Monday, September 3, 2012

The Med Beat: Plan B

Kurtis Morrish

Deep breathes. Don’t forget to take some.”

“Never say never. No one plans on having unprotected sex, but it happens to the best of us.”

“That’s life. Accidents happen, we make mistakes, and some things are out of our control.”

These are the reassuring words that grace the main pages of the Plan B website. The whole web page seems to be designed for someone frantic to search Google in hopes of finding when, how, and where to avoid pregnancy: Plan B! Many people don’t know much about Plan B, other than the fact that it exists simply as “the morning after pill,” and they reserve their rushed research of the drug for that morning after.

If you wake up with the suspicion that your previous night’s activities were not as protected as they could have been, chances are you are worrying about becoming pregnant. Before you panic and rush out to the drug store (or possibly your own medicine cabinet) to do a pregnancy test, remember a few things about conception, and more importantly, preventing conception.

Conception is not instantaneous! Sperm can actually live up to seven days inside a woman’s reproductive system, and conception can occur at any point while the sperm are still there. Conception can also occur quite quickly though, and it is wise to be aware of what to do next if you fear you are pregnant and are not interested in having a baby at this point in your life.

Plan B is proven to be an effective method of preventing pregnancy (that’s right: it’s an emergency contraceptive, not an abortion pill) if taken within 72 hours or whenever Plan A failed (or perhaps never happened). It has been shown that the sooner you take Pan B (within that 72 hour window), the more likely it is to prevent a pregnancy from occurring (within the first 12 to 24 hours is best). 

The drug works in three steps:
1) Plan B stops the ovaries from releasing an egg. 
2) If an egg has already been released, it stops fertilization from occurring. 
3) If fertilization has already occurred, it stops the fertilized egg from implanting in the uterine wall. 
Note that if all three of these effects of the drug fail, then pregnancy is extremely likely to occur.

If you are already pregnant, do not take Plan B! It will not abort the pregnancy. It is good to know that Plan B taken after pregnancy will not have any effects on the fetus.

If you have taken a dose of Plan B (doses vary by medication types and should be determined by consultation with a pharmacist and also your doctor if possible), do not take another dose of Plan B to be “extra safe.” Studies have shown that taking more will not improve your chances of preventing a pregnancy. Excess Plan B is actually more likely to make you feel nauseous, perhaps even enough to induce vomiting, which would only cause you to lose your original dose as well as the extra one you just took.

Pregnancy can be tested within a few days of having unprotected sex, and it is important to do a pregnancy test shortly after taking Plan B (pregnancy tests are more reliable 5 or more days after the fact) in order to double-check that the drug has worked. You should also see your doctor before you take Plan B! Or shortly afterward, if you are not able to see them right away.

In some places, access to Plan B medication is available by prescription only (though most places sell it over the counter), which can be obtained after a brief consultation with a pharmacist. If you find yourself roaming the shelves of a drug store, searching for what you hope to be the prevention of an unwanted pregnancy and can’t find it, do not fear. Don’t hesitate to approach the pharmacist and ask about it. Pharmacists, like doctors, are health professionals that are sworn to confidentiality, and though they may ask a few questions about other medications you are taking, or why you are trying to use Plan B, they are there to help you, not judge you.

Some drugs can conflict with Plan B and make it less effective. Anticonvulsant drugs (phenytoin, carbamazepine), antibiotics (ampicillin, cotrimoxazole, tetracycline, clarithromycin), rifampicin, acetaminophen (in Tylenol, Midol, etc.) have been proven to reduce or negate the effectiveness of Plan B. If you are taking any of these medications, then you should go to your doctor and discuss exactly what you are taking, when you had unprotected sex, and what to do next. Some people are allergic to Plan B and therefore should not take it even if they are extremely anxious about a possible pregnancy. It is also suggested that if you are currently experiencing abnormal vaginal bleeding (not the same as your period) that you do not take Plan B.

Approximately 1/4 of all women who take Plan B feel nauseous after taking it, and half of those who feel nauseous may feel so sick that they begin to vomit. If this happens to you, do not take more Plan B. Go to your doctor! After using Plan B, some women notice changes in their menstrual cycle– possibly coming one week early or late and with a greater or lesser flow than you might be used to. If your period is more than one week late, do a pregnancy test at home or at your doctor’s office; you might be pregnant.

There are some rare and more serious side effects that can accompany taking Plan B, these include: Breast tenderness, headache, dizziness, fatigue, lower abdominal pain, and diarrhea. If any of these persist more than 48 hours, you must seek medical attention immediately. In some cases, women can also develop itching or a rash, sever migraine headaches, or sudden cramps in the stomach or belly. For any of the above it is advised you see your doctor as soon as possible!

If there is one single fact about Plan B to take away from this article, it is that Plan B should not be used regularly as a contraceptive. If you are infrequently sexually active and therefore don’t regularly use any method of birth control, do not simply rely on Plan B after every time you have unprotected sex. Plan B is essentially a high hormone dosage (like a super strong, one-time-use version of a birth control pill) that does exert a strain on your reproductive system. It has also been shown that multiple uses of Plan B will reduce it effectiveness over time.

When thinking about Plan B, start with Plan A!

For more information check out the following links:

Medical Section Columnist, Kurtis Morrish:

My name is Kurtis Morrish. I graduated from Cal last year as an Integrative Biology major. I am now in the process of applying to medical school in the hopes of one day serving people as a family doctor. By no means do I write to you as an M.D., but I have extensive experience doing all kinds of scientific research; boiling-down long, dry, mumbo-jumbo-dense medical journals into a reduction that is a little sweeter, useful, and hopefully informative for you. I hope to learn as much from my writing as you do, so please hit me up with further questions, concerns, or comments!

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