Emergency Contraception: The Facts

 
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Knowing what to do the morning (or night) after you have had unprotected sex or contraceptive failure isn’t always easy. But don’t panic, we’re here to offer you all the help and advice you need to make the best decisions. Read on to find out the facts about emergency contraception and have the myths busted...
 

What is emergency contraception?

Emergency contraception can be used to help prevent pregnancy after you’ve had unprotected sex or contraceptive failure. However, for it to be most effective, it has to be used as soon as possible after unprotected sex has taken place.

 

What types of emergency contraception are available?

There are a number of different types available. These include the intrauterine device, also known as the IUD or the coil, and morning after pills, an oral method of emergency contraception. It’s all about finding what’s best for you and your situation…

The copper-T intrauterine device (aka IUD, or the emergency coil)

The copper-T intrauterine device (IUD) is a small, T-shaped plastic and copper device that is placed in the womb (uterus) by a doctor or nurse. This is considered to be the most effective emergency contraceptive method overall and it also provides an ongoing contraceptive solution. However, fitting the IUD can take some time, requires an appointment and involves an invasive procedure.  An IUD can be fitted up to 120 hours (5 days) after unprotected sex. 

The morning after pill (oral emergency contraception)

Oral emergency contraception is also known as, the “morning after pill.”

There are two forms of morning after pill available – the first type contains an ingredient called ulipristal acetate (ellaOne®). ellaOne is the most effective morning after pill available. i The second type of morning after pill contains levonorgestrel.

You want to be taking the morning after pill as soon as you can after unprotected sex as the sooner it is taken, the more effective it is, however this doesn’t mean it can only be taken the morning after… some oral emergency contraceptive pills can be taken up to 5 days (120 hours) after unprotected sex has taken place. ii, iii

 

How emergency contraception works

The copper-T intrauterine device (aka IUD, or the emergency coil)

The IUD works by releasing copper into the womb. The copper alters the cervical mucus (yes, your cervix has mucus), which makes it more difficult for sperm to reach an egg and survive. It can also stop a fertilised egg from being able to implant itself.

An IUD works as soon as it’s put in, and provides ongoing contraceptive protection for between 5 to 10 years, depending on the type.

You will need to book an urgent appointment with your GP or at your local sexual health clinic if you want to have the IUD fitted within 120 hours following unprotected sex. It is always worth consulting your pharmacist about the morning after pill while waiting for your appointment, to reduce your risk of pregnancy, especially in case of any delays or if you change your mind. Speak to your pharmacist or doctor to find out more about this option.

The morning after pill (oral emergency contraception)

Morning after pills work to prevent pregnancy after unprotected sex by delaying ovulation (when your egg is released), if it has not already happened. This means that the sperm waiting in the fallopian tubes will be unable to meet an egg and fertilise it. This is similar to regular contraceptive pills, which also work by preventing egg release.

Morning after pills are not 100% effective. There is a chance that you may have already ovulated when you take an emergency contraceptive pill. Taking the morning after pill as soon as possible after unprotected sex gives you the best chance of success.

If you want to have sex after taking the morning after pill, use a condom even if you are taking a regular contraceptive pill until your next period. Morning after pills will protect you against one episode of unprotected sex. If you do have further unprotected sex within the same cycle, you may be able to use the morning after pill again, but you should discuss it with a healthcare professional first.

Sexually transmitted infections (STIs) – what you need to know

Emergency contraception does not protect against sexually transmitted infections. This applies to both the IUD and oral emergency contraceptive methods. So we’re talking about chlamydia, herpes, gonorrhea…

If you have had unprotected sex you might be at risk of having a sexually transmitted infection. If this is the case, talk to your doctor, or another healthcare professional, about getting tested. They can put your mind at rest and provide treatment.

 

Where to get emergency contraception

The copper-T intrauterine device (aka IUD, or the emergency coil)

The copper IUD is available from contraception clinics, sexual health or genitourinary medicine (GUM) clinics and GP surgeries.

You will need to book an urgent appointment with your GP or at your local sexual health clinic if you want to have the IUD fitted within 120 hours following unprotected sex. It is always worth consulting your pharmacist about the morning after pill while waiting for your appointment, to reduce your risk of pregnancy, especially in case of any delays or if you change your mind. Speak to your pharmacist or doctor to find out more about this option.

As such, it is important to seek advice from a pharmacist about taking the morning after pill while waiting for an appointment with your doctor, in case there are any delays in having the IUD fitted or if you change your mind. Speak to your pharmacist or doctor to find out your options.

