In the vast universe of contraception methods, understanding the nuances between different types of methods is crucial for making informed decisions about reproductive health. Among these, emergency contraceptive pill (ECP) and oral contraceptive pills (OCPs), or birth control pills (BCPs), stand out for their specific uses and mechanisms. This blog delves into the key differences between these two important contraceptive methods.
1. Purpose
Emergency Contraceptive Pill (ECP):
Often referred to as the morning-after pill or plan B, the ECP is designed to prevent an unintended pregnancy after unprotected sex (when no contraception is used) or contraceptive failure (for example, when the condom breaks, slips, or leaks during sex). It is intended for emergency use only and not as a regular form of birth control or contraception.
Birth Control Pill (BCP) or Oral Contraceptive Pill (OCP):
Often referred to as simply the pill, it is used as a regular contraceptive method that is taken daily, irrespective of whether any sex occurs on the day, to prevent pregnancy over a long term.
2. How They Work
Emergency Contraceptive Pill (ECP):
The most common type of ECP used in India is the one containing the synthetic progestogen (a female hormone) called Levonorgestrel (LNG). The LNG ECP works primarily by preventing or delaying ovulation, which occurs when the ovary releases the mature egg that can be fertilized by a sperm to eventually lead to a pregnancy. It may not work if ovulation has already occurred.
Birth Control Pill (BCP) or Oral Contraceptive Pill (OCP):
These pills come in two forms: combined pills (containing estrogen and progestogen) and progestogen-only pills (also known as mini-pills). Both types work by:
preventing ovulation so that the mature egg is not released,
thickening the cervical mucus so that, in case ovulation has already occurred, the sperm is less likely to reach the egg, and
thinning the inner lining of the uterus so that, in case fertilization has already occurred, the fertilized egg in less likely to attach to the uterus to begin a pregnancy.
3. Usage & Timing
Emergency Contraceptive Pill (ECP):
An ECP is intended for emergency use only and not as a regular form of birth control. The LNG ECP should be used as soon as possible up to 72 hours (3 days) after unprotected sex.
Birth Control Pill (BCP) or Oral Contraceptive Pill (OCP):
Regular BCP or OCP is intended for daily use to consistently prevent pregnancy over a long period. It should be taken daily, at about the same time each day, irrespective of sexual activity. This consistency helps maintain the hormone levels necessary. The progestin-only pill, has a tighter window, usually within a 3-hour window of the same time each day, because it has a shorter duration of action.
While the BCP or OCP can be started on any day, it is typically started on the first day of the menstrual cycle, which is usually also the first day of the period. This is to mimic the natural menstrual cycle and minimize any chances of spotting or intermenstrual bleeding. When starting for the first time, the BCP or OCP takes up to 7 days to be effective. Therefore it is necessary to use an alternative contraceptive method like a condom during this time.
4. Effectiveness
Emergency Contraceptive Pill (ECP):
The effectiveness of an ECP depends largely on how soon it is taken after the first episode of unprotected sex. The LNG ECP is about 95% effective if taken within 24 hours of unprotected sex, but its effectiveness drops to about 58% if taken between 48 to 72 hours, and it may not be effective if ovulation has already occurred, as the LNG ECP works primarily by preventing or delaying ovulation.
Birth Control Pill (BCP) or Oral Contraceptive Pill (OCP):
In perfect use, when taken consistently and correctly (the same time each day without missing any pills), BCPs or OCPs are more than 99% effective at preventing pregnancy. The effectiveness of combined BCPs or OCPs in typical use, which accounts for occasional missed pills, is around 91%. On the other hand, progestin-only BCPs or OCPs have a slightly higher failure rate in typical use, due to stricter timing requirements.
5. Potential Side Effects And Risks
Emergency Contraceptive Pills (ECPs):
Potential side effects of an ECP include nausea, cramps, fatigue, headache, dizziness, and breast tenderness. These symptoms are usually mild and resolve within a few days. An ECP can also cause temporary changes in the menstrual cycle, such as spotting or altering the timing of the next period. Some women may experience a heavier or lighter next period than usual.
While there are no serious long-term effects from repeated use, an ECP is not recommended as a regular contraceptive method due to lower effectiveness compared to other forms of birth control, and potential for more frequent side effects and menstrual irregularities.
Birth Control Pill (BCP) or Oral Contraceptive Pill (OCP):
Potential short-term side effects of a BCP or OCP can include nausea, headaches, breast tenderness, weight gain, mood changes, and spotting between periods. These often diminish over a few months as the body adjusts to the hormones.
Although rare, BCPs or OCPs may slightly increase the risk of high blood pressure, breast and cervical cancers, and blood clots (especially in women who smoke or are over 35). On the other hand, BCPs or OCPs can decrease the risk of ovarian, endometrial, and colorectal cancers, regulate the menstrual cycle, and reduce menstrual cramps.
Conclusion
Understanding the differences between an emergency contraceptive pill (ECP) and birth control pill (BCP) or oral contraceptive pill (OCP) can empower individuals to make informed decisions regarding their reproductive health. While both play crucial roles in preventing unintended pregnancies, their mechanism, usage timing, effectiveness, and potential side effects and risks differ significantly. By educating oneself about these differences, one can choose the most appropriate method for their needs and circumstances.
Important
This blog, including its text, images, and infographics, are for educational purposes only and not a substitute for professional medical advice. For personalized advice, always consult a doctor.
Further Reading
For more details on this or related topics, refer to the papers listed in references below, the FAQs on the ECP page, or other blogs on the Learn page of our website dulycare.in.
References
World Health Organization (WHO). Family Planning: A Global Handbook. 2022.
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