In Singapore, common myths and misconceptions shroud the elusive topic of emergency contraception. We share a story from one of our ladies at Dame, delving into the crucial truths about the subject.

Understanding the truths about emergency contraception is a step towards informed decision making. Going beyond the morning after pill, this article exposes the truths every woman should know about emergency contraception in Singapore. At Dame, get your emergency contraception pills delivered directly to your doorstep, it is as easy as one-two-there, click here, get a consultation and get the medication before it is too late. 

Myth #1: Emergency contraception causes an abortion.

The Truth: Emergency contraception does not terminate an existing pregnancy.

Emergency contraception works primarily by preventing ovulation or fertilisation. It does not terminate an existing pregnancy. Emergency contraception is a preventive measure, not an abortion method. 

How it Works

All methods of emergency contraception work by lowering the chance that an egg will be fertilised by sperm. Intrauterine devices (IUDs) may also reduce the chance that a fertilised egg will implant and start a pregnancy.

Emergency contraceptives cannot reverse a pregnancy that has already occurred. If a fertilised egg has already implanted itself in the uterus, emergency contraception will not interfere with or harm the pregnancy. 

Pills for emergency contraception like the morning after pill or Plan B do not contain the same medications as pills for abortion. 

Myth #2: They are 100% effective.

The Truth: The effectiveness of emergency contraceptive methods reduces with time.

While emergency contraception is highly effective, especially when taken soon after unprotected sex, it is not 100% foolproof. There is still a chance of pregnancy, and it is more effective the sooner it is taken. 

How Well Does it Work?

The emergency IUD is more effective than pills. The copper IUD is the most effective form of emergency contraception. It can prevent more than 99% of pregnancies when inserted within 5 days of unprotected sex. Also, the intrauterine device works very well to prevent pregnancy regardless of body weight. 

Several different factors affect how well emergency contraceptive pills work like:

  • How soon the pill was taken after sex
  • Which part of the menstrual cycle you are in
  • How many times you had unprotected sexual intercourse
  • How much you weigh

In general, the sooner emergency contraceptive pills are taken after unprotected sex, the better they work. When used within 72 hours (three days) of unprotected sex:

  • The risk of pregnancy for women taking ulipristal acetate (brand name: Ella) is 1-2%. This means that 1-2 women out of 100 will get pregnant anyway.
  • The risk of pregnancy for women taking levonorgestrel (brand name: Postinor-2 or Plan B) is 1-7%. This means that 1-7 women out of 100 will get pregnant anyway. 

Myth #3: It leads to infertility.

Exploring DAME emergency contraception options in Singapore

The Truth: Emergency contraception does not affect future fertility.

There is no evidence to suggest that using emergency contraception leads to infertility. It is a temporary and short-term method that does not affect future fertility.

Is it Safe?

The different types of emergency contraception are safe in most women. The intrauterine device (IUD) can be used by most people. Emergency contraceptive pills like Postinor-2 or Plan B contain levonorgestrel, a synthetic hormone that mimics the natural hormone progesterone. This hormone is also found in birth control pills and have been used safely for years. 

Women who cannot use hormonal contraception can usually use the emergency counterpart because it is taken for only one day. Always check with your doctor if you have any concerns. Some types of contraception like the copper IUD or Ella do not contain any hormones. 

Myth #4: It encourages risky behaviour.

The Truth: Emergency contraception is a back up plan.

There is currently no evidence of a relationship between increased access to emergency contraception and sexual risk-taking. Emergency contraception is meant to be a backup method for contraception and should not replace regular contraceptive practices. It is not intended to promote or encourage risky behaviour; rather, it provides an option for unexpected situations. 

Emergency contraception serves as a backup option for situations where regular contraceptive methods may have failed or were not used. Being well-informed about regular birth control empowers women to take control of their sexual health. In unforeseen circumstances, understanding emergency contraception becomes crucial. 

Does it Prevent Sexually Transmitted Infections (STIs)?

