Emergency contraception

Benefits

  • there are no serious side effects of using emergency contraceptive pills

  • reduces risk of pregnancy if you haven't used contraception, or if your contraception has failed.

The emergency contraceptive pill (sometimes called the ‘morning after pill’) can be taken after unprotected sex to prevent pregnancy.

There are two types of hormonal emergency contraceptive pill; one which has to be taken within three days of unprotected sex, and the other within five days.

The non-hormonal coil (IUD) is the most effective emergency contraception if inserted up to five days after unprotected sex.

The emergency contraceptive pill is by far the most popular method of emergency contraception.

*most effective within 24 hours. Effectiveness decreases with time since unprotected sex
**can make earlier or later

Which pill should I choose?

There are two types of emergency contraceptive pill. One has to be taken within five days and one has to be taken within three days of unprotected sex.

They contain slightly different hormones but work in the same way to prevent pregnancy by delaying ovulation.

We will assess your medical history before we prescribe your pill. However, before ordering we suggest checking our questions section as some medications can make emergency contraception less effective.

If you’re unsure which pill to order for recent unprotected sex, complete the health questions within the order form and we will suggest which pill would be safe for you to take. Alternatively, you can email our clinicians for advice at info@fettle.health.

Up to 5 days / 120 hours

This pill contains ulipristal acetate (UPA). It may not be effective if you have taken any hormonal contraception up to five days before taking UPA, or if you use hormonal contraception within 7 days. This means that you will need to take a 7 day break from using a regular contraceptive pill, patch, or ring after taking UPA.

It may not suitable for people who take certain medications or who have a lactose allergy.

Up to 120 hours after unprotected sex, UPA is more effective than LNG (see below). It is more expensive as it is still under patent, which means only one manufacturer makes it. This may change soon, so the price could come down.

EllaOne

Ulipristal acetate 30mg

From £30

Up to 3 days / 72 hours

Levonorgestrel (LNG) does not interfere with your regular method of contraception, which means you can continue to use your contraception as normal.

LNG becomes less effective over time, so the sooner you take it the more effective it is.

It may not suitable for people who take certain medications.

LNG is cheaper than UPA as it can be made and sold by multiple manufacturers.

Levonelle

Levonorgestrel 1500mcg

From £15

How it works

How to use it

emergency contraception how

Take one pill, within the specified time period. The emergency contraceptive pill is much more likely to work if you take it within 24 hours of having sex.

We will ask you about when you had unprotected sex in our order form, so we can advise on the most suitable method of emergency contraception.

Why it works

emergency contraception why

Both types of pill contain ingredients which prevent or delay ovulation (the egg being released from your ovaries).

This means that neither pill is effective if taken after you have ovulated.

Things to consider

Emergency contraceptive pills or emergency IUDs do not protect against STIs. You should use condoms to protect yourself from STIs.

STIs can pass from one person to another during sex, especially if you don’t use a condom. It is a good idea to get tested, especially if you have recently changed partners. Most infections can be cured.

Using the emergency contraceptive pill repeatedly can disrupt your natural menstrual cycle.

What if?

You’re already using another form of contraception:

  • Ulipristal acetate (UPA) may prevent other types of hormonal contraception from working for a week after use. You can take it more than once in a menstrual cycle. Read more in our questions section
  • emergency contraceptive pills do not protect you against pregnancy during the rest of your menstrual cycle and are not intended to be a regular form of contraception
  • the IUD will not interfere with your regular method of contraception and will continue to give you protection against pregnancy for the rest of the cycle - you can choose to keep it for ongoing contraception.

Emergency contraceptive pills can become less effective at preventing pregnancy if:

  • if you’re sick (vomit) within two hours of taking Levonorgestrel (LNG), or three hours of taking Ulipristal acetate (UPA), seek medical advice as you will need to take another dose or have a non-hormonal coil (IUD) fitted
  • you are taking other medicines - ask your clinician, GP or pharmacist, and read the information that comes with your medicine

Suitability

Most women can take the emergency contraceptive pill. This includes women who cannot usually use hormonal contraception, such as the combined pill and contraceptive patch.

Ulipristal acetate (UPA)/EllaOne is not suitable for women who:

  • are allergic to any of the components of the drug
  • have severe asthma that is not properly controlled by steroids
  • have hereditary problems with lactose metabolism.

