Emergency Contraception

What is Emergency Contraception?

There are two types of emergency contraception:

  • Emergency contraceptive pills (Levonelle and EllaOne)
  • IUD (intrauterine device)

The IUD is the most effective.

Emergency contraception pills can be used to help prevent an unwanted pregnancy up to five days after unprotected sex.  An emergency IUD possibly longer. 

Emergency contraception can be used if a contraceptive method fails, for instance a condom splits or a pill is forgotten or taken late, or if no contraception is used (i.e. 'unprotected' sex).

Emergency contraception makes it much less likely that you will get pregnant, but emergency contraceptives are not as effective as any contraceptives that are used before or during sex (including the most effective ones that are injected, worn in the womb or implanted under the skin of the arm, otherwise known as LARCs: Long Acting Reversible Contraceptives).

Unlike the emergency IUD, emergency contraception pills do not prevent pregnancy from unprotected sex in the rest of the menstrual cycle after the pill has been taken so it is important that ongoing effective contraception is used.  Emergency contraception does not cause an abortion.

Emergency contraception does not protect against sexually transmitted infections, like chlamydia and HIV (only condoms do). Also, emergency contraception will not cause an ectopic pregnancy but may not stop one (in an ectopic pregnancy the fertilised egg is implanted outside the womb. If this happens, it will require emergency treatment).

There are two forms of emergency contraception:

Emergency Contraceptive Pills

Levonelle (Levonogestrel) - pill

When to use Levonelle:

This can be taken up to 3 days after unprotected sex to prevent pregnancy. It is taken as a single dose of 1.5mg and appears to work by inhibiting ovulation. There are no long term or serious side effects and it is generally very safe for women to take. Regards side effects, nausea occurs in less than 20% and vomiting in less than 1%. If vomiting occurs within 2 hours of swallowing Levonelle, the dose should be repeated.The next period can be early or late but for most women, their period will come at the expected time. Other reported side effects include headaches, abdominal pain, period cramps and dizziness.

How reliable is Levonelle?

The effectiveness of Levonelle declines with delay in treatment and also depends on where you are in your cycle. In the earlier part of the cycle, when taken within 24 hours of unprotected sex, it is 95% effective at preventing pregnancy; when it's taken between 25-48 hours after unprotected sex it is 85% effective and when it's taken between 49-72 hours after unprotected sex it is 58% effective at preventing pregnancy. So it's important to get advice and supply of emergency contraception as soon as possible after having unprotected sex. Levonelle is licensed for 3 days but can be prescribed for up to 5. However, on day 4 and 5 there is a further decrease in effectiveness.

It is important to know the effectiveness of Levonelle is altered by where you are in the menstrual cycle. It is known to act by delaying or inhibiting ovulation (egg production) but this is less likely the nearer to ovulation that treatment is given. It is no more effective than dummy tablets in the 2-3 days running up to ovulation. If at this stage of menstrual cycle, an alternative emergency method should be chosen. Whoever issues the Levonelle will advise on this.

Levonelle may be less effective in obese women.

Regular contraception (like the Pill) can be started or continued (if already being used) on the day Levonelle is taken. Whoever issues the Levonelle will advise on this.

Where can I get Levonelle?

It is available FREE from:

  • Any family planning clinic
  • Your GP
  • Some pharmacies (some may charge)
  • Sexual Health Clinics
  • Some School Nurses

Please see a list of venues in Hull here. For the East Riding please find a list here.

 

ellaOne (Ulipristal Acetate) - pill

When to use ellaOne:

There is a new emergency pill called ellaOne which can be taken up to 5 days (120 hours) after unprotected sex to prevent pregnancy. It works by inhibiting or delaying ovulation.

How reliable is ellaOne?

The effectiveness of ellaOne is sustained over 5 days and unlike Levonelle, does not decrease over this time. However, it is slightly less effective if taken within a day of ovulation.

After ellaOne is taken, periods can sometimes occur earlier or later than expected by a few days. In approximately 20% the delay was greater than 7 days. Other reported side effects include headaches, abdominal pain, period cramps and dizziness. It is not recommended for use in women with uncontrolled severe asthma or on certain medication. Whoever issues the ellaOne will advise on this.

It cannot be taken more than once in a menstrual cycle and affects hormonal contraceptive effectiveness for a short while afterwards so it is essential that condoms are used too, for example for up to 2 weeks if on the combined oral contraceptive. Whoever issues the ellaOne will advise on this.

Where can I get ellaOne?

ellaOne is not available over the counter in pharmacies and can only be prescribed by a GP or issued from a Family Planning or Sexual Health clinic or school nurse.

 

Intrauterine Device -IUD

When to use an IUD:

This can be fitted up to 5 days after the calculated date of ovulation or after unprotected sex, whichever is later, to prevent pregnancy.

It is also known as a coil and is a small 'T' shaped piece of plastic and copper that is inserted into the womb.

It works by reducing the survival of the ova (egg), as well as the number of sperm reaching the fallopian tube and their ability to fertilize an egg. If inserted after fertilization, the IUD works by preventing the egg implanting in the womb.

It can be fitted as an emergency contraceptive up to 5 days after unprotected sex, or up to 5 days from the calculated date of ovulation (which may be more than 5 days from the unprotected sex) and has to be fitted by a specially trained doctor or nurse. Whoever fits the IUD will advise on this.

How reliable is an IUD?

The emergency IUD is over 99% effective at whatever stage you fit it in the cycle and can continue to be used for your regular contraception. It's effectiveness is not altered by where you are in your cycle.

If you do not wish to use it as your regular method of contraception, it can be removed after your next period.

Where can I get an IUD?

An IUD can be fitted at:

  • Most Family Planning clinics
  • Some GP surgeries
  • Sexual Health Clinics

 

REMEMBER!

Emergency contraceptioin is less likely to be required if you use a contraceptive that works 24/7 like the Long Acting Reversible Contraceptives (LARC). For a list of all Family Planning and GU clinics in Hull and the East Riding, please click here.

For further information please visit not2late 

Please see a list of venues in Hull here. For the East Riding please find a list here.