• You can also view Your guide to emergency contraception as a PDF.
• Our contraception booklets can be purchased in the publications and resources section.

Introduction

If you have had unprotected sex, that is, sex without using contraception, or think your contraception might have failed, you can use emergency contraception. There are different types of emergency contraception:

• the emergency contraceptive pill, Levonelle
• the emergency contraceptive pill, ellaOne
• the emergency intrauterine device (IUD). The emergency IUD is the most effective.

If you act quickly, emergency contraception will usually prevent pregnancy.

The emergency contraceptive pill ellaOne is a new method. It can be taken up to five days (120 hours) after sex and is only available with a prescription. Most of the information in this booklet is about Levonelle. For more information about ellaOne, speak to a doctor or nurse.

Does emergency contraception cause an abortion?

No. Emergency contraception may stop ovulation, fertilisation of an egg, or a fertilised egg from implanting in the uterus (womb). Medical research and legal judgement are quite clear that emergency contraception prevents pregnancy and is not abortion.

Abortion can only take place after a fertilised egg has implanted in the uterus. People who believe life begins when the egg is fertilised may not wish to use emergency contraception.

Where can I get emergency contraception?

You can get the emergency contraceptive pill Levonelle and the emergency IUD free from:

• any general practice that provides contraceptive services
• a contraception clinic
• any young person's service or Brook clinic
• any sexual health clinic
• some genitourinary medicine (GUM) clinics.

You can also get Levonelle free from:

• most NHS walk-in centres (in England only)
• some pharmacies (there may be age restrictions)
• most NHS minor injuries units
• some hospital accident and emergency departments (phone first to check).

You can buy Levonelle from:

• most pharmacies if you are 16 years old or over
• some fee-paying clinics.

The price will vary but at the pharmacy it will cost around £25. All the advice and treatment you receive is confidential – wherever you receive it.

The emergency contraceptive pill – Levonelle

What is Levonelle?

Levonelle is a tablet containing progestogen, a hormone which is similar to the natural progesterone women produce in their ovaries.

How do I take it?

You will be given one pill to take. It should be taken within three days (72 hours) of having unprotected sex. It is more effective the sooner it is taken.

How does Levonelle work?

Levonelle is most likely to stop an egg being released (ovulation) or delay ovulation. It may also stop a fertilised egg settling in your uterus (implanting).

How effective is Levonelle?

It is very effective and is more effective the sooner it is taken after sex. However, it is not as effective as using other methods of contraception regularly and does not protect you against sexually transmitted infections.

Of the pregnancies that could be expected to have occurred if no emergency contraception had been used Levonelle will prevent:

• up to 95 per cent if taken within 24 hours
• up to 85 per cent if taken between 25–48 hours
• up to 58 per cent if taken between 49–72 hours.

The emergency pill ellaOne is effective up to five days (120 hours) after unprotected sex.

An emergency IUD is more effective at this stage (see The emergency IUD section). Get advice from your doctor, nurse or pharmacist.

Who can use Levonelle?

Most women can use Levonelle. This includes women who are breastfeeding and women who can’t use estrogens – the hormone that is used in the combined pill, the contraceptive vaginal ring and the contraceptive patch. However, if you are taking certain prescribed medicines, or complementary medicines such as St John’s Wort, you will need special advice and the dose of Levonelle may need to be increased. The emergency IUD may be a preferred option as there are no medicines known to affect it.

I’ve just had a baby. Can I use Levonelle?

Contraception needs to be used from day 21 after the birth of a baby. If you have sex before this time you will not get pregnant. Levonelle can be used safely after day 21 even by women who are breastfeeding.

Can I use Levonelle after a miscarriage or abortion?

Yes, you can use Levonelle immediately as you can become pregnant again very quickly following a miscarriage or abortion.

What are the side effects?

There are no serious short- or long-term effects from using Levonelle.

• Some women may feel sick, dizzy or tired, or may get headaches, breast tenderness or abdominal pain.
• A very small number of women will vomit.
• It can disrupt your periods (see section below).

How will Levonelle affect my next period?

Your period is likely to either come on time or be a few days early or late. For some women it can be up to a week late or sometimes even later.

You may have some irregular bleeding between taking Levonelle and your next period. This can range from spotting to being quite heavy.

Do I need to see a doctor or nurse after I've taken Levonelle?

Not usually, but do go and see a doctor or nurse if:

• you think you might be pregnant
• your next period is more than seven days late
• your period is shorter or lighter than usual
• you have any sudden or unusual pain in your lower abdomen.

