How Effective is The Morning After Pill?

The dreaded and 'embarrassing' morning after pill. This week we discuss everything morning after pill- how it works, what it does and why you should not be embarrassed to go see the pharmacist about it.

That frightfully embarrassed look in your eyes, the constant fidgeting, and plucking up the courage to ask for the pharmacist… ah yes, it's the morning after pill you are needing isn't it? Believe me when I say this that is a very common occurrence in pharmacy, and you should not be embarrassed to ever seek help. In this article, we discuss some frequently asked questions around these little tablets. It is important to preface this article by saying that the morning after pill, or emergency contraception, should not be used regularly. If you find you are using it more than you should, it may be advisable to speak to a GP or nurse about having regular contraception in place

What is The Morning After Pill?

The morning-after pill is a type of emergency birth control. Emergency contraception is used to prevent pregnancy for women who have had unprotected sex or whose birth control method has failed. The morning-after pill is intended for backup contraception only, not as a primary method of birth control. Emergency hormonal contraception (EHC) is available as two different drugs, levonorgestrel and ulipristal acetate.

How Does The Morning After Pill Work?

Levonelle contains levonorgestrel, a synthetic version of the natural hormone progesterone produced by the ovaries. It works mainly by preventing the release of an egg during your menstrual cycle. It also makes vaginal fluid thicker to help prevent sperm from reaching an egg and changes the lining of the uterus to prevent attachment of a fertilized egg.

The EllaOne emergency contraceptive pill contains ulipristal acetate which stops progesterone from working normally, and in turn works by stopping or delaying the release of the egg. 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.

Another form of emergency contraception is an intrauterine device (IUD) which can be used up to five days, or 120 hours, after unprotected sex. It is a small, T-shaped plastic and copper device that's inserted into your uterus by a doctor or nurse. It releases copper into the surrounding area to prevent sperm attaching to an egg. So, unlike the morning after pill, it works even after you have ovulated. Unlike the morning after pills, an IUD can actually be kept in place to act as continual contraceptive cover. 

How Effective is The Morning After Pill?

Whilst these handy tablets have been dubbed as a “morning after” pill, it can actually still be clinically effective beyond that dreaded morning. The morning after pill is most effective the earlier it is taken after having sex. Studies have shown that for levonorgestrel it is 95% effective if the tablet is taken within the first 24 hours of having sex. Respectively on day two and three the tablets efficacy is only 85% and 58%. With regards to Ulipristal, it is 98% effective if taken within the five day time frame. 

Several factors can affect the efficacy of emergency contraception, such as a person's weight and if they are on certain medication such as epileptic medication, blood thinners, and some antibiotics. If this is the case then two tablets may be required to ensure there is a suitable level of drug absorbed into the body.

What Are The Side Effects of The Morning After Pill?

The good news is there are no serious or long term side effects from taking the morning after pill. For levonorgestrel some common side effects can include nausea, abdominal pain, tiredness, dizziness, changes in vaginal bleeding, breast tenderness, diarrhoea, or headache may occur as a side effect. If you experience severe lower stomach pain please seek medical help.

Serious drug reactions to levonorgestrel are incredibly rare.  However, seek medical attention right away if you notice any symptoms of a serious allergic reaction, such as a rash, itching, swelling of the face or throat and trouble breathing.

For Ulipristal, common side effects include headache, nausea, abdominal pain, tiredness, dizziness, or painful menstrual period.. If any of these effects persist or worsen then please see your GP. Similarly if you do have a severe lower stomach pain or symptoms of an allergic reaction, please seek urgent medical attention.

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 Many Times Can You Take The Morning After Pill?

The morning after pill was developed for use in emergencies - for example if you have forgotten to take the pill or a condom splits, so it really is advised to be used only when absolutely necessary. It is not recommended as a regular method of contraception. Ideally you should only use emergency contraception once in the same cycle, any more than this and it can start to cause upset with your periods. However, if it is needed, then you can use levonorgestrel more than once in the same cycle but ulipristal is only once. 

How Long After Sex Can You Take The Morning After Pill?

As mentioned earlier, the efficacy of the morning after pill diminishes with time. Levornogestrel, or levonelle, has to be taken within 72 hours (3 days) of unprotected sex to prevent pregnancy. Whereas with Ulipristal, or EllaOne, It must be taken within 120 hours (5 days) to prevent pregnancy. Once the morning after pill is taken, you must practice safe sex with an additional method of contraception such as condoms for seven days. 

In summary, the morning after pill can really help you when you need it most. It is important to take the morning after pill as soon as possible and bear in mind that if you have unprotected sex after taking the pill then it will be ineffective