Everything you need to know about emergency contraception

The morning after pill vs the IUD

If you have had unprotected sex or if your contraception has failed, for example, a split condom or a missed pill, you can use emergency contraception to prevent unwanted pregnancy. 

What types of emergency contraception are there?  

There are two types of emergency contraception: the morning after pill and the IUD, known as the copper coil. Levonelle and ellaOne are the two types of emergency contraceptive pill known as the morning-after pill. The copper coil is a long term reversible method of contraception which lasts for 5-10 years after insertion. 

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Levonelle from £12.05
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ellaOne from £23.65
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How soon do I need to take it? 

Emergency contraception is more effective, the sooner you use it. The Levonelle contraceptive pill must be taken within three days of having unprotected sex. EllaOne can be taken up to day five, and the IUD can be fitted up to 5 days after unprotected sex. 

How effective is it? 

Levonelle is most effective within the first 12 hours. If you take it in the first 24 hours, it has a 95% efficiency. After this, it will be 85% effective when taken within 48 hours and 58% when taken within72 hours. EllaOne is 95% effective at protecting against pregnancy for up to 5 days, and the IUD has an efficiency rate of 99%. 

Where can I get it from? 

You can access the morning-after pill from your local pharmacy, sexual health clinic or GP. You don't need a prescription for it; you can go straight to a pharmacy and request it. You can either purchase it outright or get it issued for free after having a consultation. We have both forms of the morning-after pill available from Dr Felix to order. Due to the time-sensitive nature of the medicine, we cannot issue it for emergency use by post. Hence, if you request it, it should be in advance for future purposes. The IUD is available from some GPs, sexual health or family planning clinics. 

How does the morning-after pill work? 

Levonelle delays ovulation by releasing levonorgestrel, a synthetic version of progesterone, into the womb, essentially tricking the body into thinking that ovulation has already taken place. EllaOne works in the same way by releasing ulipristal acetate to alter the way the natural progesterone in your ovaries works. 

How does the IUD work as emergency contraception? 

The IUD is a small, T-shaped copper and plastic device which releases copper into the womb to prevent pregnancy from occurring. It also alters the mucus surrounding the cervix to prevent sperm from entering. You can have it inserted up to 5 days after having unprotected sex, and it will prevent unwanted pregnancy. It is more than 99% effective and can be left in place for 5-10 years as a long term method of contraception. 

What are the side effects of the morning-after pill?  

The emergency contraceptive pill does not result in any serious or long-term effects but it can cause temporary side effects. These can include: 

  • Headaches
  • Stomach pain 
  • Changes to your menstrual cycle (it may start earlier or later than usual) 
  • Nausea or vomiting 

If you vomit within 2 hours of taking Levonelle or 3 hours of taking ellaOne, see a doctor or pharmacist as you will need to take another dose. 

What are the side effects of the IUD? 

It's rare to experience complications with the IUD but it can cause: 

  • Pain and discomfort 
  • A pelvic infection 
  • Damage to the womb 
  • Heavier and more painful periods  
  • Expulsion of the IUD 

Are there medications which can interfere with the morning after pill? 

Certain medications can interact with the morning after pill. These include: 

  • HIV medications 
  • Epilepsy medications 
  • Tuberculosis medications 
  • Omeprazole or similar medicines to reduce stomach acid 
  • Rifampicin 
  • Rifabutin 

EllaOne cannot be taken alongside any of these medications, but you may still be able to take Levonelle. Medication will not affect the IUD, but it may not be suitable if: 

  • You have a pelvic infection or an untreated sexually transmitted infection 
  • You have problems with your womb or cervix 
  • You have unexplained vaginal bleeding 

Emergency Contraception and the Pill 

It may be necessary to take the morning-after pill if you have forgotten to take the pill or if the patch or vaginal ring has been misused. After Levonelle you should: 

  • Take your next pill, apply the patch or insert a vaginal ring within 12 hours 
  • Continue to take the rest of your pills as usual 
  • Use condoms for the next 7 days if you use the combined pill, patch or ring 
  • Use condoms for the next 9 days if you are using Qlaira, a type of the combined pill 
  • Use an additional contraceptive for 2 days if you are on the progesterone-only pill. 

After using ellaOne: 

  • Wait for 5 days until you take another contraceptive pill or use the ring or patch 
  • Use additional contraception during this time and for an extra: 
  • 7 days for the combined pill, patch or vaginal ring 
  • 9 days if you use a pill called Qlaira 
  • 2 days for the progesterone-only pill 

Can you get emergency contraception if you are under 16? 

Emergency Contraception is freely available for adolescents under the age of 16. The doctor or nurse will want to ensure that you have enough information and understanding of your situation. They will encourage you to tell your parents, but they will not tell anyone else unless they believe you are at risk or harm or abuse. 

Sources:

Patient Information Leaflet > Levonelle

Patient Information Leaflet > ellaOne

NHS > Emergency Contraception

NHS > Intrauterine Device (IUD)

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