![]() The dominant side effects, which not all women may experience, are temporary breast tenderness, nausea and vomiting indeed, a woman may vomit the pills before they can take effect. The morning-after pill (which despite its name can be taken anytime within 72 hours after intercourse) reduces that likelihood to somewhere between 0 and 8 percent, depending on when the woman had intercourse and took the pills. The chance of becoming pregnant on a woman's most fertile day is at most about 25 percent. Other pills, with different progestins, have simply not been tested. Some lower-dose pills, like Lo/Ovral, Nordette, Levlen, Triphasil and Tri Levlen can be used in a slightly different way to achieve the same purpose. A woman who takes the morning-after pill never knows whether she would have become pregnant. The egg, fertilized or not, will be sloughed off when the woman menstruates. The pills have a Rube Goldberg-like effect, tripping up signals along the normal route of messages governing hormone release: the egg may not be released in time, the coating of the egg may resist the sperm's penetration or the uterine lining may not be synchronized for implantation. Ovral combines an estrogen (ethinyl estradiol) and a progestin (norgestrel). It is not until a day or two after implantation that a pregnancy test registers positive. But they all share one assumption: that a pregnancy begins not when a sperm has fertilized an egg - which can be as much as 18 hours after intercourse - but about a week later, when the fertilized egg lodges in the lining of a woman's uterus. THEORIES OF HOW POSTCOITAL CONTRACEPTION works have been kicking around since the 1960's. The so-called morning-after pill has probably been the best-kept contraceptive secret in America. And for those women who get their gynecological care at clinics that rely on Federal funds, it is, by Federal regulation, simply not available. Although widely prescribed on college campuses, it is largely unknown to teen-agers and to women in their 30's and 40's. Lost amid the clamor over the recent news that the French pill, RU-486, could be used in just such instances, and the uncertainty over whether it will be distributed in the United States, is the fact that a similar treatment has been available here for at least 15 years. Nor do most people consider it doublespeak for abortion. What she most likely does not know is that she still has time to prevent an unintended pregnancy - that there is indeed something called postcoital contraception obtainable in the United States. And now she is panicking, mentally flipping through the pages of a calendar: when is her period due?
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