Q. Is the “morning-after pill” safe? Does it work? Is there anything that you can do in the morning after to protect yourself against sexually transmitted diseases?
A. There are several regimens of hormones that can be used within a short period after sexual intercourse to prevent pregnancy. The “morning-after” pill that is most often used today is a higher than normal dose of the combination birth control pill Ovral. The usual protocol is two 50-mg. Ovral pills within 72 hours of unprotected intercourse, followed by two more and 50-mg pills twelve hours later. Although this method is not fool-proof, the failure rate – that is, the rate of pregnancy – among women who follow this regimen is extremely low. Keep in mind, however, that the risk of actually conceiving after one unprotected intercourse mid-cycle is also fairly low (between 1 in 6 and 1 in 4 women). The FDA has not approved Ovral for this use and there have not been any studies on the long-term effects of this treatment.
I do not recommend that you try this regimen on your own. Heavy doses of hormones can throw your natural hormonal balance out of kilter, and it is advisable to discuss the potential effect of this treatment with your doctor before doing this by yourself. In addition to upsetting your own menstrual patterns, the other side effects include extreme nausea, headaches, and dizziness.
The treatment of many sexually transmitted diseases is now simpler than it used to be: Often, a single dose of medication is all that is required. For example, gonococcal urethritis can be treated with one dose of an antibiotic like ciprofloxacin (400-mg one time). A single oral 1 gram dose of azithromycin cures chlamydial urethritis and cervicitis. If you develop urinary tract symptoms after intercourse (burning, urgency) or have a vaginal discharge that seems unusual to you, see your doctor at the earliest opportunity for appropriate cultures and treatment. Some woman develop urinary tract infections very frequently and these infections are related to sexual activity. If this is the case with you, your doctor may counsel you that one dose of an antibiotic medication the next day is in order. Be sure not to do this on your own, since the wrong medication or one taken for too short a time may well result in the development of organisms that are resistant to medication.
Dr. Marianne Legato, Professor Emerita of Clinical Medicine at Columbia University is an internationally known academic physician, author, lecturer, and specialist in gender-specific medicine. She is founding member of the International Society for Gender Medicine and also the founder and director of The Partnership for Gender-Specific Medicine at Columbia University and its next iteration, The Foundation for Gender-Specific Medicine. These enterprises are the first collaborations between academic medicine and the private sector focused solely on gender-specific medicine: the science of how normal human biology differs between men and women and of how the diagnosis and treatment of disease differs as a function of gender and sex. Her ground breaking textbook on Gender-and Sex Specific Medicine has been published in 2017 in the 3rd edition.
She has published extensively on Gender and Sex Specific Medicine, both scientifically and for the lay public. She is also the founding editor of the journal Gender Medicine, and the Journal Gender and Genome, published for the scientific community. In 1992, Dr. Legato won the American Heart Association’s Blakeslee Award for the best book written for the lay public on cardiovascular disease. She is a practicing internist in New York City and has been listed each year in New York Magazine’s “Best Doctors” since the feature’s inception in 1993.