Contraception Thursday March 10, 2016

Emergency contraception, what are the options?

What Is Emergency Contraception?

It's something you can take or do to prevent a pregnancy after unprotected sex. It's not meant to be a long-term method but a back-up plan for accidents. This can be the morning after pill or the IUD.

Contrary to some myths out there, emergency contraception does not cause an abortion, but prevents conception taking place. This is why it is important to take or use soon after sex and why it is called emergency 'contraception'.

What's Available?

There are two options - the morning after pill and the intrauterine device (IUD).

Morning after pill

There are two morning after pills available in the UK. To work they need to be taken before ovulation occurs, aka soon after unprotected sex, so a speedy trip to the pharmacy or your doctor is important.

Levonelle

Levonelle contains the hormone progesterone, albeit a synthetic version. It works by delaying or preventing ovulation. This means there is no egg present for sperm to fertilise.

Levonelle can be taken up to 72 hours after sex but it becomes less effective as time passes. It's thought to be 95% effective within 24hrs, 85% effective within 25-48 hours and 58% effective within 49-72 hours.

ellaOne

ellaOne contains ulipristal acetate, a compound that prevents progesterone working.

ellaOne also delays and prevents ovulation. You can take it up to five days after sex but it becomes less effective over time, however this window is fairly large; it's thought to be 98% effective within 120 hours.

An Intrauterine Device - IUD

The IUD is a small plastic and copper 't' shaped device that fits inside the womb. Once there it prevents egg fertilisation or stops an egg implanting in the womb. As emergency contraception, an IUD can be fitted by your doctor up to five days after sex. They are 98% effective.

Side Effects

You may experience some side effects with emergency contraception.

Morning after pills:

  • Feeling sick
  • Feeling dizzy
  • Feeling tired
  • Headaches
  • Tender breasts
  • Abdominal pain
  • It can change period patterns so your period may arrive earlier or later than usual

Like with many contraceptive pills, if you are sick (vomiting) within two hours of taking Levonelle or with three hours of taking ellaOne, you'll need another dose.

The IUD:

An IUD can be left in as your main form of contraception after the emergency has passed. Long term they are 99% effective, but may have the following side effects:

  • Longer periods
  • More painful periods
  • It can be uncomfortable to fit

Is there an age limit?

Your doctor will need to advise on whether the IUD is suitable for under-16s or those with medical conditions. The morning after pill is available over the counter to under-16s. You can speak to the pharmacist or buy it from a trusted online clinic.

Remember that emergency contraception doesn't provide protection against STIs, so it's best to get checked over in case you've picked up an infection. This is completely confidential and NHS support for sexual health in the UK has always been available to anyone who needs a check-up. See your doctor or look up your local STI clinic for advice, tests and treatment.


Sources

https://www.healthexpress.co.uk/contraception/morning-after-pill

http://www.nhs.uk/conditions/contraception-guide/pages/emergency-contraception.aspx

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