Morning-after pills.

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Abstract
Postcoital contraception has been in use in many countries for more than a decade, but some doctors still shrink from intervention in the reproductive process after ovulation--even when the timing is clearly before implantation. Around 80% of women who need postcoital treatment opt for hormone pills. The others have an intrauterine contraceptive device fitted. To be effective, hormonal treatment should be started within 72 hours of unprotected intercourse; thereafter the failure rate rises substantially above the 1% claimed. High doses of estrogen have been used, given for 5 days. More recently an estrogen-progestogen regimen has been devised in which the combination is taken in 2 doses 12 hours apart. The possibility that administration of an estrogen-progestogen combination just before implantation could be teratogenic has probably made clinicians overcautious. The circumstances in which insertion of an IUD is the preferred method include contraindications to the pill, the woman's choice of an IUD for future contraception, and instances where hormones are less effective. Up to the present, hormone treatment has been prescribed by doctors only after counselling and examination. Totally unsupervised administration of hormones should not be encouraged or condoned.