The Male Health Center

Emergency Contraception

The old expression, it takes two tango, pretty much sums up how a man ought to feel about contraception. It is as much our responsibility as it is our partners' to prevent unwanted pregnancy.

Most couples are reasonably well educated about how to accomplish that, with one significant exception. Surveys show that fewer than one in ten women are aware that the potential for contraception continues for 72 hours after having sex. So as a man who's about to be in the know, you're joining what is undoubtedly a very exclusive group.

The most common emergency contraceptives are ordinary birth control pills containing the hormones estrogen and progestin. Often dubbed "morning after pills," they're actually effective for three days after intercourse. Minipills, birth control pills that contain only progestin, are also effective as postcoital contraceptives, although they must taken within 48 hours, rather than 72.

Few couples know about emergency contraceptives because, although birth control pills are approved by the Food and Drug Administration, no company has ever applied for permission to market them in the U.S. for use after intercourse. Thus the manufacturers are not permitted to advertise such use, even though it is perfectly legal. (Emergency contraceptives are openly marketed in England, Germany, and the Netherlands.)

Emergency contraceptives must be prescribed by a doctor—preferably, but not necessarily, before they're needed. Most women can use them safely, although those who have had a stroke or blood clots, cancer of the breast or reproductive organs, migraine headaches, or heart disease, or who have liver disease or a sickle cell crisis, cannot.

The pills are generally taken in two doses about 12 hours apart and are about 75 percent effective at preventing pregnancy. When they fail, there is no known risk to the developing fetus.

Although clinical trials have proved emergency contraceptives to be safe, they do have side effects: Breast tenderness is common, and nearly half of the women who take the combination pills have nausea and 20 percent vomit. Anti-nausea medicines can help, and women who take minipills are much less likely to experience these side effects.

Emergency contraceptives ought to be just that: for emergencies. It's not something you'd want your partner to go through more often than absolutely necessary, and the office visit and prescription will set you both back $60 to $80. Contraception is much better practiced early, when you can take an active role.

Nonetheless, accidents do happen—and not just to the young and careless. Even among married couples, about 40 percent of pregnancies are unplanned.

It doesn't have to be so, and now you're one of the select few guys who knows the solution.

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