Emergency Contraception: The Morning After Pill

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: 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 UK.

• 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 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

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.

Unprotected sex is sex without any form of contraception.

These are some example scenarios below when you might need emergency contraception:

• The condom broke or came off during sex
• You forgot to take your contraceptive pill or change your ring or patch and have had sex
• You didn’t use any form of contraception including condoms

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.

There is no limit to the number of times you can take the emergency contraceptive pill during a lifetime.

During the same menstrual cycle it is possible to take the same type of emergency contraception pill 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. Depending on how long ago you took emergency contraception, you might still be protected from the last time you took it. Make sure you speak to a medical professional and tell them which one you have took and when.

Note – Emergency contraception should only be used for emergencies – where the main contraception method has failed, for example, the condom split. The morning after pill is not reliable enough to be used as a regular method as it can only be used at certain times in your menstrual cycle.

If you have had unprotected sex you can use the Risk of Pregnancy Calculator to help you work out your risk of pregnancy. It’s a good idea to talk to a nurse at a sexual health clinic, GP or pharmacist if you’re unsure. It’s better to take action now, even if that’s just talking to medical professional, than waiting- the longer you wait the less effective emergency contraception becomes.

It’s possible to get pregnant at any point during your menstrual cycle, including during your period, as sperm can survive for up to five days in the body.

It’s a good idea to use the risk of pregnancy calculator to help you decide if you need emergency contraception and talk to a healthcare professional such as a nurse at a sexual health clinic, pharmacist or GP as soon as possible after unprotected sex.