The morning after on the internet: Usage of and questions to the emergency contraception website

Objective: The objective of this study is to understand the concerns of users of a medical information website on emergency contraception (EC). Methods: This study analyzes e-mails sent to the EC website www.Not-2-Late.com over a 5-year period. It also reports on the website's most frequently viewed pages using Microsoft Site Server Analysis. Results: Of the 7022 e-mails received, 29% did not contain questions about EC. The remaining e-mails reveal that EC users are concerned with how to use EC (23%), side effects (21%), pregnancy (17%), whether EC is needed in a given situation (14%), EC access (8%), EC effectiveness (4%) and how EC works (3%). Analysis of website page visits shows that visitors were chiefly interested in how to use EC and how to interpret bleeding after EC use. Conclusion: The e-mails point to the need for further research on EC-related questions that cannot be answered with the extant medical literature but are of concern to patients - questions such as bleeding after EC use and sexual intercourse that occurs shortly after taking EC pills. The language that writers use to express themselves reveals how users conceptualize their contraceptive and sexual health experiences. Many writers referred to sex with a hormonal contraceptive but not a barrier contraceptive as "unprotected sex," suggesting that patients may be using terms that do not mean what medical professionals might expect. E-mails sent to the site also demonstrate the importance of alternative resources that provide accurate medical information for patients who are unable to access health care or to discuss certain subjects with their providers.