The Emergency Contraceptive Pill

Emergency contraception can be used if:

• you have had sex without using contraception.
• you have had sex, but there was a mistake with contraception. For example, a split condom, or if you forgot to take your usual contraceptive pills.

It is a pill that contains levonorgestrel which is a progestogen hormone. The brand name is Levonelle. You can get it free on prescription, or you can buy it from pharmacies without a prescription. The usual dose is one pill which contains 1.5 mg of levonorgestrel. (Some women need a higher dose if they are taking certain other medication. For example, women taking certain anti-epilepsy medicines.)

When do I take it and how does it work?

Take the pill as soon as possible after unprotected sex. The earlier you take the pill, the better. It is thought to work either by preventing or postponing ovulation, or by preventing the fertilised egg from settling (implanting) in the uterus (womb). It is not thought to cause an embryo that is already implanted into the womb to 'abort'.

How effective is it?

It is effective, but it is not as reliable as regular planned contraception. Therefore, it should only be used in emergencies. It becomes gradually less effective the more time that elapses. However, there is a good chance of preventing pregnancy if taken up to 72 hours after unprotected sex.

• If the pill is taken within 24 hours after unprotected sex, about 19 in 20 pregnancies that would have occurred are prevented. (Therefore, only about 1 in 200 women who have unprotected sex will become pregnant if they take the pill within 24 hours.)
• If the pill is taken between 24 and 48 hours after unprotected sex, about 17 in 20 pregnancies that would have occurred are prevented.
• If the pill is taken between 48 and 72 hours after unprotected sex, about 12 in 20 pregnancies that would have occurred are prevented.
• It is sometimes used between 72 and 120 hours after unprotected sex but the chance of it working is much less than if it is taken within 72 hours.

Are there any side-effects?

• Some women feel sick for about 24 hours after taking the pill, and a few vomit. This may be less likely to happen if you take the pill with food.
  If you vomit within three hours of taking the pill then:
  • Take another pill as soon as possible. (You may need to get a further prescription, or buy another pill from the pharmacy. You may also wish to get a prescription for some anti-sickness tablets.) - OR
  • An intra-uterine device can be inserted as an alternative method of emergency contraception.
• Other mild side-effects occur in some women for a short time such as: abdominal pain, headache, tiredness, dizziness, and breast tenderness.

Who should not take the emergency contraceptive pill?

Do not take it if you are already likely to be pregnant.

Some reasons why emergency contraception is more likely to fail

• If you take the pill more than 72 hours after unprotected sex.
• If you vomit within three hours of taking the pill, and do not take a repeat dose.
• If you had unprotected sex at another earlier time.
• If you have unprotected sex again after taking emergency contraception.

Some other points about this type of emergency contraception

• Most women have their next period at about the usual time. Sometimes it is a few days earlier or later than expected. See a doctor or nurse if your next period is more than seven days late, or if it is lighter than usual. A pregnancy test may then be advised.
• Your next menstrual cycle may also be shorter or longer than usual.
• There is still a small risk of pregnancy even if you take the emergency contraceptive pill correctly. The possibility that the hormone in the pill may harm a developing baby cannot be completely ruled out, but it is thought to be very unlikely.

Follow up

You may want to discuss your regular contraceptive needs with a doctor or nurse. This may be best in a relaxed follow-up consultation.

An important message

See a doctor urgently if you have any lower abdominal pain or abnormal vaginal bleeding over the next 2-6 weeks. These are the main symptoms of an ectopic pregnancy. This is rare, but it is best to be aware of the possibility as it is a serious condition. Also, see a doctor if your next period is more than seven days late, or if you have any other concerns.

Alternative methods of emergency contraception

An alternative method of emergency contraception is to have an intra-uterine device (IUD) inserted by a doctor or nurse. This can be done up to five days after unprotected sex. It has the advantage of providing ongoing contraception, and is more effective than taking hormone tablets (almost 100% effective). There is a separate leaflet on the IUD.

Further information

Your GP, practice nurse and pharmacist are good sources of information if you have any queries.

The fpa (formerly the family planning association) also provide information and advice.
fpa's Helpline: 0845 310 1334 or visit their website www.fpa.org.uk

© EMIS and PIP 2006   Updated: February 2006   PRODIGY Validated