Is it necessary to eat before taking Plan B? Discover the key facts about emergency contraception, including its uses, side effects, interactions, and proper dosage. Get a thorough understanding of this vital reproductive health topic.

Understanding Emergency Contraception: An Overview

Emergency contraception (EC) is a method used to prevent pregnancy after unprotected sexual intercourse or when your regular birth control method fails. It is an important option for individuals seeking to avoid an unintended pregnancy in the aftermath of a risky sexual encounter. EC can be effective up to 5 days after unprotected sex, though its efficacy is highest within the first 12-24 hours.

Types of Emergency Contraception

There are several main types of emergency contraception, each with its own unique characteristics:

ella®

ella® is a prescription-only emergency contraceptive that is up to 85% effective when taken up to 120 hours (5 days) after unprotected sex.

Levonorgestrel (Plan B One-Step™, Next Choice®, and others)

Levonorgestrel-based emergency contraceptives are available over-the-counter and are up to 89% effective when taken within 72 hours of unprotected sex, with decreasing effectiveness after 3 days.

Copper IUDs (ParaGard®)

The ParaGard copper intrauterine device (IUD) is a highly effective form of emergency contraception, with a 99.9% success rate when inserted up to 120 hours after unprotected intercourse. It also provides ongoing contraceptive protection for up to 10 years.

Hormonal IUDs (Mirena®)

The Mirena hormonal IUD is another highly effective emergency contraceptive option, with a 99.7% success rate when inserted within 120 hours of unprotected sex. It can also provide long-term contraceptive coverage for up to 8 years.

How Does Emergency Contraception Work?

Emergency contraception works by preventing ovulation, thickening the cervical mucus to block sperm, and thinning the uterine lining to prevent implantation of a fertilized egg. It does not cause an abortion if a pregnancy has already occurred.

Effectiveness of Emergency Contraception

The effectiveness of emergency contraception varies depending on the specific method and the timing of use. In general, the sooner it is taken after unprotected sex, the more effective it will be. Levonorgestrel-based options are most effective within 72 hours, while ella® and copper/hormonal IUDs can be used up to 120 hours (5 days) after the event.

Factors Affecting Effectiveness

Certain factors can impact the effectiveness of emergency contraception, including:

Body Mass Index (BMI)

Levonorgestrel-based options may be less effective for individuals with a BMI over 25. Consulting a healthcare provider can help determine the most appropriate EC method based on your BMI.

Timing of Use

The sooner EC is taken after unprotected sex, the more effective it will be. Delaying use beyond 72 hours (3 days) can significantly reduce the success rate.

Using Emergency Contraception

To use emergency contraception, follow the package instructions carefully. Most methods are taken as a single dose or in two doses, with the second dose taken 12 hours later. Eating a snack or drinking a glass of milk can help reduce the risk of nausea.

Benefits and Risks of Emergency Contraception

The primary benefit of emergency contraception is its ability to help prevent unintended pregnancy after unprotected sex. However, it does not protect against sexually transmitted infections (STIs) and is not intended for regular use as a primary birth control method.

Potential side effects of emergency contraception include nausea, vomiting, abdominal pain, and changes in menstrual bleeding. These side effects are generally mild and temporary.

Consulting a Healthcare Provider

It is recommended to talk to a healthcare provider about the best emergency contraception option for your individual needs and circumstances. They can provide guidance on the appropriate method, dosage, and timing to maximize effectiveness and minimize risks.

In summary, emergency contraception is a safe and effective way to prevent pregnancy after unprotected sex or a contraceptive failure. By understanding the different types of EC, their effectiveness, and proper usage, individuals can make informed decisions to protect their reproductive health and avoid unintended pregnancies.

Emergency Contraception | University Health Service

What is emergency contraception?

Emergency contraception (EC) is a method used to prevent pregnancy after unprotected vaginal sex or when your method of birth control fails. Depending on the type of emergency contraception, it may be effective up to 5 days after unprotected sex, but it is most effective within the first 12-24 hours. It is intended for emergency situations and does not protect against sexually transmitted infections (STIs).

There are four main types of EC, and this page will focus primarily on ella® and Levonorgestrel.

ella®

• 85% effective up to 120 hours after unprotected sex
• Requires a prescription

Levonorgestrel (e.g. Plan B One-Step™, Next Choice®, and other brands)

• 89% effective up to 72 hours after unprotected sex; continues to reduce risk of pregnancy up to 120 hours but with decreasing effectiveness.
• Available without prescription (over-the-counter).
• Generic Plan B is available for $10 at the UHS Pharmacy. This is a significant cost saving over other retail pharmacies for those without prescription insurance coverage. 

