What is the morning after pill?

It is a pill to prevent pregnancy, which is taken after sexual intercourse has occurred. It is also called hormonal emergency contraception. There are two different types of morning after pill available. Having an IUD (copper coil) inserted can also prevent pregnancy after sex has happened.

When is the morning after pill needed?

The morning after pill is used if you have had sexual intercourse without an effective form of contraception. This could be because:

• Contraception wasn't used.
• A condom has split or come off.
• A cap or diaphragm was used incorrectly.
• Using the withdrawal method failed.
• Sometimes after forgetting regular contraceptive pills, contraceptive patch or ring.
• The next implant, coil, or depot injection has been delayed.

How does the morning after pill work?

Morning after pills work mainly by delaying or stopping ovulation. Sperm survive for up to 5 days after intercourse. If ovulation does not occur during that time, fertilisation and pregnancy will not happen.

Does the morning after pill cause abortion?

No, the morning after pill does not cause an abortion, it prevents conception (fertilisation of an egg). The morning after pill will not cause abortion if you are already pregnant.

How soon should I take the morning after pill?

Take the medication as soon as possible after sex, not necessarily the next morning. Levonelle may be more effective the sooner it is taken. It can be taken up to 72 hours (3 days) after sex. EllaOne is usually effective when taken any time up to 120 hours (5 days) after sex.

How likely am I to get pregnant from having sex once, if I have not used any contraception at all?

The answer to this varies depending on the day in your monthly cycle. There is a greater chance of pregnancy close to ovulation, which tends to be 14 days before the next expected period. Averaged out over the whole month, estimates are that each single episode of sex has a 1 in 20 chance of leading to pregnancy.

How effective are morning after pills?

EllaOne is thought to prevent around 6-8 of 10 expected pregnancies after a single episode of sex, but on average only 1 in 20 episodes of sex lead to pregnancy. Out of 100 women who take ellaOne in one monthly cycle, approximately 2 will become pregnant.

If 100 women take Levonelle, at any stage in their cycle, 1 or 2 will still get pregnant.

Which morning after pills are available in the UK?

There are 2 types of morning after pill available:

• Levonorgestrel 1.5mg - a synthetic version of the naturally occurring hormone progesterone. This is produced under several names: Levonelle, Levonelle One Step, Ezinelle, and generic levonorgestrel 1.5mg.
• Ulipristal acetate 30mg (brand name ellaOne) - a selective progesterone receptor modulator (SPRM) which blocks natural progesterone function.

Where can I get the morning after pill from?

There are several options. Dr Fox supplies Levonelle, generic levonorgestrel 1.5mg, and ellaOne for standby use from £3 + P&P. See morning after pill page.
How to order

Morning after pills are also available from an NHS walk in centre, GP or sexual health clinic or from most pharmacies without prescription.

To find a local pharmacy which provides emergency contraception, send an SMS TXT:

'Pharmacy emergency contraception [and your post code]' to 80011
You will get a text response with the 3 nearest pharmacies with their names, addresses, telephone numbers and distance from the post code you entered.
Standard text message rates from your provider may apply when using this service.

Further information available at NHS - Where can I get emergency contraception?

Which morning after pill should I take?

This depends on the following:

• Time since sex took place – Levonorgestrel 1.5mg (Levonelle) is effective if taken up to 72 hours (3 days) after unprotected intercourse, ellaOne up to 120 hours (5 days).
• Frequency of use – women requiring emergency contraception more than once in a menstrual cycle should consult a doctor or specialist contraception advisor.
• Whether you usually use a hormonal contraceptive – both ellaOne and levonorgestrel 1.5mg interfere with regular contraceptive pills (both combined and progesterone only), patches, and rings, but ellaOne disrupts their function for longer.
• Health issues – ellaOne can stop steroid tablets from working, so should not be taken if severe asthma is being controlled by steroid tablets. In severe liver disease, neither morning after pill should be used.
• Other medicines – some medicines interact with both pills. These medicines are specified in the online consultation. Progesterone in other medicines affects ellaOne.
• Cost – ellaOne costs significantly more than Levonorgestrel 1.5mg. See prices on morning after pill page.

Compare ellaOne and Levonelle

How long after unprotected sex do I have to take the morning after pill?

Levonelle (levonorgestrel 1.5mg) should be taken within 72 hours (3 days) and ellaOne within 120 hours (5 days) of sex. It is advised to take as soon as possible.

If I am breastfeeding which morning after pill should I use?

This is difficult to answer.

After taking Levonelle (levonorgestrel 1.5mg) the manufacturer advises not to breastfeed for 8 hours. However there is no evidence of harm and the FSRH (Faculty of Sexual and Reproductive Healthcare in the UK) recommend that women can take levonorgestrel and continue to breastfeed.

After taking ellaOne the manufacturer advises not to breastfeed for 7 days. Milk should be expressed and discarded using a breast pump to maintain milk supply. The FSRH supports this approach, due to lack of data. However there is a body of opinion that suggests it is also ok to use ellaOne if breastfeeding.

Of course breastfeeding in itself can be a contraceptive. These conditions must be met:

• Baby under 6 months old.
• No period since birth.
• Fully breastfeeding only, with less than 4 hours between feeds during the day and 6 hours at night.

Further information from The Breastfeeeding Network.

Does the morning after pill prevent STIs?

No, only a physical barrier such as condoms will prevent STIs (sexually transmitted infections). If you need the morning after pill and are also concerned about being at risk of catching an STI, contact your GP or local sexual health clinic for a full STI screen.

