Some medications can reduce the effectiveness of levonorgestrel, including:
- Enzyme inducers: Rifampin, phenytoin, carbamazepine, St. John’s Wort.
- Certain HIV and tuberculosis medications.
- Inform your doctor about all medications and supplements you are taking.
Monitoring and Follow-Up
- If your period is more than 7 days late, take a pregnancy test.
- Consult a healthcare provider if you experience unusual symptoms or suspect pregnancy after taking the pill.
Patient Counseling Points
- Emergency contraception is not a substitute for regular contraceptive methods.
- Levonorgestrel does not protect against sexually transmitted infections (STIs).
- Always keep a backup contraceptive plan in case of emergencies.
- Use barrier contraception (e.g., condoms) until your next menstrual cycle.
- Avoid multiple doses within the same menstrual cycle unless absolutely necessary.
Storage
- Store at room temperature (20-25°C).
- Protect from moisture and heat.
- Keep out of reach of children.
FAQs About Levonorgestrel
Q1: How soon after unprotected sex should I take levonorgestrel?
- Take it as soon as possible, ideally within 12-24 hours, for maximum effectiveness.
Q2: Can levonorgestrel fail to prevent pregnancy?
- Yes, it is not 100% effective, especially if taken late or during ovulation.
Q3: Can I use levonorgestrel as a regular contraceptive?
- No, it is designed for emergency use only. Use a regular contraceptive method for routine protection.
Q4: Will levonorgestrel affect my future fertility?
- No, it does not have long-term effects on fertility.
Q5: Can I take levonorgestrel if I’m breastfeeding?
- Yes, it is safe for breastfeeding mothers.
Q6: What should I do if I vomit after taking levonorgestrel?
- If vomiting occurs within 2 hours, take another dose and consult a healthcare provider.
Q7: Can I take levonorgestrel more than once in a month?
- While it is safe, frequent use is not recommended due to hormonal imbalances and reduced effectiveness.
