Emergency Contraception

Introduction

Emergency contraception can prevent pregnancy after unprotected sex or if the contraception you have used has failed – for example, a condom has split or you have missed a pill.

There are 2 types of emergency contraception:

  1. the emergency contraceptive pill – Levonelle or ellaOne (the “morning after” pill)
  2. the intrauterine device (IUD or coil)

How the emergency pill works

Levonelle

Levonelle contains levonorgestrel, a synthetic (man-made) version of the natural hormone progesterone produced by the ovaries.

Taking it’s thought to stop or delay the release of an egg (ovulation).

Levonelle has to be taken within 72 hours (3 days) of sex to prevent pregnancy. It doesn’t interfere with your regular method of contraception.

ellaOne

ellaOne contains ulipristal acetate, which stops progesterone working normally. This also works by stopping or delaying the release of an egg.

ellaOne has to be taken within 120 hours (5 days) of sex to prevent pregnancy.

If you take Levonelle or ellaOne

Levonelle and ellaOne don’t continue to protect you against pregnancy – if you have unprotected sex at any time after taking the emergency pill, you can become pregnant.

They aren’t intended to be used as a regular form of contraception. But you can use emergency contraception more than once in a menstrual cycle if you need to.

Who can use the emergency pill?

Most women can use the emergency contraceptive pill. This includes women who can’t use hormonal contraception, such as the combined pill and contraceptive patch. Girls under 16 years old can also use it.

But you may not be able to take the emergency contraceptive pill if you’re allergic to anything in it, have severe asthma or take any medicines that may interact with it, such as:

  1. the herbal medicine St John’s Wort
  2. some medicines used to treat epilepsy, HIV or tuberculosis (TB)
  3. medicine to make your stomach less acidic, such as omeprazole
  4. some less commonly used antibiotics (rifampicin and rifabutin)

ellaOne can’t be used if you’re already taking one of these medicines, as it may not work. Levonelle may still be used, but the dose may need to be increased.

Tell a GP, nurse or pharmacist what medicines you’re taking, and they can advise you if they’re safe to take with the emergency contraceptive pill.

You can also read the patient information leaflet that comes with your medicine for more information.

Breastfeeding

Levonelle is safe to take while breastfeeding. Although small amounts of the hormones in the pill may pass into your breast milk, it’s not thought to be harmful to your baby.

The safety of ellaOne during breastfeeding isn’t yet known. The manufacturer recommends that you don’t breastfeed for one week after taking this pill.

Can I get the emergency contraceptive pill in advance?

You can get the emergency contraceptive pill in advance of having unprotected sex if:

  1. you’re worried about your contraceptive method failing
  2. you’re going on holiday
  3. you can’t get hold of emergency contraception easily

See a GP or nurse for further advice on getting advance emergency contraception. You can also talk to them about your options for regular methods of contraception.

How the IUD works as emergency contraception

The intrauterine device (IUD) is a small, T-shaped plastic and copper device that’s put into your womb (uterus) by a doctor or nurse.

It releases copper to stop the egg implanting in your womb or being fertilised.

The IUD can be inserted up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated (released an egg), to prevent pregnancy.

You can also choose to have the IUD left in as an ongoing method of contraception.

How effective is the IUD at preventing pregnancy?

The emergency IUD is the most effective method of emergency contraception – less than 1% of women who use the IUD get pregnant.

It’s more effective than the emergency pill at preventing pregnancy after unprotected sex.

Who can use the IUD?

Most women can use an IUD, including those who are HIV positive. A GP or nurse will ask about your medical history to check if an IUD is suitable for you.

The IUD might not be suitable if you have:

  1. an untreated sexually transmitted infection (STI) or a pelvic infection
  2. problems with your womb or cervix
  3. unexplained bleeding between periods or after sex

The emergency IUD won’t react with any other medicines you’re taking.

Pregnancy and breastfeeding

The IUD shouldn’t be inserted if there’s a risk that you may already be pregnant.

It’s safe to use when you’re breastfeeding and it won’t affect your milk supply.

Where can I get emergency contraception?

Getting it for free

You can get emergency contraception for free, even if you’re under 16, from these places, but they may not all fit the IUD:

  1. contraception clinics
  2. sexual health or genitourinary medicine (GUM) clinics
  3. some GP surgeries
  4. some young people’s clinics
  5. most NHS walk-in centres and minor injuries units
  6. most pharmacies
  7. some accident and emergency (A&E) departments (phone first to check)

Find your nearest sexual health clinic
Find your nearest pharmacy

Buying it

If you’re aged 16 or over, you can buy the emergency contraceptive pill from most pharmacies, in person or online, and from some organisations, such as the British Pregnancy Advisory Service (BPAS) or Marie Stopes. The cost varies, but it will be around £25 to £35.

Contraception for the future

If you’re not using a regular method of contraception, you might consider doing so to protect yourself from an unintended pregnancy.

There are several methods of contraception that protect you for a long period, so you don’t have to think about them once they’re in place, or remember to use or take them every day or every time you have sex.

These methods include the:

  1. contraceptive injection
  2. contraceptive implant
  3. intrauterine system (IUS)
  4. intrauterine device (IUD)

See a GP, nurse or visit your nearest sexual health clinic to discuss the options available.

If you're under 16 years old

Contraception services are free and confidential, including for people under the age of 16.

If you’re under 16 and want contraception, the doctor, nurse or pharmacist won’t tell your parents (or carer) as long as they believe you fully understand the information you’re given, and the decisions you’re making.

Doctors and nurses work under strict guidelines when dealing with people under 16. They’ll encourage you to consider telling your parents, but they won’t make you.

The only time a professional might want to tell someone else is if they believe you’re at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.