“Accidents” also happen around sex… Be it missing a pill, breaking a condom or “forgetting” about it, the worry of getting pregnant after unprotected sex is familiar to many women. Fortunately, the problem has been largely solved with the advent of the so-called emergency contraception. In our country, it is mainly applied in the form of tablets that are taken after sex, although products for insertion into the uterus are also available. They are more effective than tablets and are more effective for a longer period – up to five days – but the need for them to be administered by a specialist has made oral products the most widely used for this indication. Pills contain progestins or a combination of estrogens and progestins, according to which they are divided into mono- or combined products. In our country, pharmacies freely dispense a single-dose product containing 1.5 mg of levonorgestrel. The pills are highly effective (but never 100 percent!) up to 72 hours after sex. It should be noted that it falls rapidly as the interval between intercourse and reception increases, therefore it is necessary to use them as soon as possible. The group of monopreparations also includes the soon-to-be-registered product containing ulipristal in the USA and the EU. Ulipristal belongs to a new class of compounds called selective progesterone receptor modulators. It provides reliable contraception for up to five days after unprotected sex, with effectiveness comparable to that of levonorgestrel. In the EU, it is only available on prescription. Combined pills contain high doses of estrogens and progestins. They are taken twice with an interval of 12 hours. The available clinical data show that they are less effective and lead to more frequent and more serious side effects than monopreparations, which is why the latter have gained a much wider market presence, at the expense of combination products. The question of the benefits and harms of emergency contraception is truly unique in medicine. According to most medical organizations and specialists, including the World Health Organization – WHO, there is no condition where the potential risks of taking them outweigh its benefits – avoiding unwanted pregnancy. Most clinicians favor monodrugs, especially in the presence of thromboembolic events or migraine, which is why they are gradually displacing combination products. Moreover, according to the WHO, the US Food and Drug Administration and a number of other influential international health organizations, there are no contraindications for monopreparations, which is why they can be considered as first-line products when the need for emergency contraception arises. If these are not available, it is switched to the combined tablets, which can be taken even in the presence of venous thrombosis and breast cancer. This is the only indication for which estrogen-containing medications can be taken in the presence of these conditions.NEWS_MORE_BOX Although the contraindications for other hormone-containing contraceptives do not apply to these products, as such they are not devoid of potential hormonal drug interactions. This includes compromising their effectiveness with recent or simultaneous intake of liver enzyme inducers – St. John’s wort, some anticonvulsants and antibiotics, especially rifampicin and rifabutin. Their intake greatly affects hormonal contraceptives, including those for planned contraception. Taking rifampicin or rifabutin for several days makes hormonal contraception unreliable for the next two months. During this period, non-hormonal contraceptives must be relied upon exclusively. Because of their short-term use, emergency contraceptive products have mostly mild and minor side effects, mostly on the part of the gastrointestinal system. This is mostly nausea, followed in frequency by vomiting. If vomiting occurs within two hours after taking such a product, it is necessary to take it again, because the complete absorption of the active ingredient(s) is uncertain. Next in frequency are abdominal pain, menstrual irregularities, fatigue, headache, and breast tenderness, which are usually transient. If menstruation does not occur until two weeks after intake, it is recommended to take a pregnancy test. Levonorgestrel-containing products should not be taken more than once in a monthly cycle due to the risk of hormonal disturbances.Levonorgestrel-containing products should not be taken more than once in a monthly cycle due to the risk of hormonal disturbances.Levonorgestrel-containing products should not be taken more than once in a monthly cycle due to the risk of hormonal disturbances.