Mirena (52 mg Levonorgestrel IUD)

• 99.7% effective up to 120 hours (5 days) after unprotected sex
• Requires a consultation and visit to a health care provider for insertion
• Provides ongoing contraception for up to 8 years
• See IUDs for more information. 

ParaGard (copper IUD)

• 99.9% effective up to 120 hours (5 days) after unprotected sex
• Requires a prescription and a visit to a health care provider for insertion
• Provides ongoing contraception for up to 10 years
• See IUDs for more information. 

EC may be used if:

• You had sex without using any type of birth control method.
• Your primary birth control method failed. For example, the condom broke and your partner ejaculated into your vagina.
• You were forced to have unprotected sex. (See the U-M Sexual Assault Survivor website for resources and information)

How does emergency contraception work?

EC consists of one of the two hormones found in birth control pills — progestin. The release of this hormone into your body helps to keep your ovaries from releasing an egg and thickens your cervical mucus to prevent sperm from joining with an egg in the uterus. Progestin also thins the lining of the uterus to keep a fertilized egg from attaching to the uterus.

EC does not cause an abortion. The “morning-after pill” (ella® or Levonorgestrel) is NOT the “abortion pill” RU-486. If you are already pregnant, emergency contraception will not end your pregnancy. If you think you may be pregnant, talk to your health care provider. 

How do I use emergency contraception?

Following package directions, take EC as soon as possible after unprotected sex.  The sooner you start the EC, the more effective it is in preventing pregnancy. Eating a snack or drinking a glass of milk can help reduce nausea.

EC is taken as one or two doses or pills, depending on the product. Take the first pill as soon as possible and, if there is a second pill, you may take it 12 hours later, or take it at the same time the next day.

How effective is emergency contraception?

EC is most effective within the first 12-24 hours after unprotected sex. The sooner you start EC after unprotected sex, the better it will work. Depending on the brand of EC, it may be effective up for to 5 days (120 hours) after unprotected sex.

The efficacy is slightly decreased from 72–120 hours (3-5 days) after unprotected sex, but it is still recommended for use.

In terms of effectiveness, Levonorgestrel:

• Is most effective for women with a body mass index (BMI) that is less than 25. To determine if this pertains to you, you can use a BMI calculator from Mayo Clinic.
• Is most effective within 3 days (72 hours) after unprotected sex. It is less effective after 3 days. 

Talk to your health care provider about which type of contraception is right for you.

What are the benefits of emergency contraception?

• EC is an effective and safe back-up birth control method to prevent pregnancy after having unprotected sex.
• EC is available at local pharmacies or health care clinics to anyone that is 17 years of age or older.
• EC does not affect your ability to get pregnant later, if desired.

What are the downsides or health risks of emergency contraception?

• EC will not provide protection from sexually transmitted infections (STIs).
• EC is not intended for regular use and is not as effective as other forms of birth control. Talk to your health care provider about other long term options that may be right for you.

You may have some negative side effects while using EC. Nausea and vomiting are the most frequent side effects. If you are worried about feeling nauseous or vomiting, you can use anti-nausea medicine about one hour before taking the pill(s). You may also want to eat a snack or drink a glass of milk before taking the pills to reduce nausea.

Other side effects may include: breast tenderness, irregular bleeding, abdominal pain, fatigue, dizziness, or headaches.

Where can I get emergency contraception?

For IUDs (Mirena or ParaGard):

• Call UHS 734-764-8320, select option 2, and request “emergency contraception IUD”
• Learn more about IUDs

By prescription (ella):  Call UHS 734-764-8320, select option 2, and request “ella emergency contraception.” You can also get it in advance (you don’t have to wait for an emergency to get it).

Without prescription (Levonorgestrel): You can buy it at pharmacies, including the UHS Pharmacy, and other stores that sell medication.  It can be purchased by both males and females of any age. There is no limit on the quantity that can be purchased at one time. 

If you are under 17 years old, you need a prescription to get EC.

