Emergency Contraception Information
Emergency contraception is the term used to describe forms of contraception that can be taken to try and prevent pregnancy after sex in situations where other contraception has either failed or not been used at all.
There are two options for emergency contraception: the morning after pill and the intrauterine device (IUD). An IUD can be used as your regular method of contraception, but the morning after pill is only meant to be used as an emergency contraceptive. Here, we’ll be discussing emergency contraceptive pill information. Find out more about the IUD here.
How does the morning after pill work?
Two main types of pill-based emergency contraception are available: levonorgestrel and ulipristal acetate. They work in different ways, so it’s important to know which one you’re about to take.
The levonorgestrel-based pill is an emergency contraceptive containing the active ingredient, levonorgestrel, which is a synthetic version of progesterone. Levonorgestrel works by delaying ovulation or, in some cases, preventing it altogether.
The ulipristal acetate-based pill does the same thing, but using the active ingredient ulipristal acetate instead of levonorgestrel. Ulipristal acetate binds to the progesterone receptors in your body so progesterone itself cannot bind. This in turn impacts ovulation.
Whether you use levonorgestrel- or ulipristal acetate-based emergency contraception, they won’t protect against pregnancy going forward. This means that you may be at risk of pregnancy if you have unprotected sex any time after you take the emergency contraceptive pill, so you should ask your pharmacist or doctor about the best regular contraception for you.
Although the morning after pill isn’t intended for regular use, you can use certain ones multiple times during a single menstrual cycle if necessary (note this is not the case for ulipristal acetate-based pills). When you access the pill, you can ask for advice on types of contraception if your current method isn’t working for you.
How to take the morning after pill
It’s best to take the morning after pill as soon as possible after having unprotected sex, but the window in which you can take it is different depending on the type of pill you choose. The levonorgestrel-based pill must be taken within 72 hours (3 days) of sex in order to be effective. The ulipristal acetate-based pill, on the other hand, can be taken up to 120 hours (5 days) after sex.
A pharmacist or doctor will advise you on which pill you can take when you access emergency contraception. They will also be able to provide you with more morning after pill information so you can make an informed decision.
Once you have taken the morning after pill, you’ll need to restart your regular contraceptive method. How you do this varies depending on the pill you took.
Within 12 hours of taking the levonorgestrel pill, take your next regular contraceptive pill or apply a new contraceptive patch. After this you should continue with your contraceptive method of choice as normal. You will need to use additional contraception for:
- 7 days if you use the implant, injection, patch or combined pill (except for estradiol valerate-based pills)
- 9 days if you take an estradiol valerate-based combined pill
- 2 days if you use a progestogen-only pill
However, if you took the ulipristal acetate pill, you must wait at least 5 days before taking your next pill or using a patch. Continue with your regular contraceptive method after this, and use extra contraception (e.g. condoms) following the above advice.
Who can take the emergency contraceptive pill?
The majority of women can take the morning after pill - even some of those who can’t normally use hormonal contraception. However, there are some circumstances in which you may not be able to take the emergency contraceptive pill. These include being allergic to any of the ingredients, suffering from asthma, or taking medications that impact its effectiveness, such as:
- St John’s Wort
- Some antibiotics (rifabutin and rifampicin)
- Some epilepsy, tuberculosis or HIV medications
- Medicines for stomach acidity
If you are taking any of these medications, you won’t be able to take the ulipristal acetate pill as it may not be effective. In some cases, you may need to take a larger dose of levonorgestrel instead. Always talk to your doctor or pharmacist about all of the medicines you are taking before taking an emergency contraceptive pill.
If you’re a breastfeeding mother, levonorgestrel is safe for you to take. Small amounts of the hormone levonorgestrel may pass through the milk to your baby, but it isn’t believed to be harmful to babies. There is less research on the ulipristal acetate-based pill’s safety when breastfeeding. It is recommended to not breastfeed for at least a week after taking the ulipristal acetate pill.
Common side effects of the morning after pill
Taking the emergency contraceptive pill isn’t known to have any long-term or serious side effects. However, you may experience:
- Nausea or vomiting
- Pain in the abdomen
- Changes to your next period
If you are sick within 3 hours of taking the ulipristal acetate-based pill, or 2 hours of taking the levonorgestrel-based pill, seek medical attention. You may need to take another dose of emergency contraception or have an IUD fitted in order to prevent pregnancy.
You should also get medical help if you:
- Experience sudden pain in the lower abdomen (in rare cases, a fertilised egg may implant outside of the womb in an ectopic pregnancy)
- Think you might be pregnant
- Have a shorter or lighter next period than usual
- Have your next period more than 7 days later than expected
Where to get the morning after pill
You can get the morning after pill for free from a number of places, including:
- Most pharmacies
- The majority of minor injury units and NHS walk-in centres
- Some GP surgeries
- Contraception clinics
- Genitourinary medicine (GUM) or sexual health clinics
- Some young people’s clinics
You can also get the morning after pill in advance if you need to. You might do this if you’re going on holiday, if you can’t easily access emergency contraception, if you’re worried your usual method of contraception might fail or for a number of other reasons. Speak to a pharmacist to find out where to get emergency contraception in advance.