Morning after Pill (Emergency Contraception)

Some women may need to take emergency contraception if they have had unprotected sex or another form of contraception has not worked. There are two main systems of emergency contraception, which include the morning after pill and the intrauterine device (IUD). You may need the pill if you have used a condom and it has split, you have had unprotected sex or if you have missed a contraceptive pill, but it is important that you do not use the morning after pill as a regular form of contraception.

Types of emergency contraception

The morning after pill

The name ‘morning after pill’ can actually be quite misleading because it is not essential to take the pill the morning after. The pill can be effective for as long as 72 to 120 hours following intercourse, depending on the pill you take, although it is advisable to take as quickly as you can after intercourse. There are now two types of morning after pill on offer, which include:

• Levonelle: this pill must be taken within 72 hours of intercourse and it is most effective within the first 12 hours. Levonelle is obtainable at no charge when prescribed from GP surgeries, GUM clinics and family planning clinics, but you will have to pay for it if you buy it over the counter at a pharmacy. The pill is available to women aged above 16.
• EllaOne: A newer pill introduced in 2010 which can be effective for up to 120 hours after sexual intercourse. The pill is only obtainable on prescription and it is not usually recommended for women under 18 years of age.

The emergency contraceptive pill is successful in 95% of cases if you have it in a time frame 24 hours of when you had sexual intercourse, but after this period of time the efficacy decreases. The pill is safe for breastfeeding mothers and most women who are usually unable to use hormonal contraceptives, but you should seek advice from a GP or pharmacist before you take it.

The IUD

The IUD (intrauterine device) is a copper device which is fitted into the uterus to prevent the sperm from reaching and fertilising the egg. This method is more effective than taking the emergency contraceptive pill and it prevents around 99% of unwanted pregnancies. The IUD is beneficial for people who cannot or don’t wish to take hormonal contraceptives, those who want long-term contraception and people who are taking certain types of medication. An IUD can be affixed at a GP surgery, GUM clinic or family planning clinic.

How does the morning after pill work?

The morning after pill (emergency contraceptive pill) works by preventing the ovaries from freeing an egg. It also makes the lining of the womb thinner and the mucus in the womb thicker to make it more difficult for the sperm to reach the egg.

Is the emergency contraceptive pill safe?

The emergency contraceptive pill is safe though it can cause mild side-effects, but these are uncommon and they tend to wear off quickly. Possible side effects include:

Levonelle:

• Nausea.
• Headache.
• Abdominal pain.
• Sickness.
• Slight changes to your menstrual cycle, which may mean that your next period is slightly earlier or later than usual.

If you are sick within a short period of time after taking the pill it may be necessary for you to have another one, but always ask your GP or pharmacist for advice.

EllaOne:

• Muscular pain.
• Vomiting.
• Nausea.
• Abdominal pain.
• Back ache.

If you are already taking medication or you have existing health problems, it is important that you tell your doctor or pharmacist before you take the emergency contraceptive pill. The pill can have interactions with other forms of medication so it is important to check that it is safe to take it. Levonelle should not be taken by people who have liver disease or a condition known as porphyria. EllaOne can also interfere with some drugs so always check with your pharmacist or GP before taking it.

If you fall pregnant despite use of the emergency contraceptive pill there is a slightly increased risk of suffering an ectopic pregnancy, which is when the egg implants outside the womb. If this is the case it is advisable to visit your GP so that they can rule out an ectopic pregnancy.

Where can I get the morning after pill?

You can get EllaOne on prescription only, while Levonelle is available over-the-counter. Emergency contraceptive pills are obtainable without charge from:

• GP surgeries.
• Family planning and sexual health clinics.
• GUM clinics (genitourinary medicine).
• Most walk-in NHS centres.
• Young person’s clinics, such as The Brook clinics.

You can buy the morning after pill from pharmacies, supermarkets with pharmacy counters and private health clinics. The cost may vary but it is usually around £25. It is worth noting that the pharmacist will usually want to have a talk with you before they give you the pill. This is nothing to worry about, they will just explain how the pill works, how to take it and check that you can take the pill safely (they will ask if you are taking any other form of medication, for example).