Important tips

• Take EC as soon as possible! The sooner you start the EC after unprotected sex, the more effective it is.
• If you do not regularly use another form of birth control, you can keep some EC at home in case of an emergency. This will allow you to take it as soon as possible after unprotected sex.
• EC is a good backup birth control option. After you use the morning-after pill, talk with your health care provider to find the best type of birth control for you to use on a regular basis.
• If you vomit within two hours after taking EC pills, call your health care provider.
• After you take EC, it is normal for your next period to be different than usual. Your period may come earlier, be lighter or heavier, or you may have spotting throughout the month.
• If you do not have a period in the next month after taking EC, take a pregnancy test and talk with your health care provider.

Personal Experiences

I had broken up with a long-term boyfriend and decided to take a break from birth control pills, thinking I wouldn’t be sexually active until I had found someone new. On New Year’s Eve, I was still off the pill and I had unprotected sex with one of my friends.While it wasn’t necessarily a negative sexual experience, I got nervous that I could become pregnant. I went to the pharmacy and picked up Plan B Emergency Contraception and while it was a little pricey, it was easy and well worth it! I recommend it for anyone who runs into a similar emergency.

I have taken Plan B in emergency situations only, 3 times over the past five years. Each time after I took it, I was exhausted and had an upset stomach for 3 days. The last time I took Plan B, my period came early. I thought it was strange, but the directions said it could happen. I have never gotten pregnant.

Resources on EC:

• For questions, call for Nurse Advice. 
• Planned Parenthood Emergency Contraception

Related resources from UHS:

• Contraception
• Pregnancy Testing
• STI Assessment
• HIV Antibody Testing
• Resources for Sexual Health

Effectiveness, How It Works, Side Effects, and More

Plan B —also known as the “morning-after pill” —is a type of emergency contraception (EC).

It’s designed to be taken soon after unprotected penis-in-vagina sex to help prevent pregnancy.

Anyone who can become pregnant can take Plan B when needed —there isn’t an age restriction.

However, it isn’t regular contraception, so it should only be used in emergency situations.

For example:

• if you had sex without a barrier
• if the condom broke during sex
• if you forgot to take your birth control pill the day before or after sex

If taken within 72 hours of unprotected sex, this form of EC can reduce the chance of pregnancy by 75 to 89 percent.

According to Plan B’s manufacturer, the sooner you take the pill, the more effective it is.

Certain medications can alter its effectiveness.

If you take any of the following, speak with a healthcare professional before buying Plan B:

• rifampin (an antibiotic)
• griseofulvin (an antifungal)
• St. John’s wort (an herb)
• seizure medications, including carbamazepine, phenobarbital, and primidone
• some HIV medications, including efavirenz

Although the manufacturers advise taking Plan B within 3 days of unprotected sex, you can take it up to 5 days after penis-in-vagina sex.

Research has found that Plan B is “moderately effective” when taken between 72 and 120 hours after sex.

But remember that its effectiveness decreases the longer you wait.

There’s no official weight limit for Plan B.

But the pill may not be as effective for people who have a BMI of 30 or more or weigh 155 pounds or more.

After conflicting results, some researchers have recommended a greater level of counseling for people who fall into those two categories.

But they point out that there’s no reason to restrict Plan B.

More research is needed into whether a higher weight and BMI decreases the effictiveness of Plan B. For now, you’re free to take it, no matter how much you weigh.

However, other forms of EC (mentioned below) may be more effective.

Plan B only works to prevent a pregnancy — it can’t end one.

It helps prevent pregnancy by using a bigger dose of levonorgestrel, the synthetic hormone found in birth control pills.

This mimics the natural hormone, progesterone, delaying the release of an egg from the ovary, thereby preventing ovulation.

If no egg has been released, there’s nothing for sperm to meet, and therefore no fertilization. Plan B also prevents fertilization by making it more difficult for the sperm and egg to meet. Additionally, Plan B may prevent the fertilized egg from sticking to the uterus.

There’s been talk of Plan B also working to prevent a pregnancy after fertilization. But this is near impossible to prove, according to a 2019 review.

Plan B is considered safe. Although it contains a higher hormone dose than birth control pills, the hormone doesn’t remain in the body for a long time.

Of course, you may experience mild side effects, including:

• headaches
• abdominal pain or cramps
• nausea or vomiting
• dizziness
• breast tenderness

Your menstrual cycle may also temporarily change.

This means your period could come earlier or later, and it could be heavier or lighter.

Some people even experience spotting in between periods, while some experience no change to their periods at all.

There isn’t much you can do to prevent these side effects.

But anti-nausea medicine and painkillers may help if you do experience any of the above.

