About emergency hormonal contraception
|Type of medicine||Emergency contraception ('morning-after pill')|
|Used for||To prevent pregnancy after unprotected sex|
|Also called||Levonelle® One Step (contains levonorgestrel)
Levonelle® 1500 (contains levonorgestrel)
ellaOne® (contains ulipristal)
Emergency hormonal contraception is also called EHC and the 'morning-after pill'. If you have had unprotected sex, taking emergency hormonal contraception within a few days can help prevent pregnancy. Emergency hormonal contraception can be used if you have had sex without using contraception, or if you have had sex but there was a mistake with your usual contraception (for example, a split condom or if you forgot to take your usual contraceptive pills).
There are two types of pill available - one contains levonorgestrel which is a female hormone, and the other contains ulipristal which works on female hormone receptors within the body. They are both thought to work by stopping your ovaries from releasing an egg. Levonorgestrel may also have an effect in your uterus (womb) to prevent an egg already released from becoming fertilised and attached.
Although emergency contraception is effective, it is not as reliable as regular planned contraception. Therefore, it should only be used in an emergency. It becomes gradually less effective the more time elapses after having unprotected sex, so it should be started as soon as possible. The levonorgestrel pill is available free on prescription as Levonelle® 1500, or can be purchased from pharmacies as Levonelle® One Step. It is effective up to 72 hours (three days) after unprotected sex. Ulipristal is effective up to 120 hours (five days) after having unprotected sex, and is available free on prescription through a doctor or clinic.
A non-hormonal method of emergency contraception is also available. An intrauterine contraceptive device (coil) can be inserted by a doctor or nurse up to five days after unprotected sex. This method of emergency contraception is more effective than hormonal tablets. Your doctor can give you more information about this.
Before taking emergency hormonal contraception
To make sure this is the right treatment for you, before you take the 'morning-after pill' it is important that your doctor or pharmacist knows:
- If there is a possibility that you could already be pregnant.
- If you have ever had an ectopic pregnancy.
- If you are breast-feeding.
- If you have liver problems.
- If you have severe asthma.
- If you have porphyria (a rare inherited blood disorder).
- If you have a condition of your small bowel that interferes with the way you absorb food, such as Crohn's disease.
- If you are taking other medicines, including those available to buy without a prescription, herbal and complementary medicines. This is important because some medicines reduce the effectiveness of emergency hormonal contraception.
- If you have ever had an allergic reaction to a medicine.
How to take emergency hormonal contraception
- Before you start this treatment, read the manufacturer's printed information leaflet from inside the pack. The leaflet will give you more information about the specific brand of pill you have been given, and any possible side-effects from taking it. Take it exactly as you have been told.
- The pack contains one tablet. Take the tablet as soon as possible, as it works better the sooner you take it. Levonorgestrel (Levonelle®) is best taken within 12 hours after unprotected sex - do not take it later than 72 hours after unprotected sex unless you have been advised otherwise by a doctor. Ulipristal (ellaOne®) should be taken no later than 120 hours after unprotected sex.
- You can take the tablet at any time of day, and either before or after food. Taking it after food may help reduce the risk of you feeling sick after taking the tablet.
- If you vomit within two hours of taking levonorgestrel (Levonelle®), or three hours if you are taking ulipristal (ellaOne®), then take another tablet as soon as possible. (You will need to get a further supply through your doctor or pharmacy. You may also wish to get a prescription for some anti-sickness tablets).
Getting the most from your treatment
- Emergency hormonal contraception is for occasional emergency use only. It should not be relied upon as a regular method of contraception. Do not use emergency hormonal contraception more than once in the same menstrual cycle.
- This tablet will not provide protection against pregnancy for the rest of your cycle. It is recommended that you use a barrier method such as a condom until your next period. You may also want to discuss your regular contraceptive needs with your doctor. If you are already using a regular method of contraception such as the contraceptive pill, you can continue to take this at your regular times, although you should also use a condom until your next period.
- Your next menstrual period may occur a few days earlier or later than expected. If your periods are delayed by more than about 5-7 days, or if your bleeding is unusual in any way, you should see your doctor for further advice. Even if you have taken the tablet correctly, there is still a small risk of pregnancy and a pregnancy test may be advised.
- If you have any lower abdominal pain or unusual vaginal bleeding in the following 2-6 weeks, you should see your doctor. These may be symptoms of an ectopic pregnancy. This is rare, but it is best to be aware of the possibility as it is a serious condition.
- Emergency hormonal contraception will not protect you against sexually transmitted diseases. Ask you pharmacist, doctor or clinic if you are concerned about this and need advice.
Can emergency hormonal contraception cause problems?
Along with their useful effects, most medicines can cause unwanted side-effects although not everyone experiences them.
|Common side-effects of emergency hormonal contraception||What can I do if I experience this?|
|Feeling or being sick||If you vomit within two hours of taking levonorgestrel (Levonelle®) or three hours of taking ulipristal (ellaOne®), then take another dose as soon as possible|
|Light or heavy periods, early or late periods||If your periods are delayed by more than about 5-7 days, or are unusually light or heavy, see your doctor for further advice|
|Pain in your lower abdomen||See your doctor for further advice|
|Feeling tired or dizzy, headache, breast tenderness, diarrhoea, back pain||These should get better within a few days|
If you experience any other symptoms which you think may be due to this medicine, speak with your doctor or pharmacist.
How to store emergency hormonal contraception
- Keep all medicines out of the reach and sight of children.
- Store in a cool, dry place, away from direct heat and light.
Important information about all medicines
Further reading & references
- British National Formulary; 62nd Edition (Sep 2011) British Medical Association and Royal Pharmaceutical Society of Great Britain, London
- Manufacturer's PIL, Levonelle® One Step; Manufacturer's PIL, Levonelle® One Step, Bayer plc, electronic Medicines Compendium. Dated July 2009.
- Manufacturer's PIL, ellaOne® 30 mg; Manufacturer's PIL, ellaOne® 30 mg, HRA Pharma UK Limited, electronic Medicines Compendium. Dated July 2010.
|Original Author: Helen Allen||Current Version: Helen Allen||Peer Reviewer: Prof Cathy Jackson|
|Last Checked: 20/02/2012||Document ID: 3697 Version: 22||© EMIS|
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.