The copper IUD can be inserted up to five days after having unprotected sex. The IUD is more effective than the emergency pill at preventing pregnancy after unprotected sex.

Read more information about what happens once your coil has been inserted – Coil advice and aftercare

 

There are two kinds of emergency contraceptive pill – levonorgestrel and ullipristal . Both work by preventing or delaying ovulation. The sooner you take emergency contraception, the better.

What is it?

The emergency contraceptive pill is sometimes called the “morning after pill”. There are two kinds of emergency contraceptive pill: levonorgestrel and ulipristal. Both work by preventing or delaying ovulation.

You can take levonorgestrel more than once in a menstrual cycle and it does not interfere with your regular method of contraception. It has to be taken within 72 hours (three days) of sex.

Ullipristal may also be taken more than once in a cycle but may prevent other types of hormonal contraception from working for a further five days after use. It has to be taken within 120 hours (five days) of sex. Neither protect against sexually transmitted infections (STIs).

Ullipristal is more effective than levonorgestrel. Both are less effective than the copper IUD (coil) at preventing pregnancy. The sooner you take either pill, the better.

Who can use it?

Most can use the emergency contraceptive pill. This includes those who cannot usually use hormonal contraception, such as the patch or the combined pill.

It is advised that you should not use ullipristral if you:

• Are allergic to any of the components of the drug.
• Have severe asthma that is not properly controlled by steroids.
• Have hereditary problems with lactose metabolism.
• Are taking liver enzyme-inducing medication (as ullipristal will not be effective).
• If you are breast-feeding unless you express and discard the milk for one week.

What are the advantages?

• There is no evidence that levonorgestrel or ulipristal affect a developing baby.
• Levonorgestrel and ulipristal can be used even if there has been an earlier episode of unprotected sex in the menstrual cycle in addition to the current episode.
• Levonorgestrel can be taken while breastfeeding (even though small amounts of the hormones contained in the pill may pass into your breast milk, it is not thought to be harmful to the baby).
• Certain medications such as some HIV, epilepsy, TB treatments and St John’s Wort may affect levonorgestrel or ulipristal while they are being taken and for 28 days afterwards). You may be offered a double-dose of levornogestrel in this circumstance.
• After taking either emergency contraceptive pill, you may bleed at the expected time or may have your period later or earlier than normal. If your bleed is more than seven days later than you were expecting your period, or it is unusually light or short, contact your GP as soon as possible and perform a pregnancy test. You can take levonorgestrel or ulipristal more than once in a menstrual cycle. Levonorgestrel does not interfere with your regular method of contraception but ulipristal does.

What are the disadvantages?

• The manufacturer recommends that you do not breastfeed for one week after taking ullipristal.
• Taking either can have some common side effects. This includes abdominal pain, headache, irregular menstrual bleeding (spotting or heavy bleeding) before your next period is due and nausea.
• Less common side effects include breast tenderness, dizziness, headache and vomiting. It is important to seek medical advice if you vomit within two hours of taking levonorgestrel or three hours of taking ulipristal, as you will need another dose or an IUD fitted.
• Either contraceptive pill may interact with other medicines. This includes St John’s Wort, medication and some medicines used to treat HIV, epilepsy and TB. Ullipristal is not used if you are taking one of these medicines, as it may not be effective. Levonorgestrel may still be used but the dose will need to be increased (your doctor or pharmacist can advise on this).
• Ullipristal may prevent other types of hormonal contraception from working for five days after use.
• Neither protect against sexually transmitted infections (STIs).
• Both are less effective than the copper IUD at preventing pregnancy.

Remember: talk to your GP or go to your sexual health clinic if you are concerned about any of your symptoms after taking either pill, especially if:

• You think you might be pregnant.
• Your next period is more than seven days late.
• Your period is shorter or lighter than usual.
• You have any sudden or unusual pain in your lower abdomen. This could be a sign of an ectopic pregnancy, where a fertilised egg implants outside of the womb. This is rare but serious, so you will need immediate medical attention.

What if I am already using hormonal contraception?

You may need to take the emergency pill because you forgot to take your regular contraceptive pill, you did not use your contraceptive patch or vaginal ring correctly, or you were late having your contraceptive injection. If this is the case, you will likely be offered levonorgestrel and should take your next contraceptive pill, apply a new patch or insert a new ring within 12 hours of taking this. You can then continue taking your regular contraceptive pill as normal. You will need to use additional contraception, such as condoms, for the next seven days if you use the patch, ring, combined pill or injection, or the next two days if you use the progestogen only pill.

If you have taken ullipristal, you will need to delay using hormonal contraception such as pills/patches/rings for the next five days and use condoms until the hormonal method has been used for seven days if you use the patch, ring, combined pill, or injection, or two days if you use the progestogen only pill.

 

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