If you vomit within 2 hours of taking this morning-after pill, speak with a healthcare professional to see if you need to take a second dose.

Remember that the biggest risk is that the morning-after pill fails. So, if your period is significantly late, take a pregnancy test.

It’s also wise to remember that you can become pregnant soon after taking Plan B, so ensure you use birth control before having penis-in-vagina sex again.

Expect to pay between $40 and $50 for Plan B.

As Plan B is a branded form of EC, it tends to be more expensive. Generic levonorgestrel pills cost less and work in the exact same way.

There are other ways to reduce the cost.

If you have insurance or Medicaid, for example, you may be covered for some form of EC.

No insurance? You may be able to get EC for free or at a much lower cost at a family planning clinic or local health department.

Plan B’s manufacturer also has a coupon and rebate scheme. Get $10 off by printing out this coupon and taking it to a store that stocks Plan B.

Alternatively, if you’ve already bought the morning-after pill, you can upload a picture of your receipt online or mail it in for a rebate.

Plan B is available over the counter at drugstores and pharmacies. So you don’t need a prescription or ID when buying it.

You may find it in the family planning aisle or need to ask the pharmacist to get it if it’s behind the counter.

Family planning clinics and local health departments, as well as Planned Parenthood centers, also offer the morning-after pill.

If you’d rather buy it online, you can buy directly from the manufacturer. Note that delivery takes around 4 to 6 days.

Stores like Walgreens and CVS also sell Plan B online.

Remember to always buy from a reputable retailer and try to buy in advance, as you can’t guarantee when it’ll be delivered.

Plan B can affect the timing of your next period.

But, if you haven’t had a period within 3 weeks of taking Plan B, it’s best to take a pregnancy test.

If you get a positive result, talk with a healthcare professional for advice on the options that are available to you.

Plan B isn’t the only form of EC out there. Here’s the lowdown on other EC options, how often you can use this form of contraception, and more.

Are there other EC pills you can take?

Ella

If you’re looking for an EC pill that’s more effective longer after unprotected sex, consider ella.

It’s known as an ulipristal acetate pill. It works by delaying or preventing ovulation.

Most importantly, it is said to remain consistently effective when taken up to 5 days after unprotected sex, reducing the risk of pregnancy by 85 percent.

It’s also more suitable for people with a higher BMI or weight. The only drawback is that you need a prescription to get hold of ella. Plus, it can be pricier than Plan B.

Copper IUD

There’s one other type of EC, but it doesn’t come in the form of a pill.

A copper intrauterine device (IUD) can be inserted into the uterus to prevent fertilization up to 5 days after unprotected sex.

It’s more than 99 percent effective if inserted within a 120-hour timeframe.

Of course, you’ll need to book an appointment with a healthcare professional to get an IUD.

But the best part is that you can use it as a regular form of birth control afterwards.

How often can you take EC?

You can take Plan B and other levonorgestrel pills as often as you need them.

There are no long-term side effects.

But ella does have a limitation: The label says you should only take it once during a single menstrual cycle.

It’s also advised not to take two different kinds of EC pills within 5 days of each other, as there’s a risk that they may not work.

Is there a way to stock up on EC?

It makes sense to buy EC pills in advance, so that you have it on hand if you ever need it.

Remember that the quicker you take some forms (like Plan B), the better they work.

You can stock up by purchasing in drugstores, pharmacies, or online — there are no restrictions.

Will EC affect your period?

EC is known to affect the timing of people’s periods.

Some experience an earlier period, while others find theirs comes later.

You may also notice changes in heaviness or light spotting in between taking the pill and your next period.

There’s also a link between regularly taking EC and irregular periods.

So it’s always better to use regular birth control instead of relying on Plan B, ella, and the like.

How long do I have to take Plan B for?

Plan B One-Step consists of one pill, which should be taken as soon as possible after having unprotected sex, missing a contraceptive pill, or contraception failure.

The pill can be taken with or without food, and should be swallowed whole, preferably with water. Plan B should be taken within 72 hours of unprotected sex, for a higher efficacy rate.

Is Plan B the same as the ‘abortion pill’?

Plan B isn’t an “abortion pill.”

Levonorgestrel works to halt pregnancy before it takes place. “Plan B prevents ovulation, so if you’re already pregnant, it won’t work,” says Dr. Amy Roskin, a practicing OB-GYN and the medical director of The Pill Club.

How will I know if Plan B worked?

Plan B is most effective if taken within 72 hours. However, if ovulation has already occurred, the medication might not be able to prevent pregnancy.