Side effects & risks

CommonRare
Short term

Next period earlier or later than usual.

Can make you feel sick, dizzy or tired, or give you a headache, tender breasts or abdominal pain.

Some women using Ulipristal acetate (UPA) experience painful periods, mood swings, and muscle or back pain.

Long term

Questions?

Can I take emergency contraception whilst breastfeeding?

Yes, you can take emergency contraceptive pills while breastfeeding. You can also have the IUD fitted while breastfeeding as long as you are more than 28 days post-delivery.

How will the emergency contraceptive pill affect my normal contraception?

The emergency contraceptive pill will not prevent future pregnancies if you have unprotected sex again, so you should make sure you are taking your contraception correctly.

For Ulipristal acetate (UPA): If you forgot your regular pills, did not use the patch or vaginal ring correctly, or want to start using hormonal contraception, you should wait for 5 days after taking UPA. This is because UPA can can reduce the effect of hormonal contraception.

Use additional contraception, such as condoms:

  • with the patch, the ring and the combined pill, for 7 days (9 days for Qlaira pill)
  • with the progestogen only pill, for two days.

For Levonorgestrel (LNG): If you are using emergency contraception because you forgot your regular pill or did not use the patch or vaginal ring correctly, you should take your regular pill again, insert a new ring or apply a new patch. Use additional contraception, such as condoms:

  • for seven days with the patch, the ring and the combined pill
  • for two days with the progestogen only pill.

How will Ulipristal acetate (UPA) affect my next period?

Your period may come on time or a few days early or late. If your period is over a week late, take a pregnancy test.

How will Levonorgestrel (LNG) affect my next period?

Your period is likely to come on time or a few days early or late. Sometimes it can be a week late and sometimes even later. You may have some irregular bleeding after you take the pill, and before your next period. This can range from spotting to quite heavy bleeding. If your period is over a week late, take a pregnancy test.

What if I take an emergency contraceptive pill but my period doesn’t start as usual?

The sooner you take the emergency contraceptive pill, the more effective it will be.

If your next period is more than seven days late, or is unusually light or short, you should take a pregnancy test as soon as possible. You can buy test kits from pharmacies and major supermarkets, or you can ask your GP.

What happens if I keep using emergency contraceptive pills?

Using the emergency hormonal contraceptive pill repeatedly is much less effective than using a regular method of contraception.

It can also disrupt your natural menstrual cycle.

What if I can’t remember exactly when I had unprotected sex or when my last period was?

If you are unsure about either of these things, and you think you may have had unprotected sex in the last 72 hours, you should take emergency contraception.

Are emergency contraceptive pills affected by other medicines?

Emergency contraceptive pills can become less effective at preventing pregnancy if you are taking other medicines (including those used to treat epilepsy, HIV and TB, other antibiotics and the herbal medicine St John’s Wort).

  • Ulipristal acetate (UPA) cannot be used if you are already taking one of these medicines, as it may not be effective
  • Levonorgestrel (LNG) may still be used, but the dose may need to be increased. One of our clinicians will happily advise on this
  • Ulipristal acetate (UPA) may not be suitable for people who are using proton pump inhibitors such as omeprazole (antacids that regulate their stomach acid levels)
  • always ensure you read the information that comes with your medicine, and get in touch if you have any questions or concerns.

What information do I need to share to order emergency contraception?

As part of our order form, we will ask for the following information:

  • when you have had unprotected sex in your current menstrual cycle
  • the date of the first day of your last period
  • if you've used any medications that may affect your contraception
  • your medical history and health history.

One of our clinicians may call you to discuss some of your answers to make sure that it is appropriate for you to take emergency contraception. We will contact you quickly to avoid any delay to dispatch of your pill.

In what cases would I not need to take emergency contraception as I am not at risk of pregnancy?

  • if you have given birth in the last 21 days
  • if you have had a termination of pregnancy, miscarriage, ectopic pregnancy or uterine evacuation for gestational trophoblastic disease in the last 5 days.

Options for ongoing contraception

If you're not using a regular method of contraception, you might consider doing so in order to lower the risk of unintended pregnancy. You can order several types of contraception on Fettle. Read more about long lasting methods on SH:24.