Morning After Pill

The morning after pill is a type of emergency contraception.

You can use emergency contraception to prevent pregnancy if you’ve had unprotected sex. Unprotected sex means having sex without regular contraception, like condoms or the contraceptive pill. You can also use the morning after pill if your normal contraceptive has failed, like a condom splitting.

There are 3 types of morning after pills available: EllaOne, Levonelle and generic levonorgestrel. These work by delaying the release of an egg from your ovaries (ovulation). They can also thicken your cervical mucus to make it difficult for sperm to enter your womb. The sooner you take one of these medications, the more effective they are at preventing pregnancy.

EllaOne

• contains the active ingredient ulipristal acetate
• can be taken up to 120 hours after having unprotected sex

Levonelle

• contains the active ingredient levonorgestrel
• can be taken up to 72 hours after having unprotected sex

Generic levonorgestrel

• contains the active ingredient levonorgestrel
• can be taken up to 72 hours after having unprotected sex

EllaOne and Levonelle work by preventing the ovaries from releasing an egg. If no egg is available, sperm cannot fertilise it, which would result in pregnancy.

The morning after pill also thickens the cervical mucus, making it difficult for sperm to enter your womb.

Studies show that EllaOne is 98% effective if you take it within 120 hours (5 days) of having unprotected sex. Levonelle and generic levonorgestrel are 95% effective at preventing pregnancy if taken within 24 hours, but they remain effective for up to 3 days. In all cases, the sooner you take the morning after pill, the more effective it will be.

The morning after pill will only prevent pregnancy if you take it after you have had unprotected sex. If you take it and then have unprotected sex again, you will be at risk of pregnancy.

If you have already ovulated (released an egg from your ovaries), the morning after pill will not work. Ovulation usually happens in the middle of your menstrual cycle or around 10 to 16 days after your period. You can keep track of your menstrual cycle using a period tracking app. If you have unprotected sex after you’ve ovulated, the best emergency contraceptive to use is the copper coil, which your GP or local sexual health clinic can insert. This can be used up to 120 hours after sex.

If you are already pregnant and take the morning after pill, it will not stop that pregnancy. It does not impact the developing foetus if you take the morning after pill without realising that you are pregnant.

Other medications and the morning after pill

Tell your doctor or pharmacist if you are taking any other medications. Certain drugs can make the morning after pill less effective such as:

• epilepsy treatment (such as primidone, phenobarbital, phenytoin and barbiturates)
• tuberculosis treatment (such as rifampicin and rifabutin)
• HIV treatment (such as ritonavir and efavirenz)
• Griseofulvin (an antifungal medication)
• St John’s wort (a herbal remedy used to treat low moods)

Your doctor may suggest a different form of emergency contraception, such as the copper intrauterine device (IUD).

How soon after unprotected sex should you take the morning after pill?

EllaOne, Levonelle and generic levonorgestrel have different timeframes for how long you can take them after unprotected sex.

EllaOne: up to 120 hours (5 days)

Levonelle or generic Levonelle: up to 72 hours (3 days)

However, they are all more effective the sooner you take them. Take the morning pill as quickly as possible, preferably within the first 24 hours.

Take the morning after pill with water as soon as possible after having unprotected sex. You can take it at any time of the day, with or without food.

How often can you take the morning after pill?

Only take the morning after pill if you have had unprotected sex. The morning after pill is not something to use as your regular form of contraception.

You can take the morning after pill more than once in your menstrual cycle, but it can cause irregular periods and may make you feel unwell. Having irregular periods can make it harder to know if you have ovulated, which can also make it harder to know if you can take the morning after pill or not.

Using a regular form of contraception, such as the contraceptive pill or a copper IUD is a more reliable method of preventing pregnancy.

You may get some side effects after taking the morning after pill. These will not last very long and should disappear after a few hours.

The common side effects of the morning after pill include:

• feeling sick or being sick
• tiredness
• irregular bleeding from the vagina
• breast tenderness
• abdominal pain
• mood changes
• headache
• pelvic pain

Take another pill if you are sick within 3 hours of taking the morning after pill. The first one may not have been absorbed into your system.

For more information about side effects, you can read the patient information leaflets for EllaOne and Levonelle.

How long do side effects last?

If you experience side effects, these usually clear up within a couple of days. If they don’t or get worse, talk to your doctor.

You may also notice a change in your menstrual cycle, with your period being later than usual. Doctors recommend taking a pregnancy test if your period is late to ensure you are not pregnant.

Other types of emergency contraception

The other type of emergency contraception is a copper intrauterine device, also known as an IUD. It is a small device fitted into your womb (uterus) by a trained doctor or nurse within 5 days of you having unprotected sex.

The copper IUD is 99% effective in preventing pregnancy. It is the most effective form of emergency contraception.

Copper is released from the coil into your uterus and stops sperm from travelling into your womb. It can also prevent a fertilised egg from implanting into your womb lining. You can then leave the copper IUD in place and use it as regular contraception. Depending on the device, it can be in your womb for 5 to 10 years.

Which morning after pill is the best?

EllaOne is often considered the ‘best’ morning after pill as it is the most effective pill in preventing pregnancy. It is 98% effective in preventing pregnancy throughout the 120 hours you can take it. Levonelle and generic levonorgestrel are 84% effective if you take them within 72 hours.

However, as they contain different medicines, you may get different side effects from each medication. So what is best for one person might not be suitable for you.

What if I throw up after taking the morning after pill?

If you throw up within 3 hours of taking either EllaOne or Levonelle, you should take another tablet as soon as possible. The medication will not have been absorbed and will not be effective in preventing pregnancy.

Can I get pregnant after taking the morning after pill?

There is a minimal chance that you can still get pregnant after taking the morning after pill. No contraceptive method is 100% effective, which means there’s always a risk of pregnancy after unprotected sex.

The morning after pill does not make you infertile. If you want to try for a baby after taking the morning after pill, wait until after your next period to be certain you are not already pregnant and can make sure you have ovulated.

If you have unprotected sex after taking the morning after pill, you must use emergency contraception again if you want to prevent pregnancy.

Can I take my usual contraceptive pill at the same time?

You may have to wait to take your regular contraceptive pill after the morning after pill, and you may need to use additional contraception. It depends what type of morning after pill you’ve taken, and the contraceptive you’re on. Always ask a healthcare professional for advice and read the patient information leaflet in your pack of pills.

If you take EllaOne, you must use condoms as well as take your regular contraceptive pill until you get your period. EllaOne can make normal contraceptive pills temporarily less effective.

How can you tell if the morning after pill worked?

You can only tell if the morning after pill worked if you get your period. You can take a pregnancy test up to 6 days before your period is due.

Can I buy the morning after pill online?

You can buy the morning after pill from online pharmacies. Make sure you know about buying medicines online safely. The General Pharmaceutical Council (GPhC) registers online pharmacies: look for their logo and a GPhC registration number on the website.

You can request the morning after pill from ZAVA. All our services are registered with the GPhC and the General Medical Council (GMC) for doctors. We can deliver the morning after pill to your doorstep in discreet packaging, or you can collect it from your local Post Office.

Can I get the morning after pill for free?

You can get the morning after pill for free from certain NHS services. These include:

• sexual health clinics
• selected pharmacies
• NHS walk-in centres

If your doctor prescribes you the morning after pill, you will not need to pay for this prescription. All prescribed contraceptives are free on the NHS.

Can you get the morning after pill over the counter?

Yes, you can get both EllaOne and Levonelle over the counter from a pharmacist.