“If your period is more than a week late after taking Plan B, you may be pregnant. You should take a pregnancy test and follow up with a healthcare professional,” says Dr. Betsy Koickel of GoHealth Urgent Care.

There are lots of online resources packed with EC information and advice.

Take a look at the following:

• Office on Women’s Health
• Planned Parenthood

Healthline has also published plenty about EC:

• Find out more about your EC options.
• Here’s where it’s available.
• Learn more about potential side effects.
• Know what to do after taking EC.

Lauren Sharkey is a U.K.-based journalist and author specializing in women’s issues. When she isn’t trying to discover a way to banish migraines, she can be found uncovering the answers to your lurking health questions. She has also written a book profiling young female activists across the globe and is currently building a community of such resisters. Catch her on Twitter.

Emergency contraception | 72HRS.RU

Among the many contraceptives, there are those that come to the rescue even in a hopeless situation. These are emergency contraceptives. They are effective in preventing unwanted pregnancy up to 72 hours after an episode of unprotected sex.
The active ingredient in these pills is levonorgestrel, a synthetic hormone that prevents or delays ovulation, preventing fertilization from occurring.

Emergency
contraception

Among the many contraceptives, there are those that come to the rescue even in a hopeless situation. These are emergency contraceptives. They are effective in preventing unwanted pregnancy up to 72 hours after an episode of unprotected sex.
The active ingredient in these pills is levonorgestrel, a synthetic hormone that prevents or delays ovulation, preventing fertilization from occurring.

WHEN AND HOW TO TAKE?

01

When are these

tablets used?

– If you did not use protection

– If you used protection, but the contraceptive was used incorrectly or something went wrong (see
in the table if it suits your case)

02

How should they be taken?

Usually one or two tablets per package. If one – you must drink it within 48 hours (but no later than 72 hours!) After sexual intercourse. If two tablets, then the first you take within 48 hours, and then after 12 hours – the second.

The drug can be used on any day of the menstrual cycle. Tablets are taken orally, regardless of the meal.

48 hours

72 hours

unprotected
intercourse

03

Need to take a pill as soon as possible?

Yes, that’s right! The more time passed between sexual intercourse and taking the drug, the lower its effectiveness (95% during the first 24 hours, 85% – from 24 to 48 hours, and 58% – from 48 to 72 hours) ¹ .

95%

0-24 hours

85%

24 to 48 hours

58%

48 to 72 hours

04

And if it’s night, where can I get medicine? It can wait?

Calculate, if more than 24 hours will not pass until morning, then, apparently, it is not worth running to the pharmacy on duty at night. And for the future, it’s better to buy a pack of pills to use them just in such exceptional cases.

05

Do I need to do any tests before taking the pill?

These drugs are considered safe for women’s health. Before use, it is not required to undergo a gynecological examination, measure blood pressure or take tests.

HOW DO THEY WORK?

06

How do emergency contraceptive pills work?

Typically, most of these drugs contain levonorgestrel, a synthetic derivative of the hormone testosterone. Its main action is to inhibit the process of ovulation ² .

07

But are these pills effective at all?

Yes, especially if you used emergency contraception immediately. Studies show that taking a pill reduces the risk of pregnancy by at least half, and if you drink the drug during the first 24 hours, then generally 95% ¹ .

IS IT DANGEROUS?

08

And if I suddenly become pregnant, what will happen? Medical abortion?

No. Emergency contraceptive pills do not cause abortion. Moreover, they do not harm either the pregnant woman or her fetus. This has been confirmed by studies of women who became pregnant despite taking levonorgestrel, or who used it accidentally after pregnancy.

During the existence of emergency contraceptive pills, no serious complications have been recorded. The side effects that occur are not dangerous to health. These may include: irregular spotting (bleeding), nausea, headache, abdominal pain, vomiting, diarrhea, breast tenderness, dizziness, and fatigue. As a rule, all this goes away on its own without additional treatment.

10

I have heard that emergency contraceptive pills increase the risk of having an ectopic pregnancy in the future.

Is it so?

Let’s turn to research again. Only 1% of women using these tablets experienced an ectopic pregnancy ⁴ . These figures are close to the percentage risk of ectopic pregnancy among pregnancies in which emergency contraception was not used.

Accordingly, we can conclude that these drugs have no effect on the risk of ectopic pregnancy.

11

Can bleeding occur? Does the menstrual cycle get interrupted as a result?

