Morning After Pill

The morning after pill is taken to prevent pregnancy after unprotected sex. It can be taken after sex if no protection has been used or if your contraception method has failed.

Most women find that their next period comes as usual, but it might be earlier or later and may feel different to normal. You should always take a pregnancy test 3 weeks after any episodes of unprotected sex to check for pregnancy. If your period is not as expected, more than a week late or if it is unusually light or short, speak to a doctor.

It comes in a single dose, so you just need to take one pill with a glass of water.

Both work in similar ways, EllaOne and Levonelle (and generic Levonelle) both affect ovulation. EllaOne postpones ovulation. If ovulation has already occurred, EllaOne is no longer effective. The timing of ovulation cannot be predicted and therefore EllaOne should be taken as soon as possible after unprotected intercourse. Levonelle (levonorgestrel) is thought to work mainly by preventing ovulation if sex has occurred before ovulation. Levonorgestrel is not effective once the process of implantation has begun.

If unprotected sex is likely to have taken place during the 5 days before ovulation, risk of pregnancy is very high and EllaOne is the recommended emergency contraception in this case.

Both are only effective if taken before ovulation has occurred however as the time of ovulation is difficult to determine their use is still recommended.

The morning after pill is more effective the sooner you take it. You can take Levonelle until up to 72 hours (3 days) after you have had unprotected sex. You can take EllaOne until up to 120 hours (5 days) after unprotected sex.

Both should be taken before you have ovulated to be effective.

You can get this from your GP, pharmacist or sexual health clinic or, if you feel uncomfortable talking to someone face to face, you may prefer to get the morning after pill online via a remote consultation using an online doctors service, like ZAVA. The price, availability and convenience of getting an emergency contraceptive pill will vary from place to place, so it's important to decide which option is the right one for your situation.

You can get both the emergency contraceptive pill and the emergency IUD (intrauterine device, a small plastic and copper device that's fitted directly into your uterus for up to five years) for free from:

• your GP
• any sexual health clinic
• any family planning clinic
• any young persons' clinic or Brook Advisory Centres
• most NHS walk-in centres or A&Es

Additionally, you can also buy the morning after pill (but not the IUD) from most pharmacies.

Some pharmacies participate in an NHS backed scheme to make the morning after pill freely available to all under-25s.

For your GP: yes, you will need to book an appointment in advance if you want to get the pill from your GP, but be sure to tell the receptionist explicitly that this appointment is urgent. No appointment is necessary for walk-in centres, pharmacies and A&E departments (although A&E should be your absolute last resort).

For clinics: the protocol with sexual health, young persons' and family planning clinics varies from place to place, so you're advised to check your local clinic's website, or give them a call. You may have to make an appointment (it's usually possible to book an immediate appointment), or sometimes they run drop-in clinics where you can just turn up. These are usually held at the same time each week, (like 12- 2pm Mondays & Thursdays, for example) but again, there will be a specific timetable published online that you can check.

If you don't have time to go to a clinic, or you'd just prefer to avoid the embarrassment, it is possible to purchase the morning after-pill over the counter from a number of stockists. Although you might want to do your homework first, as prices can vary quite significantly.

If you're under 16 you may be able to buy the morning after pill over-the-counter though some pharmacists may advise you to go to your GP, sexual health, walk-in or family planning clinic directly. Additionally, most online doctors and pharmacies will not sell any medication (including the morning-after pill) to anyone under the age of 16 for legal reasons.

You may be encouraged to tell you parents or guardian that you’re having sex but in most circumstances the information you tell a health professional is completely confidential and they will not tell your parents or anyone else unless they feel you are at risk.

The likelihood of getting pregnant after unprotected sex highly depends on your cycle. During the first two days of your period, your chance of getting pregnant is very low if you have a regular cycle. The chance of becoming pregnant is highest 5 days before and on the day of ovulation, remembering that sperm can live for up to a week in your vagina. It is impossible to know exactly when ovulation has occurred so it is recommended to take an emergency contraceptive if you do not want to become pregnant.

If you decide not to use a morning after pill and you become pregnant, you will have to decide whether to continue with the pregnancy or consider an abortion.

The morning after pill is for emergencies only and is not as effective as taking or using regular contraception. Try not to take it too often – for example, if you’re bad at remembering to take your contraceptive pill, talk to your GP or family planning nurse about other options of contraception (such as implants, coils, injection etc). If you miss a pill, follow the instructions in the manufacturers leaflet or speak to your GP or local pharmacist about what to do next.

According to media coverage, a growing number of women appear to be buying and taking the morning after pill regularly. Doctors are clear that they do not recommend regular use of the morning after pill. It’s less effective than regular contraception and the emergency pill wasn’t designed to be taken long term, so we don't know about the impact it will have on your periods and fertility.