The morning after pill (oral emergency contraception)

In most cases, you don’t need to visit your doctor to get the morning after pill. Oral emergency contraception is available directly from your pharmacist, without a prescription. It is available from most pharmacy stores, or you can order on-line.

If you’ve had unprotected sex or your regular contraception has failed, you are right to ask for the most effective morning after pill, ellaOne®. It is possible to order ellaOne online here.

You can also get oral emergency contraception from your GP, Family Planning Clinic, walk-in centre, or out of hours services.

Did you know:

You can buy the morning after pill in advance as a back up to your regular contraception (for example if you rely on condoms or you are planning to travel abroad etc.). For more information click here.

 

Myths & Facts

Myth #1

The morning after pill works by causing an ‘emergency period’
 

Fact

The morning after pill does not work by causing an ‘emergency period’. The morning after pill works by delaying egg release. (This is similar to regular contraceptive pills, which also work by preventing egg release.)

Myth #2

You will experience loads of horrible side effects after taking the morning after pill
 

Fact

The morning after pill is generally well tolerated, but as with all medicines, some people may experience side effects after using the morning after pill, although not everyone gets them. Common side effects of the morning after pill include: Nausea, vomiting, diarrhoea, tiredness, irregular menstrual bleeding before your next period, and sometimes back pain, breast tenderness, headache and dizziness.

Myth #3

I cannot take the morning after pill twice in the same cycle
 

Fact

The morning after pill should be for occasional use only, and is not a regular method of contraception. The aim of taking an emergency contraceptive pill is to delay or inhibit egg release until the sperm that are waiting in the fallopian tube are no longer capable of making you pregnant. If you want to have sex after using emergency contraception, use a barrier method of contraception until your next period. This is because your fertility can come back very quickly. The morning after pill is not regular contraception, and should be viewed as a “back-up”.

If you do have further unprotected sex within the same cycle, you may be able to use the morning after pill again, but you should discuss it with a healthcare professional. It is advised that you have a reliable regular method of contraception in place, as they are more effective in preventing pregnancy.

Myth #4

The morning after pill is a mini abortion
 

Fact

The morning after pill does not cause an abortion. The morning after pill works by delaying egg release. This means that the sperm waiting in the fallopian tubes will be unable to meet an egg and fertilise it. (This is similar to regular contraceptive pills, which also work by preventing egg release.) This all happens before pregnancy can begin, which is 6-12 days after unprotected sex. If you are already pregnant at this point, emergency contraception will not interrupt your pregnancy.*

Myth #5

The morning after pill will have a negative effect on my fertility
 

Fact

The morning after pill has no effect on your future fertility. If you want to have sex after taking the morning after pill, use a barrier method of contraception until your next period. This is because your fertility can come back very quickly.

Myth #6

The morning after pill is a ‘hormonal bomb’ that will mess up my cycle
 

Fact

The hormones contained in emergency contraception can alter the build-up and shedding of the lining of the womb, but only for the cycle in which you take them. This means that after taking the morning after pill, your period might be on time, or earlier, or later than normal. After this, your cycle normally returns to its regular pattern.

Myth #7

Emergency contraception can be taken any time after having unprotected sex and still be effective
 

Fact

The morning after pill must be taken as soon as possible after unprotected sex. ellaOne (ulipristal acetate) must be taken within five days (120 hours) ii of unprotected sex and levonorgestrel containing morning after pills must be taken within 3 days (72 hours) of unprotected sex. iii Both types work by preventing or delaying ovulation (release of an egg) and must therefore be taken as soon as possible. Emergency contraceptive pills are not effective if ovulation has already taken place. The emergency IUD can be inserted up to five days after unprotected sex.

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We hope you're feeling reassured and clear on your next steps should you have had unprotected sex. While this can be a confusing time, considering emergency contraception after unprotected sex has occurred is the responsible thing to do. So stay calm, don’t panic and speak to your pharmacist or GP as soon as you can.

*ellaOne is not intended for use during pregnancy

i Glasier AF et al. The Lancet 2010; 375: 555-562.
ii Electronic Medicines Compendium (eMC): ellaOne 30 mg. Summary of Product Characteristics. Available from: http://www.medicines.org.uk/emc/medicine/22280/SPC/ (Last accessed: May 2018)
iii Levonorgestrel Summary of Product Characteristics. Available from: https://www.medicines.org.uk/emc/medicine/28337 (Last accessed: May 2018)