The morning after pill is designed to be used in those moments of panic when the condom has broken or they have been carried away at the moment and have had unprotected sex. To some extent the morning after pill has been shrouded in mystery and stigma; to admit to its use is like a public declaration that your behaviour is promiscuous and reckless rather than the simple explanation which is that ‘accidents happen’.
Despite the contraceptive pill being legalised for the use of all women (not just married women) in 1967 and perhaps not coincidentally that abortion could be carried out legally in 1968, public attitudes to women’s sexuality may not have come as far as we may think. This stigma which is associated with the morning after pill may explain why it is surrounded by so many myths about how it should be used and how effective it is.
There are two types of morning after pill, Levonell and ellaOne:
Levonelle can be taken up to 72 hours (3 days) after unprotected sex. The active ingredient in Levonelle is levonorgestrel which is a synthetic form of the hormone progesterone which is produced naturally in the ovaries. It is believed that it will delay or completely prevent ovulation (release of an egg from the ovary).
ellaOne can be used up to 120 hours (5 days) after unprotected sex. The active ingredient in ellaOne is ulipristal acetate. This chemical prevents progesterone from working properly as well as either delaying or preventing ovulation.
Many people are under the misconception that the morning after pill will only work if taken within 24 hours of sex. In actual fact, some forms can be taken up to five days after sex (see above).
It is advisable to take the morning after pill as soon as possible after unprotected sex but it is preferable to take it later than not at all.
As discussed above, there are two types of morning after pill, Levonelle and ellaOne but for many years, only Levonelle existed.
It is worth mentioning that whilst it is not a morning after pill, the copper coil (intrauterine device or IUD) is a third option for emergency contraception and it is effective provided it is fitted within 5 days of unprotected sex. The copper that is wrapped around the IUD makes sperm unable to fertilise an egg.
Sadly this is not always the case. Its efficacy depends on:
Which type of pill you take
How soon you have managed to take the pill after sex
Both Levonelle and ellaOne are most effective if taken up to 24 hours after sex but after 48 hours after this, the efficacy of Levonelle will decline rapidly.
Some mediation can also interfere with the effectiveness of the morning after pill. These include medication for epilepsy and heartburn as well as St. John’s Wort.
We also need to be aware that as the morning after pill operates to delay or prevent ovulation as part of its contraceptive protection if the pill is taken later in the menstrual cycle after ovulation has already occurred it is more likely to fail.
Whilst you can get emergency contraception from your GP surgery, it is also available from family planning clinics, NHS walk-in centres, sexual health clinics and places like Brook and BPAS clinics. Hospital emergency departments also have emergency stocks of the morning after pill. You do not need a prescription in the UK for either type of pill so they can be bought over the counter in major pharmacies and online.
The emergency pill does not protect you from pregnancy as a result of sex later in your cycle and if you have sex again before your period you will need to use the morning after pill again. Whilst the morning after pill is not a regular form of contraception it can be used more than once during a cycle.
None branded versions of Levonelle which have the same ingredients are now available and are much cheaper but just as effective.
ellaOne however is more expensive and there are no generic versions available. Evidence suggests however that if it is taken more than 48 hours after sex it is more effective than Levonelle.
If you are sick within 3 hours of taking either type of pill you will need to take another dose as the pill will have been expelled from the body before it has been absorbed
This really is a myth because there is no evidence that the morning after pill will affect your fertility or future fertility in any way
Using the morning after pill increases your chance of having an ectopic pregnancy
If this myth is considered logical, the morning after pill decreases your risk of any pregnancy and so it will decrease your risk of ectopic pregnancy; there is no evidence to suggest otherwise
Occasionally, as with any pregnancy, if the emergency pill fails then an ectopic pregnancy may result so if abdominal pain develops and your period is late it is important to seek the advice of a medical professional.