Emergency contraception – your guide

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).

Emergency contraception can be very effective especially if you have an IUD fitted or if the emergency contraceptive pill is taken soon after sex.

You don’t need to use emergency contraception for the first 21 days after giving birth.

About emergency contraception

• Does emergency contraception cause an abortion?
• Where can I get emergency contraception?
• How do I buy Levonelle from a pharmacist?
• Can someone else get the emergency contraceptive pill for me?
• How will I know if my emergency contraception has worked?
• Am I protected from future pregnancy?

Emergency contraceptive pill – Levonelle

• What is Levonelle?
• Who can use Levonelle?
• What are the disadvantages of Levonelle?
• How will Levonelle affect my next period?
• Do I need to see a doctor or nurse after I've taken Levonelle?
• Can Levonelle fail?
• Can I continue to use other contraception after taking Levonelle?

Emergency contraceptive pill – ellaOne

• What is ellaOne?
• Who can use ellaOne?
• What are the disadvantages of ellaOne?
• How will ellaOne affect my next period?
• Do I need to see a doctor or nurse after I've taken ellaOne?
• Can ellaOne fail?
• Can I continue to use other contraception after taking ellaOne?

Emergency IUD

• What is an emergency IUD?
• Who can use an emergency IUD?
• What are the disadvantages of an emergency IUD?
• How will an emergency IUD affect my next period?
• Do I need to see a doctor or nurse after having an emergency IUD fitted?
• Can an emergency IUD fail?
• Can I continue to use other contraception after having an emergency IUD fitted?

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.

Where can I get emergency contraception?

You can get emergency contraception free from these places but they may not all supply ellaOne or fit the IUD.

• 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.

Search online for your nearest emergency contraception clinic.

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.

Ask your doctor, nurse or pharmacist about getting emergency pills in advance, just in case you need them.

How do I buy Levonelle from a pharmacist?

It will cost around £25. The pharmacist 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. All the advice and treatment you receive is confidential – wherever you receive it.

Can someone else get the emergency contraceptive pill for me?

Someone else will only be given Levonelle on your behalf in exceptional circumstances. You will need to visit the doctor yourself to be prescribed ellaOne.

How will I know if my emergency contraception has worked?

It is unlikely that you will be pregnant but do a pregnancy test to make sure you are not pregnant if:

• you feel pregnant
• you have not had a normal period within three weeks of taking Levonelle, ellaOne or having the emergency IUD inserted
• 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 will be accurate if the test is done three weeks after the last time you had unprotected sex.

Am I protected from future pregnancy?

Levonelle and ellaOne will not protect you from pregnancy if you have unprotected sex again. Seek advice – you can take Levonelle as many times as you need to in any menstrual cycle. ellaOne cannot be used more than once in the same menstrual cycle or in the same cycle as taking Levonelle.

You can continue to use the IUD as your long-term contraceptive method.

Emergency contraception is not as effective as using other methods of contraception regularly – seek advice on using other methods.

Emergency contraceptive pill – Levonelle

What is Levonelle?

Levonelle is a tablet containing a hormone called progestogen.

You will be given one pill to take. It should be taken within three days (72 hours) of having unprotected sex.

Ask your doctor for advice about taking it within five days (120 hours) of having unprotected sex.

Who can use Levonelle?

Most women can use Levonelle. However, if you are taking certain prescribed medicines, or complementary medicines you will need advice and the dose of Levonelle may need to be increased. The emergency IUD may be preferred.

Levonelle can be used from day 21 of giving birth. You can use it after a miscarriage or abortion.

What are the disadvantages of Levonelle?

There are no serious short- or long-term side-effects.

• Some women may feel sick, dizzy or tired, or may get headaches, breast tenderness or abdominal pain.
• A very small number will vomit.
• It can disrupt your next period.

How will Levonelle affect my next period?

Your period is likely to come on time or a few days early or late. Sometimes it can be a week late and 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?

You should see a doctor or nurse if:

• Your next period is more than seven days late, it is shorter or lighter than usual or you have any sudden or unusual pain in your lower abdomen. These could be signs of an ectopic pregnancy. Although this is not common, it is very serious.
• You are worried that you might have a sexually transmitted infection.

Can Levonelle fail?

Some women get pregnant even though Levonelle was taken correctly.

