Emergency Contraception: The Morning After The Night Before

This article examines the vast array of emergency contraception, what it is, how they work, and what may be the best option out there for you.

Oh no. It happened. It split. You always think it will happen to someone else, yet here we are. Now, don’t start picking out baby names, although Matthew would be a great one for a boy, or look for good areas to live for the local schools. There are a multitude of options that you can choose from for emergency contraception. In this week's article we discuss and examine the vast array of emergency contraception, what it is, how they work, and what may be the best option out there for you. It is worth noting that, yes, this article may be a little sensitive to readers, however, it is an incredibly common topic that pharmacies, GUM clinics, and GP practices carry deal with daily. 

What is "The Morning After Pill"?

Emergency contraception comes in two forms - either in a tablet or “pill” form known as Levonelle or EllaOne, or as an intrauterine device (IUD). Emergency contraception can prevent pregnancy after unprotected sex or if the contraception you have used has failed – for example, a condom has split or you have missed a pill. Now, you can use an IUD as a form of emergency contraception, but you can also leave it to work as regular contraception going forward. However, this is not the same for the morning after pill as they are more recommended just for emergencies and not suitable as a regular contraception method.

When Can I Take The Morning After Pill?

For Levonorgesterel, you need to take this tablet within 3 days for it to be effective and within 5 days of unprotected sex for the EllaOne tablet. The sooner you take the tablet the more effective it will be. The IUD can be fitted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated, for it to still be effective. If you are sick within 2 hours after taking Levonorgestrel or 3 hours after taking EllaOne - you will need to visit your GP, pharmacy, or GUM clinic as you will need to take another dose of EHC or possibly have an IUD fitted. This is because your body may not have absorbed all of the drug before you were sick.

How Does The Morning After Pill Work?

Levonelle contains levonorgestrel, a synthetic (man-made) version of the natural hormone progesterone produced by the ovaries. Taking Levonelle stops or delays the release of an egg (ovulation). Levonelle has to be taken within 72 hours (3 days) of unprotected sex to prevent pregnancy. It doesn't interfere with your regular method of contraception.

EllaOne contains ulipristal acetate which stops progesterone from working normally, and in turn works by stopping or delaying the release of the egg. It must be taken within 5 days to prevent pregnancy. 

Levonelle and EllaOne do not continue to protect you against pregnancy – if you have unprotected sex at any time after taking the emergency pill, you can become pregnant. They aren't intended to be used as a regular form of contraception. But you can use emergency contraception more than once in a menstrual cycle if you need to.

Side Effects of Morning After Pill

The good news is there are no serious or long term side effects from taking the morning after pill. However, they can cause headaches and stomach pain, as well as making your next period either late, early, or more painful than usual. However, if you are still feeling like this after a few days then you should go and see your GP. You should also see your GP if your next period is more than 7 days late, your period is shorter or lighter than usual, or if you have a sudden pain in your lower tummy. 

How Does an IUD Work?

The intrauterine device (IUD) is a small, T-shaped plastic and copper device that's put into your womb (uterus) by a doctor or nurse. It releases copper to stop the egg implanting in your womb or being fertilised. The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy. You can also choose to have the IUD left in as an ongoing method of contraception. It is the most effective method of emergency contraception – less than 1% of women who use the IUD get pregnant. It's more effective than the emergency pill at preventing pregnancy after unprotected sex.

Side Effects of IUD

Some uncomfortable but rare side effects of having the IUD fitted include pain, the IUD coming out of the womb, and future periods can be more painful, heavier, and can last longer. There can sometimes be a risk of infection when the IUD is fitted initially.

Where Can I Get The Morning After Pill?

You can get emergency contraception for free, even if you're under 16, from these places, but they may not all fit the IUD:

• Contraception Clinics
• Online Pharmacy
• Sexual Health or Genitourinary Medicine (GUM) clinics
• Some GP Surgeries
• Some Young People's Clinics
• Most NHS Walk-in Centres and Minor Injuries Units
• Most Pharmacies
• Some A&E Departments 

However, you can also buy the morning after pill over the counter at most pharmacies - you can buy EllaOne even if you are under 16 years of age.

If you are under 16 and want emergency contraception, the doctor, nurse or pharmacist will not tell your parents (or carer) as long as they believe you fully understand the information you have been given, and the decisions you are making. The only time a professional might want to tell someone else is if they believe you are at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first. So please, if you are reading this and you are under 16 it is incredibly important that you speak to a healthcare professional if you need emergency contraception.