Emergency contraception does not protect against STIs. It also does not reduce the risk of STIs. Practising safe sex such as the consistent and correct use of condoms and regular screenings reduce the risk of STIs. 

Practising safe sex is a multifaceted approach that involves both physical precautions and responsible behaviour. Being well-informed protects women from the potential negative consequences of sexual activity, promoting overall sexual health and well-being.

Myth #5: Only young or unmarried women need emergency contraception.

The Truth: Emergency contraception is relevant to women of all ages. 

I used to assume that women in long-term relationships or marriages have better control over family planning. Therefore, emergency contraception is irrelevant to them as “they’ve got it all figured out”. 

However, after joining the “married club” – it dawned on me that unplanned situations can occur at any stage of life. Emergency contraception is relevant to women of all ages, regardless of their marital status. 

When to Use Emergency Contraception

Emergency contraception is a way to prevent pregnancy if you recently had sex. According to the World Health Organisation (WHO), emergency contraception can be used in these situations:

  • When no contraceptive has been used
  • Sexual assault (you can seek help in Singapore here)
  • When there is concern of possible contraceptive failure, from improper or incorrect use, for example:
    • A condom breaks, slips off or is not used correctly
    • You forgot to take your regular birth control pills
    • You missed your birth control injection appointment
    • Your birth control skin patch comes off, is removed too early, or is put on too late
    • You miscalculate the fertile days of your cycle
    • Your partner does not “pull out” or withdraw in time, ejaculating inside your vagina or on your genitals
    • Your intrauterine device (IUD) accidentally comes out

Dame offers consultations with MOH approved doctors on emergency contraception, speak to one today!

Different Types of Emergency Contraception in Singapore

DAME: Your partner in safe and effective emergency contraception in Singapore

Not all emergency contraceptives are created equal. There are two main types of emergency contraception in Singapore: emergency contraceptive devices and oral emergency contraceptive pills. 

The Copper Intrauterine Device (IUD)

The copper IUD is also commonly known as the non-hormonal IUD. The copper IUD can be inserted for emergency contraception within 5 days (120 hours) of unprotected sex. It is the most effective option with the lowest pregnancy rate (<0.1%). When left in place, the device can provide at least 5 years of reversible contraception. 

How Does The Copper IUD Work?

The intrauterine device is wrapped in a copper coil. This introduces copper ions in the uterus, providing contraceptive benefits as they are found to be fearsome sperm killers. This prevents the sperm from moving to the egg so fertilisation cannot happen. 

Additionally, since the device sits inside the uterus, fertilisation and implantation of the fertilised egg cannot occur. 

Is The Copper IUD Available in Singapore?

In the United States, ParaGard is the only brand of copper IUD approved by the FDA. In Singapore, brands of the copper IUD registered with the HSA include Nova T® by Bayer and Multilan AG Multiload by MSD Pharma Singapore.

How Much Would The Copper IUD Cost in Singapore?

The copper IUD is available through polyclinics in Singapore that offer women’s sexual  health service. It can cost between SGD150-300. 

For cases that are more complex requiring specialised women’s services, it can be done at public hospitals like KKH and NUH. This will usually incur more costs. You can also check with your private clinic if this service is provided, costs normally vary with private clinics. 

How Is The IUD inserted?

The IUD insertion process is a simple procedure. There is no need for sedation or general anaesthesia. Your doctor will examine your vagina to determine the size of your uterus and the appropriate IUD size. They may also test you for sexually transmitted diseases (STDs).

Using an introducer, the doctor will then insert the IUD in a procedure that typically lasts about 5 minutes. You can find out more about the procedure here

Most women experience some cramping or pain during IUD insertion. The intensity varies, lasting only a minute or two. Factors influencing discomfort include individual pain tolerance, cervical canal length and whether you have previously delivered a baby vaginally.