Irregular spotting (bleeding) due to the use of tablets is not dangerous and stops without any treatment.

And with the cycle there may be slight shifts – an earlier onset or a delay in the next menstruation by 5-7 days.

12

And if menstruation has not started?

If you do not have a period after 3 weeks, you should see a doctor and check if you are pregnant.

13

I know that there are many contraindications for taking hormonal contraceptives, such as liver disease, obesity and diabetes.

Does the same apply to emergency contraception?

No, these pills are relatively safe for any woman’s health.

Contraindications to their use are: hypersensitivity to any component of the drug, use in adolescents under 16 years of age, severe liver failure, pregnancy, the presence of rare hereditary diseases – lactose intolerance, lactase deficiency or glucose-galactose malabsorption.

WHAT’S THEN?

14

The last thing I want in the world is to get pregnant right now. Can I take such a pill BEFORE sexual intercourse, so as not to worry?

Theoretically you can, but… Emergency contraception is called emergency contraception because you only use it as a last resort. If you can use any other methods of contraception in advance, then it is better to use them.

15

And if I have another unprotected sex, can I take the pill again?

In general, these tablets are not intended for regular use. But if it happened – yes, you can accept it. Studies have shown that taking multiple doses of levonorgestrel per cycle does not cause serious negative side effects ⁵ .

1. In what cases are these tablets used?
2. How should they be taken?
3. Need to take a pill as soon as possible?
4. And if it’s night, where can I get the medicine? It can wait?
5. Do I need to do any tests before taking the pill?
6. How do emergency contraceptive pills work?
7. But are these pills actually effective?
8. And if suddenly I’m already pregnant – what will happen? Medical abortion?
9. Are there any serious side effects from taking it?
10. I have heard that emergency contraceptive pills increase the risk of ectopic pregnancy in the future. Is it so?
11. Can there be bleeding? Does the menstrual cycle get interrupted as a result?
12. What if you haven’t started your period?
13. I know that there are many contraindications for taking hormonal contraceptives – for example, liver disease, obesity and diabetes. Does the same apply to emergency contraception?
14. The last thing I want in the world right now is to get pregnant. Can I take such a pill BEFORE sexual intercourse, so as not to worry?
15. And if I have another unprotected sex, can I take the pill again?

1. Raymond E, Taylor D, Trussell J, Steiner MJ. Minimum effectiveness of the levonorgestrel regimen of emergency contraception. Contraception 2004;69(1):79-81.

2. Stratton P, Levens ED, Hartog B, et al. Endometrial effects of a single early luteal dose of the selective progesterone receptor modulator CDB-2914. Fertil Steril 2010;93(6):2035-41. Croxatto HB, Devoto L, Durand M, et al. Mechanism of action of hormonal preparations used for emergency contraception: a review of the literature. Contraception 2001;63(3):111-21. Marions L, Hultenby K, Lindell I, Sun X, Stabi B, Gemzell Danielsson K. Emergency contraception with mifepristone and levonorgestrel: mechanism of action. Obstet Gynecol 2002;100(1):65-71.

3. De Santis M, Cavaliere AF, Straface G, Carducci B, Caruso A. Failure of the emergency contraceptive levonorgestrel and the risk of adverse effects in pregnancy and on fetal development: an observational cohort study. Fertil Steril 2005;84(2):296-9. Zhang L, Chen J, Wang Y, Ren F, Yu W, Cheng L. Pregnancy outcome after levonorgestrel-only emergency contraception failure: a prospective cohort study. Hum Reprod 2009;24(7):1605-11.

4. Cleland K, Raymond E, Trussell J, Cheng L, Zhu H. Ectopic pregnancy and emergency contraceptive pills: a systematic review. Obstet Gynecol 2010;115(6):1263-6.

5. Raymond EG, Halpern V, Lopez LM. Pericoital oral contraception with levonorgestrel: a systematic review. Obstet Gynecol 2011;117(3):673-81.

symptoms, causes, treatment, removal, rehabilitation

This text was written by a reader in the T⁠—⁠F Community. Carefully edited and formatted according to editorial standards.

Misato Katsuragi

had her gallbladder removed

Author profile

I am 26 years old. A year ago, my gallbladder was removed, and my life has changed.

For the first time I felt that something was wrong when I was at home: my stomach hurt badly, the pain radiated to my back so that I could not lie down and rolled on the floor waiting for an ambulance. By the time the ambulance arrived, the pain had stopped. She passed in an instant, it even seemed to me that I had invented everything. The doctors reprimanded me that I should have taken painkillers and left.

