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Dr HANX: The Morning After Pill and Emergency Contraception

Dr HANX: The Morning After Pill and Emergency Contraception

Wed, Jul 31, 19 - Dr Sarah Welsh

Ok, so you’ve had sex but forgotten to use a condom or missed a pill and you want to avoid pregnancy. What next?

This is not an uncommon situation, but it often brings much anxiety. Some of this anxiety comes from uncertainty around what the morning after pill actually is and if there other options apart from taking a pill. Dr HANX give us the low-down on what emergency contraception is out there, how they work, and what your options are…

What is emergency contraception?

Emergency contraception is used to prevent pregnancy after unprotected sex or if the contraception you were using failed, such as missing a pill or your condom spliting.There are two types, including the emergency contraceptive pill, commonly known as the morning after pill. Of which there are two types (Levonelle and ellaOne), and the intrauterine device (also know as the IUD or copper coil). 

Emergency contraception should not be something that is used regularly, but can be used as a fallback for when other methods of contraception fail. It’s also important to remember that emergency contraception does not protect you against sexually transmitted infections, so you must protect yourself with condoms and ensure you get an STI check if you have unprotected sex or your condom breaks.

The morning after pill

 The two types of morning after pills on the market are Levonelle and ellaOne. Both come in the form of a single tablet, which should be swallowed whole with water, with or without food. If you vomit within two hours after taking the tablet, you should take another, as it may not have been fully absorbed. If you’re seeing a medical professional, it is worth asking for an anti-sickness medication to take with the second tablet to ensure it stays down! Once you have taken the morning after pill, it only acts to prevent pregnancy for that one time, and will not prevent pregnancy from any further occurrences of unprotected sex in that menstrual cycle.

Levonelle  

Levonelle can be taken up to 72 hours after unprotected sex. It contains a synthetic hormone, called levonorgestrel, which prevents your ovaries releasing an egg. If an egg has already been released when you take Levonelle, the medication also helps stop the sperm from fertilising it. Hence, it’s effect is two-fold.

 You will need a prescription for Levonelle, as you can’t buy this pill over the counter. As the name suggests, the sooner you take the morning after pill after unprotected sex, the more likely it is to be effective at preventing pregnancy. If taken within the first 24 hours after sex, it is 95% effective, and this efficacy drops to 85% if taken 24-48 hours after, and only 58% at 48-72 hours after sex.

Levonelle, emergency contraception

ellaOne

ellaOne is another type of morning after pill, that contains a substance called ulipristal acetate. This substance acts on your natural hormones to postpone ovulation, meaning it is difficult for a sperm to fertilise an egg. You can take ellaOne up to 5 days after unprotected sex. 

The main difference between Levonelle and ellaOne is the time frame in which you can take the tablets. The effectiveness of Levonelle at preventing decreases drastically if taken 12 hours after sex (although it can work up to 72 hours after sex), whereas ellaOne remains 95% effective for up to 5 days after unprotected sex. ellaOne can be bought over the counter, whilst Levonelle requires a prescription.

ellaOne, morning after pill

Morning after pill side effects

The morning after pill is very safe to use, but like all medication, some people experience side effects. These include nausea, vomiting, dizziness, tiredness, breast tenderness, headaches and abdominal pain. It is very common to have an irregular menstrual cycle after taking a morning after pill, and this should return back to normal by 3 months.

Emergency contraception

The copper coil

The copper coil, also known as the intrauterine device or IUD, is a small T-shaped device that is covered in copper and is inserted into the womb to act as a very effective contraceptive. It can be inserted up to 10 days after unprotected sex to act as emergency contraception too. The copper coil can remain inside the womb for up to 5 or 10 years for contraception, and removed at any time. It is inserted using a speculum to open the vagina and visualise the neck of the womb (the cervix). The device is inserted through the cervix into the womb, where it sits. The copper is released slowly into the womb, and acts to change the mucus at the cervix, which makes it difficult for sperm to survive or to reach an egg, as well as preventing a fertilised egg to implant into the womb lining.

Side effects of copper coil

As the copper coil does not contain hormones, the side effects are not hormonal and it is unlikely the timing of your menstrual cycle will alter. However, some women experience bleeding between periods or spotting. Many women also experience heavier menstrual bleeding as a side effect of the copper coil. The coil can cause discomfort in some women, especially immediately after insertion. It’s also worth noting that if you’ve had pelvic infections the copper coil may not be suitable for you.

Where do I get emergency contraception?

All NHS sexual health clinics offer the morning after pills and the copper coil as emergency contraception options. ellaOne can be bought over the counter at your local pharmacy, and your GP can prescribe Levonelle. Some GPs and practise nurses can also insert copper coils.

What else do I need to consider?

So you’ve taken the morning after pill, or had the copper coil inserted. Is that all? As not all emergency contraception is 100% effective, it is worth considering taking a pregnancy test if your period is late/delayed or even if it is lighter or shorter than is normal for you.

It’s worth thinking about your choice of contraception moving forwards if this is something that could happen again. Check out our previous blog on contraceptive options to help make up your mind. There is more to consider than just preventing pregnancy when it comes to your sexual health, so don’t forget to have a sexual health check. This includes checking for STIs, and also considering what lead to theneed for emergency contraception.

 If you want Dr. HANX to discuss a topic in particular, please drop us a line at hello@hanxofficial.com. She would love to hear from you.