Morning-after Pill

Health Library - Morning-after Pill

Anytime Doctor's Morning-after Pill service is for advance use only. This means that your doctor can provide you with a morning-after pill pack for you to use should a need arise in the future. The morning-after pill service is not for women who have had unprotected sex recently and need the pill, if you need the morning-after pill urgently you are advised to speak to your local doctor or pharmacist immediately.


If you have unprotected sex, then if you take an emergency contraceptive pill (sometimes known as the morning after pill) within 72 hours you have a good chance of preventing pregnancy. Alternatively, an IUD (coil) can be inserted up to 5 days after having unprotected sex.


Emergency contraception can be used if:

• You have had sex without using contraception.
• You have had sex, but there was a mistake with contraception. For example, a split condom or if you forgot to take your usual contraceptive pills.

What is the emergency contraceptive pill?
It is a pill that contains levonorgestrel which is a progestogen hormone. The brand name is Levonelle®. You can get it on prescription or you can buy it from pharmacies without a prescription. The usual dose is one pill which contains 1.5 mg of levonorgestrel. (Some women need a higher dose if they are taking certain other medication. For example, women taking certain anti-epilepsy medicines.)


When do I take it and how does it work?
Take the pill as soon as possible after unprotected sex. The earlier you take the pill, the more effective it is. It is thought to work either by preventing or delaying ovulation (the release of an egg each month) or by preventing the fertilised egg from implanting (settling) in the uterus (womb). It is not thought to cause an embryo that is already implanted into the womb to 'abort'.


How effective is it?
Although emergency contraception is effective, it is not as reliable as regular planned contraception. Therefore, it should only be used in emergencies. It becomes gradually less effective the more time that elapses after having unprotected sex.

However, there is a good chance of preventing pregnancy if it is taken up to 72 hours after unprotected sex. If the pill is taken within 24 hours after unprotected sex, about 95 in 100 pregnancies are prevented.

If it is taken between 25-48 hours then about 85 in 100 pregnancies are prevented and if it is taken between 49 and 72 hours then about 58 in 100 pregnancies are prevented. It is sometimes used between 72 and 120 hours after unprotected sex but the chance of it working is much less than if it is taken within 72 hours.


Are there any side-effects?
Side-effects with the emergency contraception pill are uncommon. However, some women feel sick for about 24 hours after taking the pill and a few vomit. This may be less likely to happen if you take the pill with food.

If you vomit within three hours of taking the pill then:

• Take another pill as soon as possible. (You may need to get a further prescription, or buy another pill from a pharmacy. You may also wish to get a prescription for some anti-sickness tablets.) OR
• An intra-uterine device can be inserted as an alternative method of emergency contraception.

Other mild side-effects occur in some women for a short time such as: abdominal pain, headache, tiredness, dizziness and breast tenderness.


Who should not take the emergency contraceptive pill?
There are no women who should not take the emergency contraceptive pill, even pregnant women, as there is no evidence to show that taking emergency contraception if you were to be pregnant is harmful.


Some reasons why emergency contraception is less likely to be successful

• If you take the pill more than 72 hours after unprotected sex.
• If you vomit within three hours of taking the pill and do not take a repeat dose.
• If you had unprotected sex at another earlier time.
• If you have unprotected sex again after taking emergency contraception.

Some other points about this type of emergency contraception

• Most women have their next period at about the usual time. Sometimes it is a few days earlier or later than expected. See a doctor or nurse if your next period is more than seven days late or if it is lighter than usual. A pregnancy test may then be advised.
• Your next menstrual cycle may also be shorter or longer than usual.
• There is still a small risk of pregnancy even if you take the emergency contraceptive pill correctly.

Follow up
You may want to discuss your regular contraceptive needs with a doctor or nurse. This may be best in a relaxed follow-up consultation.


An important message
See a doctor urgently if you have any lower abdominal pain or abnormal vaginal bleeding over the next 2-6 weeks. These are the main symptoms of an ectopic pregnancy. This is rare, but it is best to be aware of the possibility as it is a serious condition. Also, see a doctor if your next period is more than seven days late or if you have any other concerns.


Alternative methods of emergency contraception
An alternative method of emergency contraception is to have an intra-uterine device (IUD) inserted by a doctor or nurse. This can be done up to five days after unprotected sex. It has the advantage of providing ongoing contraception and is also more effective than taking hormone tablets (it is almost 100% effective).


Further information
Your GP, practice nurse and pharmacist are good sources of information if you have any queries. The fpa (formerly the family planning association) also provide information and advice. fpa's Helpline: 0845 310 1334 or visit their website www.fpa.org.uk


References
Dr David Delvin, NetDoctor, Patient UK, Contraception - emergency, Clinical Knowledge Summaries (2007), Emergency contraception, Faculty of Family Planning and Reproductive Health Care RCOG (2006)