What is the morning after pill?

It is a pill to prevent pregnancy, which is taken after intercourse has occurred.

When is it needed?

If you at risk of pregnancy i.e. had unprotected sex, or if your birth control method fails.

How does it 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 in that time, fertilisation will not happen. The lining of the womb may also be affected, decreasing the chance if implantation.

Do these treatments cause abortion?

No, emergency contraception does not cause an abortion, it prevents conception or implantation.

When should I take the morning after pill?

Emergency contraception is more effective the sooner it is taken. Take the medication (a single tablet) as soon as possible after unprotected sex, not necessarily the next morning.

Which morning after pills are available in the UK?

There are 2 available:

• Levonelle (Levonorgestrel) a synthetic version of naturally occurring hormone progesterone. This is produced under two names: Levonelle One Step (levonorgestrel 1.5mg) – which can be sold to women over 16 years by pharmacists and Levonelle 1500 (levonorgestrel 1.5mg) which is exactly the same medicine but only available on prescription.
• ellaOne (ulipristal acetate 30mg) a selective progesterone receptor modulator (SPRM) which blocks progesterone function. ellaOne is also available without prescription.

Which morning after pill should I take?

This depends on the following:

• Time since unprotected intercourse – 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 take a hormonal contraceptive – both ellaOne and Levonelle interfere with regular contraceptive pills (both combined and progesterone only), but ellaOne disrupts pill function for longer.
• Health issues – you should avoid ellaOne if you think you may already be pregnant, are allergic to it, or have uncontrolled severe asthma. Some medicines interact with both pills. These medicines are specified in the online consultation.
• Cost – ellaOne costs approximately twice as much as Levonelle. See prices on emergency contraception page

Where can I obtain the morning after pill?

There are several options. As well as online from Dr Fox, you can see your GP, out-of-hours GP (telephone 111), go to a pharmacy (most, not all), sexual health or family planning clinics, walk in centres. Further information from NHS website.

How to order

How long after unprotected sex do I have?

Levonelle should be taken within 72 hours (3 days) and ellaOne within 120 hours (5 days) of intercourse.

If I am breastfeeding which should I use?

Levonelle can be taken whilst breastfeeding. The manufacture advises against taking ellaOne whilst breastfeeding because of a lack of data.

Will it prevent STIs?

No, only a physical barrier such as condoms will prevent STIs.

If I drink alcohol before or after taking emergency contraceptive 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 putting on a condom incorrectly.

What other emergency contraception is available?

The IUD (intrauterine device or coil) can be inserted into the womb to prevent implantation. It is effective up to 120 hrs (5 days) after unprotected sex. 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 family planning clinics, 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 within two hours of taking Levonelle, or three hours of taking ellaOne, 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, if Levonelle was taken, or an alternative emergency contraceptive method (coil), if EllaOne was taken.

When will my next period come?

Levonelle and ellaOne can make your period a few days earlier or later than usual. Your next period should start within the next month. If you don't get your period by the time you expect it or 3 weeks after unprotected intercourse, you should have a pregnancy test.

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

Yes, morning-after-pills are more effective the sooner they are taken. Avoiding the delay in obtaining your medicine will decrease the risk of pregnancy. The 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.

How often can I take it?

Women requiring emergency contraception more than once in a menstrual cycle should consult a doctor or specialist contraception advisor.

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

Hormonal contraception used	Need for emergency contraception
Combined oral contraception	If 2 or more pills have been missed in the first 7 days of the packet and unprotected sexual intercourse (UPSI) has taken place in these 7 days or in the 7-day pill-free interval. If 4 or more pills have been missed from the middle of the packet and UPSI has taken place within 7 days of the last missed pill. If UPSI takes place without the use of an additional barrier method of contraception within 7 days of an episode of vomiting or severe diarrhoea. In all cases, additional barrier methods are needed for 7 days if progestogen-only emergency contraception (Levonelle) is used, whilst continuing normal pill taking. If these 7 days run beyond the end of the packet, the next packet should be started immediately without a break. If more than 2 pills are missed during the last 7 days of the packet, the next packet should be started immediately without a 7-day pill-free interval. The pill-free interval will be shorter and the woman will be more protected than usual. Emergency contraception is very rarely indicated for pills missed days 15-21.
Progestogen-only contraception	If one or more pill has been missed or taken more than 3 hours late (more than 12 hours late for Cerazette), and UPSI has occurred before 2 further tablets have been correctly taken. Additional barrier methods are required for a further 2 days whilst continuing the normal progestogen-only pill regime.

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