Morning After? Day Before? Not So Fast…


You might have seen recent media about the possibility of using emergency contraception, not only as a ‘morning after’ pill, but also a ‘morning of’ pill.  A recent literature review was published online in Obstetrics and Gynecology on Monday, concluding that there is definite potential, down the road, for something researchers like to call a ‘pericoital oral contraceptive.’

A pericoital oral contraceptive is a pill that a woman can take around the time she has intercourse.  This means a woman takes it only when she actually has sex, either before or after.  Since most women at risk for unintended pregnancy have sex once a week or less, this option makes sense, why take a pill everyday if you are only having sex once a week? 

Although this review concludes there is potential for a safe and effective pericoital oral contraceptive, it isn’t telling you to go ahead and ditch your regular or backup method of birth control.  As the authors admit there are limitations to the conclusion drawn from this literature review.  The studies included examined the effectiveness of varying levonorgestrel regimens, for women in different age groups, and for use ranging from ‘infrequent’ to ‘unlimited.’ It is tough to compare data for a 16-year-old who has sex twice a week to a 39-year-old who has sex twice a month.  Further, this literature review also includes studies that lack “modern standards of design and analysis.”  Finally, the authors agree that this study doesn’t have enough conclusive information to promote emergency contraceptive pills as a regular method of contraception.

Nevertheless, this literature review does suggest that a pericoital emergency contraceptive could be more convenient for many women.  Because this pill is only taken around the time of sex, it may be easier to plan for and remember.  In addition, many participants in the studies that were reviewed preferred a pericoital oral contraceptive to other pericoital methods like condoms or vaginal spermicides.  Of course, as with any birth control methods, there are some negative aspects too, the biggest one for this method causes variation in menstrual length and timing.

While this literature review does not go so far as to recommend emergency contraceptive for pericoital use, it certainly opens the door to a realm of possibility for such a method in the future.  With more research, especially research that uses a standard regimen, a better determination can be made about the window of effectiveness and other unanswered questions illuminated by this review.


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