Local NHS Sexual Health Clinics

• England
• Wales
• Scotland
• Northern Ireland

If I drink alcohol before or after taking morning after pills, will they be less effective?

No, there is no effect of alcohol on the morning after pill. Alcohol can indirectly affect contraceptives – e.g. causing you to forget to use them, or not putting on a condom correctly. Drinking alcohol can also impact your decision making around choosing to have sex. See also Getting it on - Alcohol and unprotected sex.

What other emergency contraception is available?

The IUD (intrauterine device or copper coil) can be inserted into the womb to prevent implantation. It is effective up to 120 hours (5 days) after unprotected sex, or 5 days after expected ovulation (egg release). It is the most effective form of emergency contraception, although can be harder to access than a pill. IUDs can be fitted by a trained healthcare professional at sexual health clinics and some GP surgeries.

An IUD can be left in place as a regular method of contraception, or it can be removed during the next period.

What if I vomit after taking my morning after pill?

If you're sick/vomit within three hours of taking the morning after pill, the medicine cannot be guaranteed to work and you will need to take another dose or have an IUD fitted.

What if I took the morning after pill and then had unprotected sex the next day?

You would not be protected and would need a further dose. You are not protected for the rest of that monthly cycle, as the morning after pill only delays ovulation, and does not stop it completely. It is therefore best to start a regular form of contraception as soon as possible after taking the morning after pill.

When will my next period come if I have taken a morning after pill?

Levonelle (levonorgestrel 1.5mg) and ellaOne can make your period a few days earlier or later than usual. Your next period should start within the next month. If, after using emergency contraception, a completely normal period (not lighter, or much more painful, than usual) does not arrive within 5-7 days of when expected, take a pregnancy test.

Are you more likely to have an ectopic pregnancy if you take the morning after pill?

There is a risk that any pregnancy can be ectopic (growing outside the womb, usually in the fallopian tubes).

If you have had an ectopic pregnancy in the past or have damage to your tubes, possibly from a chlamydia infection, it is more likely that a pregnancy could be ectopic.

When an IUD or IUS is used for contraception, it is more likely that any pregnancy occurring would be ectopic.

If you take the morning after pill you are much less likely to get pregnant. There is no difference in the proportion of pregnancies which would be ectopic, so the answer is no you are not more likely to have an ectopic pregnancy after taking the morning after pill.

Can I buy emergency contraception in advance in case I need it?

Yes, morning after pills are often more effective the sooner they are taken. Avoiding the delay in obtaining your medicine will decrease the risk of pregnancy. They can be purchased in advance online.

Emergency contraception is not as effective as regular contraception. If you are not using regular contraception and need it, you should see your GP or local sexual health clinic.

How often can I take the morning after pill?

In some circumstances morning after pills can be used more than once in the same cycle, but advice from your GP or a specialist contraception advisor is needed. In general it is better to use a regular form of contraception than use the morning after pill frequently. Using a Long Acting Reversible Contraceptive (LARC) such as an implant, depot injection, IUD or IUS is much more reliable and doesn't depend on you remembering it, for it to work.

Are morning after pills needed, if I already take contraceptive pills?

In some instances missing pills can lead to loss of contraceptive cover and you need to use extra contraception such as condoms. Failing to use extra contraception may mean you need to use the morning after pill. It is complicated!

When emergency contraception (EC) is needed after missing pills

Combined oral contraceptive pill (COC)

If EC is required, condoms will continue to be needed until after 7 days of correct combined oral contraceptive pill use.

Missed pill situation	Need for emergency contraception
Late restart after week off pills - over 9 days since last pill	EC needed for any sex without condom since last pill
1 missed pill anywhere in pack	No EC needed if all other pills taken correctly
2-7 missed pills in week 1	EC needed for any sex without condom, since last full pack of pills
2-7 missed pills in weeks 2 or 3 (or later weeks if taking pills continuously)	No EC needed if all other pills taken correctly
More than 7 pills missed at any time	EC needed for any sex without condom

Progesterone-only pill (POP)

If EC is required, condoms will continue to be needed until after 48 hours of correct progesterone only pill use.

Missed pill situation	Need for emergency contraception
More than 12 hours late with desogestrel pill (e.g. Cerazette, Cerelle, Hana, Lovima)	EC needed for any sex without condom, before next 2 pills have been taken correctly, i.e. between 12 hours from last pill to 48 hours from restarting pills
More than 3 hours late with traditional progesterone-only pill (rarely prescribed, e.g. Noriday, Norimin)	EC needed for any sex without condom, before next 2 pills have been taken correctly, i.e. between 3 hours from last pill to 48 hours from restarting pills

Depot contraceptive injection, implant, contraceptive patch, contraceptive vaginal ring

Emergency contraception can sometimes be needed if any of these are used incorrectly or not renewed at the correct time. Discuss with your usual contraceptive provider.

Do morning after pills contain lactose?

Yes both types of morning after pill contain lactose and should not be used if you are lactose intolerant.

How do I get an emergency contraceptive coil fitted?

An emergency coil is an alternative to taking the morning after pill. They can be fitted up to 5 days after sex or up to 5 days after expected ovulation (up to about 9 days before your next expected period).

Many GPs offer a routine coil fitting service though it may be difficult to arrange an emergency fit and they may refer you elsewhere.

Sexual health clinics can also arrange an emergency coil fit, but get in touch as soon as possible as clinics can be busy.