You may also become pregnant if you delay taking it, have further unprotected sex or vomit within two hours of taking it. Speak to your doctor, nurse or pharmacist. They may give you another dose or suggest an emergency IUD.

If you vomit later than two hours Levonelle will have been absorbed.

Can I continue to use other contraception after taking Levonelle?

If you forgot your regular pills or did not use the patch or vaginal ring correctly, you should take your regular pill again, insert a new ring or apply a new patch within 12 hours of taking Levonelle.

Use additional contraception, such as condoms:

• for seven days with the patch, the ring and the combined pill (nine days for Qlaira)
• for two days with the progestogen-only pill.

Emergency contraceptive pill – ellaOne

What is ellaOne?

ellaOne is a tablet which contains ulipristal acetate.

You will be given one pill to take within five days (120 hours) of having unprotected sex.

Who can use ellaOne?

Most women can use ellaOne. If you have liver disease, severe asthma or take certain prescribed medicines or complementary medicines, an emergency IUD may be a preferred option.

Avoid breastfeeding for 36 hours after taking ellaOne.

What are the disadvantages of ellaOne?

Some women may get the same side-effects as for Levonelle above. They may also get:

• painful periods
• mood swings
• muscle and back pain.

Most side-effects go away within a few days.

How will ellaOne affect my next period?

Your period may be on time, or a few days earlier or later than expected.

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

You should see a doctor or nurse if:

• Your next period is more than seven days late, it is shorter or lighter than usual or you have any sudden or unusual pain in your lower abdomen. These could be signs of an ectopic pregnancy. Although this is not common, it is very serious.
• You are worried that you might have a sexually transmitted infection.

Can ellaOne fail?

Some women get pregnant even though they took ellaOne correctly.

You may also become pregnant if you vomit within three hours of taking it. Speak to your doctor or nurse. They may give you another dose or suggest having an emergency IUD.

If you vomit later than three hours ellaOne will have been absorbed.

Can I continue to use other contraception after taking ellaOne?

If you forgot your regular pills or did not use the patch or vaginal ring correctly, you should take your regular pill again, insert a new ring or apply a new patch within 12 hours of taking ellaOne.

Use additional contraception, such as condoms:

• with the patch, the ring and the combined pill for 14 days (16 days for Qlaira)
• with the progestogen-only pill for nine days.

Emergency IUD

What is an emergency IUD?

An emergency IUD is a small plastic and copper device that is fitted in your uterus up to five days (120 hours) after unprotected sex or within five days of the earliest time you could have released an egg. It takes about 15–20 minutes to fit. It can be uncomfortable – you can ask for a local anaesthetic.

If it cannot be fitted immediately you may be advised to take Levonelle or ellaOne.

Who can use an emergency IUD?

Most women can use an emergency IUD but it is not normally recommended before 28 days after giving birth. If you need to, you can use Levonelle or ellaOne until this time.

You may be able to use the emergency IUD after a miscarriage or abortion. Speak to a doctor or nurse.

What are the disadvantages of an emergency IUD?

Some women may get a period-type pain and light bleeding for a few days after the IUD is fitted. Pain relief can help.

There is a very small chance of getting an infection during the first 20 days after it is fitted. If you already have an infection you may be given antibiotics.

It is not common but the IUD can be pushed out or it can move. There is also a very small risk that it might go through your uterus.

How will an emergency IUD affect my next period?

Your next period should come at about the same time as you would normally expect it.

Do I need to see a doctor or nurse after having an emergency IUD fitted?

You should see a doctor or nurse three to four weeks after the IUD is fitted. This is to:

• check you are not pregnant
• discuss your future contraceptive needs
• remove the IUD if this is what you want.

The emergency IUD can be removed during your next period. If removed at any other time you will need to use additional contraception, such as condoms, for seven days before the emergency IUD is taken out.

Can an emergency IUD fail?

If you cannot feel the IUD threads in the top of your vagina, or you can feel the IUD itself, you may not be protected against pregnancy. See your doctor or nurse straightaway and use additional contraception.

The IUD is very effective but if it fails there is a small increased risk of an ectopic pregnancy. The risk is less in women using an IUD than in women using no contraception at all. Seek advice as soon as possible.

Can I continue to use other contraception after having an emergency IUD fitted?

If you want to go back to using your usual contraception, speak to a doctor or nurse about having the IUD removed or you can keep it as your regular method of contraception.

Last updated November 2012. Next update available October 2013.