The second and third attacks happened abroad. I wasn’t sure if my insurance would cover the appointment, so I just rolled on the floor for a few hours, drank a lot of water, and vomited in an attempt to clear my stomach. But even vomiting did not bring relief. The attacks lasted for hours, but they always ended in an instant, I forgot and never went to the doctor.

Finally, when I was at home, another attack occurred. I called an ambulance and agreed to go to the emergency room.

See a doctor

We do not make recommendations in this article. Please consult with your doctor before deciding on treatment. The responsibility for your health rests solely with you.

How I was diagnosed

The doctor in the emergency room asked me in detail about my symptoms: when do they start, where does it hurt, and how long do they last. I described the pain and remembered that it always starts to hurt some time after eating, although it was hard for me to say after which one. Then I was tested, put on a drip and given painkillers. It’s good that I arrived in an ambulance and all this was according to the CHI.

According to the results of the tests, the doctor said that I have stones in the gallbladder, otherwise – cholelithiasis or calculous cholecystitis. It turns out that this is not such a common disease among young people. More often it manifests itself in women 45-50 years old. The doctor said that my seizures can be stopped with “No-shpa”. He advised me to make an appointment with a gastroenterologist and a surgeon, and follow a diet – “Table No. 5″, in which there are a lot of restrictions: for example, you can not eat soup with meat broth and fresh bread.

/list/gastroenterologia/

15 important questions for gastroenterologist Alexey Golovenko

Where do gallstones come from and why are they dangerous? 002 The gallbladder is a small organ whose function is to store bile from the liver and release it into the digestive system for digestion of fats. Gallbladder stones form frequently and for no apparent reason: for example, in the UK, one in ten adults have them. Almost always, their appearance is a harmless situation, and if a person is not bothered by anything, doctors recommend simply observing them.

But sometimes stones block the duct of the gallbladder, the outflow of bile becomes difficult and inflammation develops – calculous cholecystitis. There is pain in the upper abdomen, spreading to the right shoulder or shoulder blade, the person feels sick, vomits, the temperature rises, the skin and sclera of the eyes turn yellow. In such a situation, the gallbladder is removed. Sometimes a doctor may recommend medication to dissolve the stones, but this is usually ineffective.

After removal of the gallbladder, a person can lead a completely normal life with the restriction of fatty foods: they may be bothered by bloating or diarrhea after them.

How my gallbladder was removed

Since then, I have taken the advice of the emergency doctor: as soon as I felt that pain appeared, I drank a couple of No-shpa tablets and lived on. But once, neither two, nor even ten pills helped me. Then I lived in a hostel and did not want to strain my neighbors by calling an ambulance, I suffered all night, and in the morning I went to the emergency room. I was admitted to the hospital with a diagnosis of calculous cholecystitis. The inflammation was stopped and they advised me to sign up for a planned removal of the gallbladder.

But it was not my plan to stay in the hospital for a week, I was going for an internship in France and did not even think about canceling it. According to the law of meanness, during the internship, I had an aggravation, the pain did not stop again even after taking antispasmodics and lasted for several days. The only way to get rid of the pain was the prescription drugs of my acquaintances. I did not want to lie in the hospital and fall into debt in France.

Upon returning to Moscow, the question arose sharply, since the attack could now start from anything: from salad with cucumbers, chocolate, or a stressful situation. The pain was unbearable: it seemed that the Alien was coming out of me. And there was also vomiting of bile, which did not bring relief. I did not have a Moscow residence permit, and in order to get a planned operation for free, I applied to the Moscow – Capital of Health project. This is a program for the regions, in which every Russian can register and get treatment. In my case, they answered me two weeks after submitting the application, they said that I fit the program criteria, and even offered hospitals to choose from. I chose the Botkin hospital, it was the largest of all offered and the most popular.

First, I went to the surgeon for an appointment, where they confirmed the diagnosis of calculous cholecystitis and told me that I needed to undergo an operation to remove the gallbladder — laparoscopic cholecystectomy.

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Preparing for surgery. I was given referrals for the necessary tests: a biochemical blood test, a general urinalysis, tests for HIV, syphilis and hepatitis B and C, ECG, fluorography, FGDS and ultrasound. I did all the studies in the same hospital for compulsory health insurance. The only thing I had to pay for was a measles vaccine, without which I was not hospitalized. She cost about 900 R, but not everywhere it could be done: I called about seven hospitals before I found one where the vaccine was available.

