We know you sometimes have burning questions that can best be answered by a pharmacist. Our feature, Ask Your Pharmacist , seeks to address some of those issues. Send your questions to healthandwealth@jamaicaobserver.com.

Question: How often can I take the emergency contraceptive pill?

Answer: Emergency contraceptives are used to prevent pregnancy after unprotected sex but before pregnancy begins. Emergency contraception can prevent up to over 95 per cent of pregnancies when taken within five days after intercourse. However, they are more effective the sooner they are used after sex.

The World Health Organization (WHO) has standard recommendations for emergency contraception. The most common method of emergency contraception in Jamaica is a drug called Levonorgestrel (LNG). LNG is taken as a single dose of 1.5 mg, or alternatively, as two doses of 0.75 mg each, 12 hours apart. If vomiting occurs within two hours of taking a dose, the dose should be repeated. LNG is widely available and is sold under several different brand names in pharmacies. Emergency contraceptive pills prevent pregnancy by preventing or delaying ovulation, but they do not induce an abortion. Emergency contraception cannot interrupt an established pregnancy or harm a developing embryo.

Emergency contraception allows women a second chance to avoid unwanted pregnancies. This method can be used in instances of unprotected intercourse, concerns about possible contraceptive failure, incorrect use of contraceptives, and sexual assault if without contraception coverage.

It is important to note that while 95 per cent effective, the morning-after pill doesn’t prevent pregnancy as well as other types of birth control like the IUD, implant, pill, shot, ring, or condoms. In addition, taking the morning-after pill over and over again is usually more expensive and less convenient than being on a regular method of birth control. Counselling for use of emergency contraceptive pills should include options for using regular contraception and advice on how to use methods correctly in case of perceived method failure.

Side effects from the use of emergency contraceptive pills are similar to those of oral contraceptive pills, such as nausea and vomiting, slight irregular vaginal bleeding, and fatigue. Side effects are not common, they are mild, and will normally resolve without further medications.

Taking the morning-after pill multiple times doesn’t change its effectiveness, and won’t cause any long-term side effects. You can use the morning-after pill whenever you need to. The morning-after pill might make your periods irregular and hard to predict when you’re using it a lot. Any woman or girl of reproductive age may need emergency contraception to avoid an unwanted pregnancy. There are no absolute medical contraindications to the use of emergency contraception. There are no age limits for the use of emergency contraception. Drugs used for emergency contraception do not harm future fertility. There is no delay in the return to fertility after taking emergency contraceptive pills. There are no restrictions for the medical eligibility of who can use emergency contraceptive pills. Following use of emergency contraception, women or girls may resume or initiate a regular method of contraception.

Some women, however, use emergency contraception repeatedly for any of the reasons stated above, or as their main method of contraception. In such situations, further counselling needs to be given on what other and more regular contraceptive options may be more appropriate and more effective. Frequent use of emergency contraception can result in increased side-effects, such as menstrual irregularities, although their repeated use poses no known health risks.

The WHO recommends that all women and girls at risk of an unintended pregnancy have a right to access emergency contraception and these methods should be routinely included within all national family planning programmes. Moreover, emergency contraception should be integrated into health-care services for populations most at risk of exposure to unprotected sex, including post-sexual assault care and services for women and girls living in emergency and humanitarian settings.

Many studies have documented providers’ and women’s fears about the individual and public health safety risks of emergency contraception. Some of these concerns include potentially increased risks of cardiovascular events (including arterial and venous disease), worries about possible effects on future fertility, feared teratogenic consequences following method failure or inadvertent use during pregnancy, exaggerated or extreme fears of adverse tolerability, and concerns about drug interactions with other medications. Wider public health questions include feared reductions in the use of ongoing, more effective contraception, possible ‘abuse’ of emergency contraception through overly frequent use, and potential increases in risky sexual encounters (owing to the existence of a back-up method) and therefore in rates of sexually transmitted infections, including HIV/AIDS. The behavioural practices are valid concerns and that is why counselling needs to be given when dispensing emergency contraceptives. However, there has been no scientific evidence to support any detrimental side effects.

So, it’s totally safe to take the morning-after pill as many times as you need to — it’s just not the best way to prevent pregnancy long term. Birth control that you use before or during sex is way more effective, affordable, and convenient.

Novia Jerry Stewart, MSc, RPh, is a pharmacist who specialises in ophthalmic care. She may be contacted at novia_jerry@yahoo.com.