10.4  Management of common side-effects

After you give emergency contraceptive pills to your client, they may complain about nausea, which is usually limited to the first three days following treatment. Nausea can be reduced if the client takes her pills with food or milk, or at bedtime, so advise her accordingly. In some cases, clients may develop vomiting, which is a common problem within two hours of taking emergency contraceptive pills. In this case, the same dose should be repeated, because the pill may have been vomited out without being absorbed in her stomach. However, if the client suffers from severe or continuous vomiting, advise her to put the same dose in her vagina, and this will then be absorbed into the bloodstream.

Some women may experience withdrawal bleeding (spotting) after taking emergency contraceptive pills. In this case, you should counsel them not to confuse this bleeding with menstrual bleeding. Inform women that emergency contraceptive pills do not bring on menstruation immediately. In cases where there is a delay in menstruation of more than one week, you may refer the client for pregnancy testing.

Other side-effects after using emergency contraception include breast tenderness, headaches, abdominal pain, dizziness and fatigue. These side-effects usually resolve themselves, or last less than two days. If your client complains of breast tenderness and severe headaches, you can give her a painkiller such as Asprin (300 mg), Ibuprofen (400 mg) or Paracetamol (500 mg), to take as needed.