Morning After Pill (emergency contraception)

Emergency contraception is contraception you can use after unprotected sex or a contraceptive failure to prevent a pregnancy.  There are two different methods of contraception which are suitable for emergency contraception.

The most used emergency contraceptive is the “morning after pill”.

Though often called the morning after pill, it can actually be taken up to five days after unprotected sex, depending on which type of pill you take.

The sooner you take the morning after pill, the greater the chances of avoiding pregnancy.

Alternatively, you can visit your doctor to have a contraceptive coil fitted. Some intrauterine devices are suitable for emergency contraception if fitted within 120 hours after an episode of unprotected sex. 

It is important to know that emergency contraceptive pills work by stopping ovulation (the release of an egg) in the middle of your menstrual cycle. If you take one after this has happened, you may still become pregnant. A copper coil would be more effective in this situation. You can discuss this option with your local sexual health clinic or GP.

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You must be female and at least 16 years old to purchase this product.

Levonorgestrel (Levonelle) and ellaOne contain chemicals that mimic the female sex hormone progesterone. They are thought to prevent ovulation, fertilisation and change the lining of the womb. 

Both trick the body into thinking that it has already ovulated, which prevents eggs being released from the ovaries. They also thicken the mucus in the cervix (the neck of the womb) which makes it harder for sperm to cross from the vagina into the womb to fertilise any eggs that might be there. Furthermore, Levonelle and ellaOne change the lining of the womb so that any fertilised eggs cannot implant into it.

Take the morning after pill as soon as possible after sex. You will take one single dose. Take the tablet with a drink of water and swallow it whole without chewing.

There are two different morning after pills, Levonelle (levonorgestrel)and ellaOne. When you can take it depends on which brand you take.

Levonorgestrel (Levonelle) needs to be taken within 72 hours of unprotected sex, whereas ellaOne can be taken until up to 120 hours after unprotected sex. The sooner after sex you take the morning after pill, the more effective it will be - this goes for both Levonelle and ellaOne.

This depends on how many pills were missed and from where in the pack.

Combined Pill

If you forget to take a pill, and it's not more than 24 hours late, then just take it as soon as you remember. If it is more than 24 hours late, this is called a missed pill. You can still take the missed pill as soon as possible (even if this means taking two pills at once) and you are still protected.

If you miss two or more pills from the start of your pack or you are late in starting your pack by 2 days you may still ovulate (produce an egg) and so if you have unprotected sex during this cycle then then you will need emergency contraception.  However, if you use additional (barrier) contraception for the next seven days and continue taking the rest of the pack and your seven-day pill-free break as usual, you will be protected.

If any pills are missed in the second week of a pack (pills 8-14), the contraceptive effect has built up and there is no need for emergency contraception (as long as the pills in the first seven days of the pack were taken correctly). Then finish the packet and have the usual pill-free interval.

If any pills are missed in the third week of a pack (pills 15-21), you are protected, but you should start the next pack of pills straight away without the pill free break. If your pack contains any dummy/placebo pills, throw these away and start a new pack. You are only protected if you start the next packwithout a pill free break.

Mini Pill (progesterone only)

If you are more than 3 hours late (12 hours for desogestrel pills such as Cerazette) then contraception cover is not guaranteed and additional (barrier) contraception is required for two days. You should take your pill as soon as you remember but only take one.

You will need emergency contraception if you’ve had unprotected sex in the 2-3 days before or after the missed pill(s).

Levonorgestrel (Levonelle) comes as a single tablet. You can take it within 72 hours of unprotected sex to protect against pregnancy. The sooner you take it, the more effective it is. If you vomit within 3 hours of taking it then you will need to take it again.

Levonelle is an emergency contraceptive pill, so you should try to limit its use to emergencies only. Don’t use it too regularly (for example, if you often forget to take your pill). If you do take Levonelle too frequently, it can give you unreliable and irregular periods.

EllaOne can be taken for up to five days (120h) after unprotected sex. Despite this long window period it should be taken as soon as possible after sex. The sooner you take it, the more likely it is to be effective. If you throw up or have severe diarrhoea within three hours of taking it you need to contact your doctor as you will need to take a second pill.

Use of emergency contraception does not protect against sexually transmitted diseases so you should still use condoms.

The sooner you take Levonorgestrel (Levonelle) or ellaOne after sex, the more effective it will be. 

If you are not ovulating and you take EllaOne within the 120-hour window(5 days), your chance of not getting pregnant is 98-99%. For levonorgestrel, if you are not ovulating and take it within 72 hours(3 days) then you have a 97-99% chance of not getting pregnant.

Levonorgestrel is not recommended if you are close to ovulation. If this is the case, EllaOne is a better choice of oral emergency contraceptive pill. However, EllaOne will not work after ovulation has begun.

Levonorgestrel does not make the contraceptive pill any less effective. So just keep taking your pill as normal and use an alternative form of protection until your regular contraceptive pill protects you again (usually seven days from the point after you skipped a pill and restarted taking it).

EllaOne can make the contraceptive pill less effective. As a result, you must use some other form of contraception 7 days after using ellaOne to ensure you are protected from pregnancy. These can include barrier methods like condoms .

As with all medicines, ellaOne and Levonorgestrel may cause some side effects. Neither medicine should affect your fertility in the long term.

The most common side effects for ellaOne include nausea, abdominal (stomach) pain or discomfort, vomiting - painful periods, pelvic pain, breast tenderness - headache, dizziness, mood swings - muscle pain, back pain, tiredness.              

The most common side effects for Levonorgestrel include feeling sick (nausea), irregular bleeding until your next period, lower abdominal pain, tiredness , headache.

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.

If you are on the pill, you should carry on taking your pill as usual after you have taken Levonelle, but in addition you should use condoms or a different barrier contraceptive for at least 7 days. (This is because the morning after pill can interfere with the regular contraceptive pill.)

If you take ellaOne, you should wait for 5 days before starting your hormonal contraceptive pill again and also use a barrier method like condoms until your next menstrual period.

Emergency contraception should not be used regularly in place of standard contraception, there is a much higher risk of failure and therefore pregnancy. 

There are lots of different options for contraception, and they are all free on the NHS, so please see your GP or sexual health clinic to arrange this if you do not already use anything. You can get more information regarding the types of contraception available here: https://www.nhs.uk/conditions/contraception/

Emergency contraception does not protect you against sexually transmitted infections (STIs). If you have had sex without a condom you may have been exposed to an STI. You can put your mind at ease by using our confidential and discreet sexual health service that provides tests and treatments for a range of STIs here.

Alternatively, you could visit your local sexual health clinic or arrange to see your GP.

Patient Information Leaflet for ellaOne

Patient Information Leaflet for Levonorgestrel 1.5mg tablets

Patient Information Leaflet for Levonelle