Let's Talk About the Emergency Contraception Method Called Yuzpe
It's important to know that you have options.
(SPOT.ph) Nicola (not her real name) was a year into a serious relationship when she experienced her pregnancy scare. She had just graduated from college then—nowhere near ready, not even thinking about having children—so she tried looking for ways to stop a possible pregnancy. She knew this to be the Plan B pill.
Emergency contraception like Plan B has been banned in the Philippines since 2001, leaving sexually active women like Noelle without a dedicated emergency contraceptive option and forcing them to seek out other solutions.
"Plan B was so hard to find. I remember I kept searching. Wala sa Mercurgy Drug or anywhere else. Sa Shopee naman, it would take x number of days to be delivered to my house," Nicola shared with SPOT.ph. "Puro fear and never-ending 'what ifs.' It was overwhelming."
It wasn't until she did a quick Google search when she learned that birth control pills can be used as a substitute for Plan B pills—with careful adherance to timing and dosage instructions.
She decided to give it a try. Three years later, Nicola is still in the same relationship, still childless.
Unfortunately, not everyone has the same access to information as Nicola had. An online survery by DKT Philippines Foundation revealed that only as few as 13% of women aged 18 to 29 have heard of this alternative method.
To know more about the responsible use of birth control pills as emergency contraception, SPOT.ph spoke with Anne Krisne Oquila, a senior nurse at the Likhaan Center for Women’s Health, a non-government organization that promotes women’s sexual health and reproductive rights.
Everything to know about birth control pills, emergency contraception in the Philippines
Before we talk about emergency contraception, we need to understand how birth control pills work as regular contraception first.
What are birth control pills?
There are two types of birth control pills: progestin-only pills (POPs) and combined oral contraceptive pills (COCs). Progestin-only pills are usually recommended for older women above 35 years old who smoke and have with medical problems like hypertension and a history of blood clots.
When we talk about birth control pills as regular contraception, we’re most likely referring to COCs like Lady, Trust, Yaz, Diane, and Althea.
Birth control pills should be taken at the same time every day. If you struggle with routine, other forms of contraception are available like condoms, contraceptive implants, or an intrauterine device (IUD).
COCs are 99% effective if used correctly and consistently, Oquila said. What happens is that the hormones found in COCs work together to prevent pregnancy by thickening cervical mucus and thinning the lining of the uterus, making it almost impossible for the sperm to reach the egg.
Side effects are uncommon but if a woman experiences them, it's usually either nausea, vomiting, or fatigue that they have to deal with, which can be enough to stop others from taking birth control pills.
"They are mild and will normally resolve without further medications," Oquila said, adding that women can “have any brand as long as they are happy with it and can afford it.”
For a pack of 28 tablets in the Philippines, Trust and Lady will only cost a little over P50. More expensive options include Althea (P400), Diane (P600), and Yaz (P900). Oquila said these over-the-counter pills are available in licensed pharmacies and drugstores as well as in health clinics and family planning centers without the need for a prescription.
Missed a pill? Oquila said only resume sexual contact after a week since it is taken again, otherwise use other additional forms of contraception like condoms for a more protected session.
What is emergency contraception and Plan B?
Emergency contraception, also called morning-after pills or Plan B, is used to prevent pregnancy after unprotected intercourse or contraceptive failure (e.g. a broken condom or a missed pill).
Birth control pills are not Plan B pills. The former is a regular contraception that should be taken everyday, while the latter is a dedicated pill for emergency contraception that is currently prohibited in the Philippines.
The ban on a dedicated Plan B pill in the country stems from a strong opposition the Catholic Church, who consider birth control as a form of abortion. One type of Plan B pill, Postinor, used to be allowed for importation and sale in the Philippines until the Food and Drug Administration reversed this decision in 2001 for the same belief.
Oquila said Plan Bs are not capable of harming or stopping an existing pregnancy.
"The government thinks that Plan B is an abortifacient that is why it is illegal in the country,” Oquila said. “They should be educated that Plan B is a dedicated pill that prevents pregnancy by delaying ovulation. They do not induce an abortion."
Also read: GUIDE: Birth Control Options in the Philippines
How can birth control pills be used as emergency contraception?
Birth control pills can be used as emergency contraception through what we call the Yuzpe method.
“Plan B is not available in the Philippines, so as an alternative what we have is the Yuzpe method," Oquila said. "It [involves the intake of] COC pills that contain levonorgestrel and ethinyl estradiol [that] can be [found] in Trust pills and Lady pills."
For the Yuzpe method to work, Oquila said the pills should be taken within five days after the unprotected sexual contact to prevent 95% chance of pregnancy. Take four tablets for the first 12 hours and another four tablets in the next 12 hours. The longer you wait to take the pill, the less effective it will be, she said.
“A total of eight tablets should be taken within 24 hours to complete the process,” Oquila said, citing the Word Health Organizaon’s claim that emergency contraception is extremely safe to prevent pregnancy. However, women with a history of blood clots, a stroke, or a heart attack should not use the Yuzpe method.
Likhaan's Center for Women's Health founder Dr. Junice Melgar said in a previous interview it is best to avoid Diane and Althea as emergency contraception since both have not been proven to work for the Yuzpe method.
Oquila said experiencing spotting after Yuzpe is normal—in fact, it might even be a good sign: “This is one of the signals that the ECP was effective, but others [do not spot]. In our clinic, we advise them to take a pregnancy test three to four weeks afer the unprotected sexual intercourse to ensure that Yuzpe works.”
Melgar is advising women who throw up within an hour of taking emergency contraception to swallow more pills as replacement. A medical expert told Everyday Health that the same dosage should be repeated as the last batch of pills taken.
Beyond the Yuzpe method, there are no other legal emergency contraceptives to turn to in the Philippines.
Can the Yuzpe method be used as regular contraception?
Birth control pills are not intended for emergency use. That said, the Yuzpe method should only be reserved for emergency contraception, according to Likhaan's Center for Women's Health.
“We reiterate to clients that Yuzpe should be taken only during emergencies," Oquila said. "If they are sexually active, they should have a regular birth control method to ensure that they will not suffer from unintended pregnancies."
You might be thinking: Why not? Is it unsafe? Not necessarily. Oquila said that its "repeated use poses no known health risks," but the Yuzpe method will significantly increase the likelihood for more intense or more frequent side effects like nausea, vomiting, and fatigue from taking several pills at once.
In Nicola's case, she had to endure intense migranes that lasted for days. For this reason, she wouldn't recommend the Yuzpe method to others if it can be helped. Still, she's thankful it brought her peace of mind at a time when she needed it the most.
"I probably wouldn't do it again because hindi naman talaga intended 'yung birth control pills for that reason," Nicola said. "But to be fair, napanatag naman loob ko kahit papaano na I did something for myself."
Also read: Get Birth Control Delivered Directly to Your Doorstep Through This Instagram Account