• 500 mg metronidazole, two times a day.
A woman should research contraceptive options and use a method of choice. A woman’s reproductive years on average span thirty years of her life. Each woman needs to stay informed of available contraceptive options. Some women will use every available contraceptive method.
There are many contraceptive options available to women and men. This section will not go into detail on the more common methods, as many written resources are already available on the more widely available contraceptive options: condoms, birth control pills, spermicides, etc. Instead, we will focus on the latest pharmaceutical and the alternative methods of contraception.
Appendix J: Contraception
Emergency Contraception Pills (ECP), also known as morning after pills, are synthetic hormones or steroids taken orally in the few days after sex when a woman believes she may become pregnant. The hormones or steroids in emergency contraception disrupt the body’s hormone levels and makes pregnancy less likely. Depending on where a woman is during her cycle, ECP can prevent ovulation, fertilization, or sperm transport. Around the world, ECP pills (under various brand names) are available either over-the-counter or from a pharmacist in 50 countries.
(92% effective) Mifepristone, a single dose of 100 mg, can be taken as an emergency contraception option.[545] Mifepristone is contraindicated in women who have an IUD, an ectopic pregnancy, adrenal failure, bleeding disorders, inherited porphyria, or anticoagulant or corticosteroid therapy.
(85-89% effective)[546] Levonorgestrel, also known as Plan-B, is a progestogen- only ECP. Plan-B is the only dedicated FDA approved Levonorgestrel ECP specifically marketed for emergency contraception in the United States. ECPs are available either over-the-counter or from a pharmacist without having to see a clinician in 43 countries, where more than 50 emergency contraceptive products are specifically packaged, labeled, and marketed. Progestogen-only ECPs work best the sooner they are taken after unprotected sex, but can be used up to 72 hours after unprotected intercourse.
(56% effective) Contraceptive pills may be used as ECP. With more than 60 million women worldwide on contraceptive pills, this option of emergency contraception may be more available than progestogen-only ECPs. However, the drawback to using contraceptive pills as for emergency contraception is that they are less effective than other ECP options. Birth control pills as emergency contraception can be used within 120 hours of unprotected intercourse, however the sooner the pills are taken the more effective they are. The use of contraceptive pills as ECP, can make a woman’s menstruation come a few days later than usual. Women who have had a past heart attack or stroke, blood clots in the legs or lungs, or cancer of the breast, reproductive organs, or liver are not advised to use contraceptive pills as ECP. Various brands of contraceptive pills contain varying amounts of hormones.
To use contraceptive pills as ECP, one must take 100 mcg ethinyloestradiol and 0.5 mg levonorgestrel, to be repeated 12 hours later.
It is essential to follow the latest guidelines exactly for the particular brand of pill; to find the latest guidelines, go to the online ECP web database of Princeton University, www.not-2-late.com.
Words to the Wise: Schedule your dosages of EPCs so that the second dose is taken before bed. Take anti-nausea medicine dimenhydrinate (like Dramamine™) one hour prior to the dose, if you are sensitive to nausea. If vomiting occurs within three hours of a dose, that dose should be repeated to make sure that enough hormones have entered the system to provide contraception.
Women who take ECP should watch for severe abdominal pains, chest pain or shortness of breath, severe headaches, vision problems, or severe pain or numbness in the extremities. Seek immediate medical attention if any of these problems occur.
Both men and women above the age of 18 can purchase FDA approved ECP without a prescription. If a person is under the age of 18, she or he may require a doctor or pharmacist’s prescription to obtain ECP in the United States. Not all pharmacies stock ECP, so call ahead.
The following recipes are considered tried and true among midwives and natural health practitioners. They are best used in combination with a barrier method, such as a cervical cap or diaphragm. However, they can be used alone, but they will not be as effective when used alone.
Recipe 1
1 Tbs. (15 ml) 100% Aloe Vera Juice
4 drops fresh lemon juice
Recipe 2
1 tsp. Vitamin C Powder
2 Tbs. Personal Lubricant
To make a contraceptive sponge, cover a sea sponge with silk and tie with a ribbon. Mix the chosen recipe well. Dip your sponge in your spermicide or apply to a diaphragm or cervical cap and insert at least 10 minutes prior to intercourse. A small syringe, like an infant medicine syringe available at most pharmacies, can also be used to apply spermicides. Wait 8 hours after the last sexual act to remove the sponge or diaphragm, as removing earlier will remove the spermicide and not kill all the sperm. Do not leave the diaphragm or sponge in place for longer than 24 hours.
In ancient times women are documented as using estrogenic herbs in the week following their period as a contraceptive measure. The week following the menstrual period is when a woman’s natural estrogen levels are at their lowest. For women seeking naturally derived means of birth control, a possibility exists that utilizing estrogenic herbs (like pomegranate seeds) at this time of their cycle could interfere with ovulation and prevent pregnancy. No studies have been done on this contraceptive method.
To determine the correct dosage of estrogen, a woman can monitor estrogen levels while taking herbs with a body-fluid based observation lens (see Resources). The lens is a small microscope which allows a woman to see the characteristic crystallization of estrogen in a woman’s saliva or vaginal fluids during ovulation. Altering the hormonal balance in the body by increasing estrogen immediately after menstruation (when estrogen is normally is at its lowest) would likely interfere in the ability of the body to ovulate normally that month.
1. First, for a month or two, a woman should observe her normal estrogen levels with the lens while utilizing non hormonal contraception like condoms.
2. When a woman can recognize the changes that occur in her saliva during her normal ovulation, she may begin taking estrogenic herbs in the week following her next period. A woman should continue using condoms or her chosen nonhormonal contraceptive while testing and observing estrogen levels with the following method.
3. Increase the oral consumption of the estrogenic herbal substance (pomegranate seed) until the characteristic ferning indicative of estrogen is observed with the observation lens.
4. Monitor estrogen levels with the lens and adjust dosages to keep the body at observable estrogen for the six days after menstruation.
5. Continue monitoring estrogen levels throughout the entire month. If the characteristic ferning pattern reappears, ovulation would be indicated and further methods to prevent implantation would be needed if unprotected intercourse occurs around ovulation
Online Resources
► www.YourBackline.org
545
Premila W. Ashok, Catriona Stalder, Prabhath T. Wagaarachchi, Gillian M. Flett, Louise Melvin, and Allan Templeton, “A randomised study comparing a low dose of mifepristone and the Yuzpe regimen for emergency contraception,”
546
WHO Task Force on Postovulatory Methods of Fertility Regulation, “Randomised Controlled Trial of Levonorgestrel versus the Yuzpe Regimen of Combined Oral Contraceptives for Emergency Contraception,”