Will Postinor 2 work twice in one month?

Dear Dr Mitchell,

I took the Postinor 2 pill about two to three weeks ago and one week after I had my menses. I had sex after and the condom broke and I went to the doctor and got the pills again. I just want to know if the pills will still work after taking it twice in a month.

Postinor 2 is a form of emergency contraception. This is not recommended to be used ideally more than two to three times in a month as it does not give the effective level of protection that other methods of contraception offer. Postinor 2 contains the hormone levonorgestrel which prevents an unwanted pregnancy by altering your ovulation pattern and changing the lining of the uterus to make it hostile to implantation of a fertilised egg and also thickens the cervical mucus to render it difficult for sperm to magnate into the upper part of the uterus and tubes where fertilisation takes place. It has to be taken within 72 hours of unprotected intercourse and one tablet is taken initially then repeated 12 hours later.

It prevents an unwanted pregnancy in 75 per cent of cases. This is good in an emergency setting but not good enough for a regular method. If you are concerned about an unwanted pregnancy, it is always safe to take the Postinor 2 but you should bear in mind that the more often you need to take it the less likely it is that it will be effective.

Postinor 2 does not contain any oestrogen so it is ideal for women who should not take oestrogen. This includes women at high risk of getting a clot in their legs (sicklers, obese patients, smokers and women who have had a clot before in the past). Women who have breast cancer and other oestrogen dependent cancers can safely take Postinor 2. If oestrogen is not contraindicated then you should consider taking a low dose oral contraceptive pill instead of using the Postinor 2 frequently. Other available methods include the monthly injection (Depo Provera), the intrauterine contraceptive device (IUCD), contraceptive patch (EURA), and the vaginal ring (NUVA ring).

It is important to use either the male or female condom to prevent sexually transmitted infections since none of the other methods will prevent this. Condom usage reduces your risk of contracting the human papilloma virus infection (HPV) which causes genital warts and cervical cancer by as much as 75 per cent, so you can see that you are still at risk despite good and safe sexual practices.

It is important to prevent cervical cancer which is sexually transmitted by taking the cervical cancer vaccine and also doing regular pap smears. This is now available all over the world, including Jamaica.

Consult your doctor who will advise you further on this matter.

Best wishes.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send questions via e-mail to allwoman@ jamaicaobserver.com; write to All Woman, 40-421/2 Beechwood Ave, Kingston 5; or fax to 968-2025. We regret we cannot provide personal responses.