It is ok to use emergency contraceptive more than once per cycle if needed though it is recommended that you do not take EllaOne less than 7 days after taking a levonorgestrel containing emergency contraception and that you do not take levonorgestrel containing emergency contraception less than 5 days after taking EllaOne.

There have been scaremongering stories in the press which suggest that taking the morning after pill can have adverse long-term health effects. When taken correctly, i.e. only in a genuine emergency and not as a regular form of contraception, the morning after pill is not expected to have any adverse long term effects on your health.

If you require emergency contraception, there are three options: Levonelle (or the generic version, levonorgestrel) emergency contraceptive pill, the EllaOne emergency contraceptive pill, or have the emergency copper coil which if fitted at the right time is the most effective option (>99.9% effective at preventing pregnancy).

You can take Levonelle for up to 72 hours after having unprotected sex and EllaOne up to 120 hours after having unprotected sex.

Levonelle is 97-99% effective when taken as instructed though EllaOne is more effective than Levonelle.

Levonelle and EllaOne are available via our online service and we can offer a next day delivery if you order before 4pm (please bear in mind that the post does not deliver on Sundays).

If you had unprotected sex more than 72 hours ago, you might decide to take EllaOne. This morning after pill needs to be taken within 120 hours (5 days) after unprotected sex and is 98-99% effective when taken within this timframe.

Alternatively you can consider having an intrauterine device (IUD), also referred to as “the copper coil”, fitted. The coil will need to be fitted within 5 days of your last ovulation date but has the advantage of protecting you from future unwanted pregnancies until you choose to have it removed.

Most women can take the Levonelle emergency contraceptive. This includes women who are using regular hormonal contraception. However, if you are suffering from a severe digestive condition, your stomach may be unable to absorb the active ingredient and the morning after pill won’t work. In this case, you will need to have a coil fitted for emergency contraception. You also need to inform your doctor if you have ever had an ectopic pregnancy or suffer from liver problems. If you weigh more than 70kg or have a BMI more than 26 Levonelle is less likely to be effective and you may require a double dose, which is "off label" (this means a double dose of Levonelle is not usually prescribed but that doctors may still prescribe it if appropriate). Your doctor may advise you to take ellaOne instead or have a copper coil inserted.

EllaOne can be taken by most women but there are some limitations. According to the Faculty for Sexual Health and Reproductive Care, women on oral steriods for severe asthma and women with severe liver problems shouldn’t take ellaOne. If you weigh more than 85kg or have a BMI of more than 30 EllaOne may be less effective and you should consider having a copper coil fitted (you should never take a double dose of EllaOne).

You should always tell your doctor or pharmacist if you have any medical conditions or are on any medications, as well as check the manufacturer's instruction leaflet.

You should not take either pill if you are already pregnant as they will not be effective, though they are unlikely to cause harm to your pregnancy if taken accidentally.

You should avoid either pill if you are allergic to any of their ingredients.

There are no long term side effects associated with Levonelle, but you might feel a bit sick, get a headache or stomach ache, feel dizzy or get sore breasts after taking it. You may also notice some irregular vaginal bleeding. The same short term side effects occur commonly with EllaOne, along with some changes in mood, period pain and back ache. For a full list of side effects always check the manufacturer's instruction leaflet.

If you have diarrhoea or vomitting within three hours of taking Levonelle or EllaOne, it might not work properly. If this happens, please contact your doctor or pharmacist, who will advise you on whether you should take a second dose. If it’s too late to take Levonelle (i.e. it has been more than 72 hours since the unprotected sex) you should have a coil fitted instead.

The following types of medication interact with Levonelle and/or EllaOne can reduce its effectiveness:

• St John's Wort
• Stomach acid reducing medicines e.g. Omeprazole (EllaOne only)
• Some tuberculosis medicines
• Some HIV medicines
• Some epilepsy medicines
• Some weight loss medicines
• Some antifungal medicines

If you are taking any of these medications and want to take an emergency contraceptive, you will need to discuss your treatment with a doctor and ensure you mention any medication you are currently taking or have taken in the past 4 weeks.

Yes. The morning after pill won’t protect you against future pregnancies, so you’ll need to keep using other types of contraception to avoid this. If you are on the pill, you should carry on taking your pill as usual after you have taken Levonelle, but in addition you should use condoms or a different barrier contraceptive for at least 7 days with a combined pill (9 days for Qlaira or 2 days for a progesterone only pill). If you take EllaOne, you should wait for 5 days before restarting your hormonal contraceptive pill again and also use a barrier method like condoms for up to 12 days with a combined pill (14 days for Qlaira or 7 days in total with a progesterone only pill).