Feelings after the operation. I still remember how I woke up from anesthesia in a state of mild euphoria, stretched sweetly, remembered that I had dreamed of French rap, shared my dreams with those present in the ward and started screaming in pain: the effects of anesthesia had passed.

After the operation, I stayed in the hospital for two days, during which time the surgeon who operated on me came only once. On the third day I was already discharged. They said that I could make dressings on my own and see a surgeon in my city in a month. I was also prescribed a diet and several drugs, of which at first I only drank an enzyme, as it helps digestion. Spent 600 rubles on it.

During laparoscopic surgery, no incisions are made, but only punctures in several places and all manipulations are carried out through them. This is great, because then there are no big scars. The photo shows my four laparoscopic punctures

How I dealt with the consequences of the operation

After I was discharged from the Botkin hospital, the most interesting thing began. The stitches hurt a lot, but I thought that everything was okay, because I had an operation, and this is how it should hurt. The temperature was still rising, I felt weak, but did not attach any importance to this.

Two weeks later, I went to a private clinic to have the stitches removed, because Botkin didn’t seem to owe me anything anymore. There, the surgeon told me that I had an abscess in the area of ​​the suture under the navel – this is a purulent focus that formed after the removal of the gallbladder. This could have happened due to the fact that after the operation I was not given a drain. The doctor said that now he will open everything and treat me. And so they did: they cut only the healed scar, from where rivers of pus gushed. It was disgusting, painful and embarrassing. Removal of sutures and opening of an abscess with anesthesia cost 9390 R.

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The follow-up treatment took another month: I was put on drips, dressed every two days, and I went to see the surgeon. Only two months after the opening of the abscess, I was finally able to sleep on my stomach and stretch. All this cost a pretty penny – about 65,000 R. For me, this is a huge amount, since I was still studying at that time, and I had to ask my boyfriend for money for treatment. Later, a friend told me that I could call an ambulance and they would take me away to do all these CHI procedures, but they don’t wave their fists after a fight.

What has changed after the removal of the gallbladder

Immediately after the operation, I ate very selectively and carefully, avoided spicy and fatty foods, did not lean on pastries and chocolate, as usually this could provoke a new attack. But gradually I returned to my normal life. True, I had to give up alcohol.

Once, on my first March 8 after the operation, I drank three glasses of alcohol and the next day I regretted what had happened: I felt a strong heaviness in the liver area, all day I was vomiting bile, my head was splitting. And although there was not much alcohol, this hangover was monstrous. On the same day, I realized that I would no longer be able to drink alcohol. Without gall, I just can’t digest it.

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It’s been nine months since I’ve been drinking. I miss the cultural and social phenomenon of alcohol. I would like to, as before, come to a restaurant, choose wine for a meal, try something new, become a little more fun, talk with a friend over a glass of wine.

You can have fun without alcohol, but I miss the taste of Chablis and Riesling.

Of course, a glass of wine will not kill me, but a severe headache will begin in a couple of hours and heaviness in the hypochondrium. I have suffered so much that I try to prevent this pain.

At first, at family celebrations, they poured me a glass all the time, but after a couple of explanations that I couldn’t digest it, they left me alone. By the way, advice to everyone who has also given up alcohol and does not want to draw attention to it: just let your glass be filled. Believe me, it’s much easier and faster than explaining why you don’t drink. And to drink or not to drink is your business.

In general, I try to avoid spicy, greasy, and don’t go overboard with yeasty baked goods. If I eat fatty food, I start to feel very sick, sometimes I can wake up from nausea at night. And from the abundance of pastries, it pulls in the right side, in the place where the gallbladder once hurt. The rest of the diet is the same as that of healthy people.

This is what my breakfast looks like

Expenses

The bitter truth that I remember is that a miser pays twice. The treatment of the abscess cost me the same amount that I would have paid for the removal of the gallbladder in a private clinic.

I spent 75,890 R for the treatment of calculous cholecystitis

Expenses

Expenses

Droppers and dressings in a private clinic

65,000 R

Removal of sutures and opening of the abscess with anesthesia

9390 R

Measles vaccination

900 R

Enzymes

600 R

At first I wanted to blame the doctors of the Botkin hospital for my troubles with the abscess, but then I realized that I was just unlucky, and looking for the guilty ones was a thankless task.