These could be signs of an ectopic pregnancy – a pregnancy that occurs outside the uterus, usually in a fallopian tube. Although this is not common, it is very serious.

You should also see a doctor or nurse if:

• you want to use regular contraception
• you want advice about using or changing your current method of contraception
• you are worried that you might have a sexually transmitted infection.

Can Levonelle fail?

Levonelle is very effective. However, in some women it fails and they become pregnant even though it was taken correctly. You may also become pregnant if you:

• delay taking Levonelle
• vomit within two hours of taking Levonelle
• have unprotected sex at another time, either since your last period or after taking Levonelle.

What if I vomit within two hours of taking Levonelle?

Speak to your doctor, nurse or pharmacist. They may give you another dose and a medicine to stop you vomiting again, or suggest having an emergency IUD fitted (see The emergency IUD section). If you vomit later than two hours, don’t worry, Levonelle will have been absorbed.

How will I know if Levonelle has worked?

If you have taken the pill correctly and your next period seems normal, it is unlikely that you will be pregnant. After you have taken Levonelle it is recommended that you do a pregnancy test to make sure you are not pregnant if:

• you think you feel pregnant
• you have not had a normal period within three weeks of taking Levonelle
• you do not have a bleed when you have the seven day break from using the combined pill, contraceptive patch or the contraceptive vaginal ring, or when you take the placebo tablets with EveryDay combined pills.

A pregnancy test result will be accurate if the test is done three weeks after the last time you had unprotected sex. It will not be affected if you are taking hormonal contraception.

Are there any risks if Levonelle fails?

Levonelle has not been shown to affect a pregnancy or harm a developing baby. As with any pregnancy there is a small chance that an ectopic pregnancy may occur. If you think that you might be pregnant it is important to seek advice as soon as possible.

Will Levonelle protect me from pregnancy until my next period?

No. Levonelle will not protect you from pregnancy if you have unprotected sex again. Seek advice – you can use emergency contraception again.

Can I continue to use regular contraceptive pills, the vaginal ring or the patch after Levonelle?

Yes. If you needed Levonelle because you forgot some of your regular pills or did not use the patch or vaginal ring correctly, you should take a contraceptive pill again, insert a new ring or apply a new patch within 12 hours of taking Levonelle. You will need to use an additional contraceptive method, such as condoms, for:

• seven days with the patch, the ring and the combined pill
• two days with the progestogen-only pill.

How many times can I use Levonelle?

You can take Levonelle as many times as you need to and more than once in any menstrual cycle. It is not dangerous to do this but it may disrupt your periods. However, using Levonelle is not as effective as using other methods of contraception. Speak to the FPA helpline or ask your doctor, nurse or pharmacist for advice on contraception.

Can someone else get Levonelle for me?

You need to get Levonelle from the doctor, nurse or pharmacist yourself. Someone else will only be given it on your behalf in exceptional circumstances.

How can I buy Levonelle from a pharmacist?

If you are 16 or over, you can ask the pharmacist for Levonelle. They will need to ask you some questions as there are some circumstances when they may not be able to sell it to you, for example if:

• it has been more than 72 hours since you had unprotected sex
• you have had unprotected sex more than once in the menstrual cycle
• you think that you might already be pregnant
• you are taking certain prescribed or complementary medicines
• you have certain health conditions.

In these circumstances you will need to see a doctor or nurse.

Can I get Levonelle in advance?

Yes, if you are worried about your contraceptive method failing, you are going on holiday, or you cannot get Levonelle easily. Ask your doctor or nurse about this.

The emergency IUD

What is the emergency IUD?

An IUD is a small plastic and copper device that is put into your uterus by a trained doctor or a nurse. An emergency IUD is fitted up to five days after unprotected sex. It can be fitted at any time in the menstrual cycle provided this is the only unprotected sex that has occurred since your last period.

If you have had unprotected sex more than once since your last period then an emergency IUD can be fitted up to five days after the earliest time you could have released an egg (ovulation).

If the emergency IUD cannot be fitted immediately you may be advised to take Levonelle or ellaOne in the meantime.

How does the emergency IUD work?

It may stop an egg being fertilised or implanting in your uterus.

How effective is an emergency IUD?

The emergency IUD is the most effective method of emergency contraception. It will prevent up to 99 per cent of pregnancies expected to occur if no emergency contraception had been used.

Who can use an emergency IUD?