While some describe the insertion process as more uncomfortable than painful, noting a quick pinching sensation, others may find it more challenging. If you have concerns about pain or feel anxious, it is essential to discuss this with your doctor. They can often prescribe medication such as painkillers, in advance. 

Will The Copper IUD Affect Future Fertility?

The copper IUD is a type of long-acting reversible contraception, it will not affect a woman’s fertility. It can be easily removed when a woman wishes to conceive. After removal, the return of fertility is immediate. 

Oral Emergency Contraceptive Pills (Morning After Pills)

Oral emergency contraception involves the use of pills that either contain hormones (Postinor-2) or interfere with hormones (Ella).

The Levonorgestrel Pill (Postinor-2 or Plan B)

Levonorgestrel is a synthetic hormone that mimics the natural hormone progesterone. It is the first morning after pill and has been around since the 1970s. 

Levonorgestrel is marketed under the brand “Plan B” in the United States where it is also available over-the-counter. In Singapore, Levonorgestrel is marketed under the brand name “Postinor-2” and is only available upon a doctor’s prescription. 

Read our comprehensive guide on using Postinor-2 in Singapore here. 

The Ulipristal Acetate Pill (Ella)

Ulipristal acetate is not a hormone but it works similarly to Levonorgestrel. It prevents the hormone progesterone from having its normal effect on ovulation and fertilisation. 

In Singapore, Ulipristal acetate is marketed under the brand name “Ella”. It is a more recent emergency contraceptive pill in the market, approved for use since 2010. 

How Does the Emergency Contraceptive Pill Work?

Postinor-2 or Ella lower the chance of pregnancy in the following ways:

Inhibition of Ovulation

The emergency contraceptive pill primarily works by preventing ovulation (release of the egg from the ovary). If an egg is not released, the sperm cannot meet the egg for fertilisation to happen. Pregnancy cannot happen. 

Alteration of Cervical Mucus

The emergency pill may change the consistency of the cervical mucus, making it thicker. This makes it more difficult for the sperm to move through to reach the egg for fertilisation. 

Changes in Uterine Lining

The uterus is where a fertilised egg attaches and grows into a pregnancy. The emergency pill can alter the uterine lining. If fertilisation has already occurred, the emergency contraceptive pill may prevent the fertilised egg from attaching to the uterus. This reduces the likelihood of a fertilised egg developing into a pregnancy. 

What Is The Difference Between Postinor-2 and Ella?

Postinor-2 and Ella differ mainly in their usage, effectiveness and cost. 

Usage

Postinor-2 treatment consists of TWO tablets. Both tablets should be taken as soon as possible, within 72 hours (3 days) after unprotected sex. 

Ella treatment consists of a single tablet. The tablet should be taken as soon as possible, within 120 hours (5 days) after unprotected sex. 

Effectiveness

Taking the emergency contraceptive pill soon after unprotected sex enhances its effectiveness. In clinical studies, Ella outperformed Postinor-2 within the first 120 hours, with lower pregnancy risks (1.8% vs 2.6%). Additionally, Postinor-2 is less effective in women with a higher BMI (equal to or over 30 kg/m2) compared to Ella. 

Cost

Ella is a newer emergency pill in the market, it usually costs more compared to Postinor-2. 

Which Emergency Contraception Method Should I Pick?

While the copper IUD is much more effective at preventing pregnancy than the pill, it requires a clinic visit. The copper IUD may also be more costly in the short-term. However, the copper IUD could be a good choice for women who desire ongoing contraception. 

Several different factors affect how well emergency contraceptive pills work like:

  • How soon the pill was taken after sex
  • Which part of the menstrual cycle you are in
  • How many times you had unprotected sexual intercourse
  • How much you weigh

At Dame, we would recommend Ella when the risk of pregnancy is higher. Higher pregnancy risk occurs with multiple episodes of unprotected sex during the “fertile” period. It is approximately 12 days before the expected onset of menses, which is when ovulation happens. For those with irregular periods making ovulation prediction challenging, Ella may be the more effective option. 

