Emergency Contraception: The IUD or the Morning After Pill

The IUD must be fitted by a specially trained doctor or nurse. You can get the IUD and the emergency contraceptive pill from a range of services, including Brook, sexual health clinics and your GP. Find your nearest using our find a service tool.

If you’re 16 or over, you can also buy the Levonorgestrel pill from most pharmacies for around £25, and the ellaOne pill for around £35.

When you go to get emergency contraception you will be asked some questions including:

• whether you are taking any other medications
• when you had unprotected sex
• where you are in your menstrual cycle
• whether you are taking a regular method of contraception and what this method is.

This is to check what method of emergency contraception is the most suitable.

The IUD is the most effect method of emergency contraception.

The intrauterine device (IUD) is a small plastic and copper device that is fitted in your uterus (womb) by a specially trained doctor or nurse. It is over 99% effective, but it needs to be fitted within five days (120 hours) of unprotected sex or up to five days after the earliest time you could have released an egg (ovulated).

It takes about 15-20 minutes to fit the IUD and can be uncomfortable however you can have a local anaesthetic to help with this. If you can’t have the IUD fitted straight away and an appointment is made for this to happen at a different time, you may have to take the emergency contraceptive pill before you have the IUD fitted.

After having the IUD fitted you can continue to use this is as your usual method of contraception. If you want to have the IUD removed this will need to be done by a specially trained doctor or nurse after your next period.

This type of emergency contraceptive contains a progestogen hormone called Levonorgestrel.

It is most effective when taken within 72 hours of unprotected sex, but it can be used up to 96 hours (4 days) after. So it’s important that you get advice on emergency contraception as soon as possible after having unprotected sex. Some services may only offer LNG up to 72 hours after unprotected sex.

Levonelle is effective only if taken before the release of an egg from the ovary (ovulation). The effectiveness of Levonelle may be reduced if the person taking it has a high body mass index (BMI).

The emergency contraceptive pill Levonorgestrel (LNG) does not protect you from further unprotected sex.

Brands: Different brands include Levonelle, Levonelle one step or Upostelle.

This type of emergency contraceptive contains Ulipristal Acetate, which works by stopping progesterone (a hormone that is produced in the ovaries) from working normally and prevents pregnancy by delaying or preventing ovulation. If taken within five days (120 hours) of having unprotected sex, it is almost 98% effective at preventing pregnancy.

ellaOne is effective only if taken before the release of an egg from the ovary (ovulation). The effectiveness of ellaOne may be reduced if the person taking it has a high body mass index (BMI).

The emergency contraceptive pill Ulipristal Acetate (UPA) ellaOne does not protect you from further unprotected sex.

Brand: ellaOne is the only brand of this type of emergency contraceptive pill available in the United Kingdom.

If your next period comes at about the time you would normally expect it and is not lighter than normal, it is unlikely that you’re pregnant.

If your period is lighter or shorter or you miss your next period or withdrawal bleed (if your usual method of contraception is a combined contraceptive method) then you should see a nurse or doctor. They will recommend doing a pregnancy test but to ensure an accurate result the test should be no earlier than three weeks since you had of unprotected sex.

Sometimes the doctor or nurse can start a method of contraception for you at the same time as giving you emergency contraception. They will advise when you should start using this method and when it will begin working.

If you have been given the IUD:

• You can continue to use this as a regular method of contraception

If you have been given the emergency contraceptive pill LNG:

• If you use the patch, vaginal ring or combined pill as your usual method of contraception, you should start your this within 12 hours of taking LNG. You will need to use an additional method of contraception such as condoms for the next seven days
• If you are using the combined pill Qlaira you will need to use an additional method for nine days
• If you use a progestogen-only pill you should start retaking the pill within 12 hours of taking LNG and then you will need to use an additional method such as condoms for two days
• If you are restarting the contraceptive injection you will need to use an additional method for seven days

If you have been given the emergency contraceptive pill ellaOne:

• If you use any method of hormonal contraception (for example patch, vaginal ring, combined pill or progestogen-only pill) you will need to wait five days after taking ellaOne before starting the hormonal method of contraception.
• You will then need to use condoms for 7 days if you are using the patch, vaginal ring or combined pill.
• If you are using the combined pill Qlaira you will need to use an additional method for nine days
• If you use a progestogen-only pill then you will need to use an additional method such as condoms for two days after restarting your pill

The emergency contraceptive pill is very effective and it is more effective the sooner you take it after unprotected sex. Some things which can make it less effective are:

• If you delay taking it – the emergency contraceptive pill LNG is most effective when taken within the first 12 hours
• If you vomit within three hours of taking LNG or ellaOne
• If you have had unprotected sex either since your last period or since taking the emergency contraceptive pill
• Taking medicines, such as those used to treat epilepsy, HIV and TB and the complementary medicine St John’s Wort.
• If Levonelle and EllaOne are taken after the release of an egg from the ovary (ovulation); they are only effective if taken before ovulaton.
• If the person taking the emergency contraceptive pill has a high BMI.

There are no serious short or long-term side-effects from using the IUD or the emergency contraceptive pill. Some people may experience some, or none, of these possible side effects.

IUD:

• Periods may be heavier, more painful or last longer
• Small risk of infection
• Small risk of IUD being pushed out

Emergency contraceptive pill:

• Feeling a bit dizzy or tired after taking it
• May get headaches
• Breast tenderness
• Abdominal pains
• Vomiting (a small number of people)
• Disrupt your periods for a while and/or irregular bleeding patterns

The IUD will protect you from pregnancy between 5 and 10 years. You can get the IUD replaced when it expires.

There is no limit to the number of times you can take the emergency contraceptive pill during a lifetime. You can take the same type of emergency contraception pill more than once in any menstrual cycle if you need to. However, it may not be possible to take a different type of pill in the same cycle – it depends on which one has already been taken.

If you have had unprotected sex more than five days ago, you will not be able to use emergency contraception but it’s a good idea to take a pregnancy test either:

• As soon as you realise your period is late
• If your period is shorter or lighter than usual
• Or three weeks after having unprotected sex as this is approximately how long it will take for any pregnancy hormones to show up on a urine pregnancy test.

You can get a free pregnancy test a Brook service (if you are under 25), young person’s service, contraception and sexual health clinic and some GPs.

You will not need to use emergency contraception for the first 21 days after giving birth.

• LNG can be used from day 21 after giving birth and you can breastfeed after taking LNG. A small amount of the hormone may enter your milk but this is not thought to be harmful to your baby
• Avoid breastfeeding for one week after taking ellaOne

You can take the emergency contraceptive pill if you’ve had unprotected sex after an abortion or miscarriage. Speak to your doctor or nurse about using the IUD.