Most women can use an IUD for emergency contraception. An emergency IUD is suitable if:

• you do not want to, or cannot take hormones
• you want to use the IUD as an ongoing method of contraception.

I’ve just had a baby. Can I use the emergency IUD?

Contraception needs to be used from day 21 after the birth of a baby, if you have sex before this you will not get pregnant. However, an emergency IUD is not normally recommended before 28 days after the birth. If you need to, you can use Levonelle or ellaOne until this time.

Can I use the emergency IUD after a miscarriage or abortion?

Women can become pregnant again very quickly following a miscarriage or abortion. It will depend how pregnant you were before the abortion or miscarriage as to whether it would be advisable to use an emergency IUD. A health professional can help you decide which method of emergency contraception to use.

What are the disadvantages of using an IUD for emergency contraception?

Disadvantages:

• Not all women can use the emergency IUD, for example, women who have certain problems with their cervix or uterus.
• There is a very small chance of getting an infection in your uterus within the first 20 days after the emergency IUD is put in. If you have been at risk of getting a sexually transmitted infection you may have screening tests done at the time the emergency IUD is fitted and you may also be given some antibiotics. This will help to reduce the chance of getting a pelvic infection.
• An emergency IUD might go through (perforate) your uterus or cervix when it is fitted. This may cause pain, but often there are no symptoms. If this happens, the emergency IUD may need to be removed by surgery. Perforation is uncommon when the emergency IUD is fitted by an experienced doctor or nurse.
• The emergency IUD can be pushed out by your uterus (expulsion) or it can move (displacement). This is not common.

How is the emergency IUD put in?

The doctor or nurse will first examine you internally to check the position and size of your uterus.

Fitting an emergency IUD takes about 15–20 minutes. It can be uncomfortable or painful for some women, and you might be offered pain relieving drugs beforehand or a local anaesthetic. You may get a period-type pain and some light bleeding for a few days after the emergency IUD is fitted. Pain relieving drugs can help with this too.

How will I know that the emergency IUD is still in place?

An emergency IUD has one or two threads attached to the end that hang a little way down from your uterus into the top of your vagina. You will be taught how to feel the threads to make sure the IUD is still in place. It is very unlikely that it will come out, but if you cannot feel the threads, or if you think you can feel the IUD itself, you may not be protected against pregnancy. See your doctor or nurse straight away and use an extra contraceptive method, such as condoms.

When will I get my next period?

Your next period should come at about the same time as you would normally expect it. If you have not had a normal period within three weeks of having the emergency IUD fitted it’s recommended that you do a pregnancy test.

Are there any risks if the emergency IUD fails?

The emergency IUD is highly effective. If however it does fail and you become pregnant there is a risk that the IUD can cause a miscarriage or that an ectopic pregnancy may occur. If you know that you are pregnant or think that you might be, it is important to seek advice as soon as possible.

Do I need to see a doctor or nurse after the emergency IUD is fitted?

Yes. It is recommended that you see a doctor or nurse three to four weeks after the IUD is fitted, whether or not you have had a period. This is to:

• check you are not pregnant (if you have not had a normal period)
• discuss any problems
• remove the IUD if this is what you want
• discuss your future contraceptive needs.

If you are ever worried about your emergency IUD contact your doctor or nurse as soon as you can. See them immediately if you think you are pregnant or have any of the following:

• a sudden or unusual pain in your lower abdomen
• a shorter, lighter or delayed period
• an unusual or smelly discharge from the vagina
• a high temperature.

These could be signs of an ectopic pregnancy or an infection, which can be serious.

Will the emergency IUD protect me from pregnancy until my next period?

Yes. As soon as it’s fitted it will provide ongoing contraception until it is taken out. If you want to, you can carry on using this method as your regular contraception. You can discuss this with your doctor or nurse. You will also find more information in our booklet Your guide to the IUD.

When can I have the emergency IUD removed?

If you do not want to keep the emergency IUD as your regular method of contraception, it can be removed during your next period.

If removed at any other time you will need to use an additional contraceptive method such as condoms, for seven days before the emergency IUD is taken out. This is because sperm can live inside your body for up to seven days and could fertilise an egg once the emergency IUD is removed.

Sexually transmitted infections

Most methods of contraception do not protect you from sexually transmitted infections.

Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. If you can, avoid using spermicidally lubricated condoms. The spermicide commonly contains Nonoxinol 9 which does not protect against HIV and may even increase the risk of infection.

Where can I get more information and advice?

Find out how to get help with your sexual health.