If you need some help discussing the topic of emergency contraception with your partner, read our Singapore’s Couple Handbook to the Morning After PIll and What Every Singaporean Guy Should Know About Plan B in Singapore.

Stay Empowered, Stay Informed

Being well-informed about emergency contraception is empowering.  Whether you have faced an unexpected situation or wish to support others, understanding the truths about emergency contraception is a step towards informed decision-making.

Knowledge is power. Stay empowered, stay informed and navigate emergency contraception in Singapore with confidence. With Dame, the truths you wish you knew earlier are now at your fingertips. When it comes to emergency contraception, you need to act fast, get quick delivery and a consultation here

By understanding the available options, their effectiveness and dispelling common misconceptions, you can be in control of your sexual health. Knowing that there is a back up plan in life, just helps. At Dame, we are on this journey together. You need to act fast to prevent unplanned pregancies, 

Frequently Asked Questions (FAQs)

Q: Is emergency contraception the same as regular birth control?

Emergency contraception is not the same as regular birth control. It is specifically designed as a backup option for preventing pregnancy after unprotected intercourse or contraceptive failure. Regular birth control methods are meant for ongoing prevention. 

Q: Are there age restrictions for accessing emergency contraception in Singapore?

No, but the legal age to have sex in Singapore is 16 years old. Prescribing emergency contraception is at the discretion of your doctor, who would need to assess your suitability, both medically and psychologically. 

Here at Dame, your safety and health is our top priority. While you are encouraged to inform your parents, it is not mandatory for them to join in the consultation. 

Q: How soon should one take emergency contraception for it to be effective?

The effectiveness of emergency contraception is highest when taken as soon as possible after unprotected sexual intercourse. 

For the copper IUD, it is most effective when inserted within 5 days or 120 hours. For Postinor-2 or Plan B, it is effective for up to 72 hours while for Ella, it is effective up to 120 hours. 

Q: Can emergency contraception have long-term effects on fertility?

No significant long-term effects on fertility have been identified with the proper use of emergency contraception. However, it is essential to consult with a healthcare professional for personalised advice based on individual health considerations. 

Q: Can emergency contraception be used regularly?

Emergency contraception is not intended for regular use. It is a backup option for occasional contraceptive failures or unprotected intercourse. Consistent use of regular contraceptives like the combined pill is recommended for ongoing prevention. 

Q: Are there any long-term effects of using emergency contraception?

No significant long-term effects have been identified with the proper use of emergency contraception. However, it is crucial to consult with a healthcare professional for personalised advice based on individual health considerations. 

Q: How does Ella emergency contraception work?

Ella emergency contraception contains ulipristal acetate. It works by preventing the hormone progesterone from having its normal effect on ovulation and fertilisation. It is effective when taken up to 120 hours after unprotected intercourse. 

Q: Where to get emergency contraception?

Emergency contraception in the form of an IUD is available at certain polyclinics and private clinics offering women’s health services in Singapore. Emergency pills like the morning after pills Postinor-2 or Plan B and Ella are prescription-only medications. They can be obtained from your local pharmacy or clinic upon a doctor’s prescription. Always call ahead to check for stock availability.   

Q: How does emergency contraception reduce the risk of pregnancy?

Emergency contraception primarily works by preventing or delaying ovulation, inhibiting fertilisation or interfering with the implantation of a fertilised egg into the uterus. It does not terminate or affect a pregnancy that has already happened. 

Q: How often can you use emergency contraception?

While emergency contraception is safe for occasional use, it should not be relied upon as a regular contraceptive method. Using it too frequently can disrupt menstrual cycles and may not be as effective as consistent use of other birth control methods. At Dame, you can consult our doctors for guidance on regular contraception. 

Facing an urgent need for emergency contraception? At Dame, we understand the importance of acting fast.
Getting emergency contraception in just 3 steps: Survey, consult with our Singaporean doctors, and enjoy discreet shipping – choose Dame.

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