morning-after-pill

Morning After Pill

The morning after pill is a method of contraception after unprotected sex. It doesn't matter why it happened - because of a missed pill or a split condom. While using the morning after pill, you need to remember that emergency contraception is really effective if it's taken in the right moment. 

The only two morning after pills available in the UK are Levonelle and ellaOne. You can order it here by getting the prescription.

Medication

What is the morning-after pill?

The Morning-after pill is an emergency contraception method to avoid pregnancy. This method of contraception pill can be used when you have unprotected sexual intercourse. There are some options in the market and to start thinking if you should use it or not, always pay attention, how and when to use it and the possible side effects.

How morning-after pills work?

In the market, there are two types of emergency contraceptive pills: 

EllaOne

EllaOne has ulipristal acetate, which stops progesterone hormone to work properly.  This medicine can also delay or stop the release of an egg (ovulation). You can use it until 120 hours (5 days) after unprotected sexual intercourse to avoid pregnancy. It is recommended to be sure you are not pregnant before you take it. i

Levonelle

Levonelle has levonorgestrel, which is a synthetic version of the hormone progesterone produced by the ovaries. This medicine can also delay or stop the release of an egg (ovulation). You can use it until 72 hours (3 days) after unprotected sexual intercourse to avoid unwanted pregnancy.

How can you use it?

If you had sex without protection and you do not want to be pregnant, you can consider the possibility to take this pill.  You can also consider the possibility to take it, if your primarily method of contraception failed for some reason. For example, if you forgot to take one birth control pill or if the condom broke.

The morning-after pill is a good decision to avoid unwanted pregnancy but it is not intended to be used as a regular form of contraception method. This method does not continue to protect you against pregnancy.  If you had unprotected sex after taking the emergency pill, you can become pregnant. Nevertheless, if you need it more than one time in a menstrual cycle, you can also use it.

How effective are morning-after pills?

No contraception method is 100% effective in all cases, but this method is very reliable to avoid unwanted pregnancy. The effectiveness of morning-after pills depend how soon you take it after sexual intercourse. EllaOne is a morning pill that you can use it until 120 hours after the intercourse. Studies have shown that 95% of women are protected , if morning after pills are taken between 48 to 120 hours after sexual intercourse.

Levonelle is one of the most common pills prescribed in the UK and the effectiveness are:

  • It is 95% effective if you take within 12 hours after unprotected sex;

  • It is 85% effective if you take between 12 to 24 hours after unprotected sex;

  • It is 75% effective if you take between 24 to 48 hours after unprotected sex;

  • It is 58% effective if you take between 48 to 72 hours after unprotected sex;

After 12 hours after sex, both pills have the same effectiveness. After 12 hours, with Levonelle the risk to be pregnant is 1 in 50 women, and EllaOne is 1 in 40 women.

Please be aware that this medicine can not prevent against sexually transmitted diseases, for example HIV, gonohrrea, chlamydia or herpes simplex virus. Women should always remember that the safest method to protect against sexually transmitted diseases is still considered the usage of barrier contraceptives such as condoms.

The morning-after pill is a safe method and can be taken for most women. In addition, if you will be pregnant after taking the pill, there is no effect or harm on the fetus. It is important to know, if you will not have your period within three or four weeks of taking the morning-after pill, you should do a pregnancy test or contact your doctor.

Every woman can use the morning-after pill?   

Most women can take this pill, including girls under 16 years of age can also use it. You should pay attention if you have one of the factors below, which can decrease the effectiveness of the pill or even inhibit the drug’s action, as follow:

Other medications:

Please be aware in the medications below, which can affect the effectiveness of the pill:

  • If you are using medicines to treat Epilepsy, HIV or tuberculosis;

  • If you are using St John’s Wort;

  • If you are using medicines to make your stomach less acid, or medicine for reflux syndrome such as  omeprazol;

  • If you are using rifampicin or rifabutin;

EllaOne, can not be used if you are taking some of the medicines above.  With Levonelle, you can use it but the dose needs to be increased. In both cases, it is important to talk to your doctor or pharmacist and be advised  of the best alternative that better suits you. 

Vomiting

Please be aware that if you vomit within 3 hours after taking morning-after pills, the dose should be repeated. The reason why is because your body may not have absorbed the active component and the pill will not work.

High body mass index (BMI)

Some studies have shown, that women who have a higher BMI, might have the effectiveness of the pill reduced. If you have  a high BMI, your doctor probably will recommend you to use EllaOne instead of Levonelle.

Some healthy problems

Some diseases can not be suitable with morning-after pills, as follow:

  • Certain allergies or hormones problems;

  • Stomach problems, for example Crohn’s  disease, or any kind of problem which affects the way your body processes food or medications;

  • If you suffer from porphyria or severe liver disease;

In all of these cases, you should talk to your doctor or pharmacist and discuss alternative options.

Breastfeeding

For women who are breastfeeding, it is safe to take Levonelle instead of EllaOne. However, some quantity of hormones can pass into your breast milk, but you do not need to worry, because the quantity is small and it is not harmful to your baby.

Other risk factors

If you take these pills frequently, you might experience change  within your menstrual cycle. It can be more irregular or unreliable. The next menstrual cycle can be earlier, later,  or more painful than usual. The flow in the next menstrual cycle can be more or less than usual.

If you are already using regular contraception

If you are using regular contraception and one of the events below happened, you should take the emergency pill, as follow:

  • If you forgot to take your birth control pill;

  • If you were late having contraceptive injection or contraceptive implant;

  • If you did not use in the correct form your vaginal ring or contraceptive patch;

For EllaOne, you should:

Wait for at least 5 days before taking again your next contraceptive pill, inserting a new ring or applying a new patch. In the meantime, you should use additional contraception to avoid pregnancy:

  • For 2 days you should use additional contraception, if you areonly using progesteron-pills.

  • For 7 days you should use additional contraception, if you are using ring, patch or combined pill, except Qlaira;

  • For 9 days you should use additional contraception, if you are using combined pill Qlaira;

For Levonelle, you should:

Take your next contraceptive pill, or insert a new ring or apply a new patch, after 12 hours after you take the emergency pill and keep taking the regular contraceptive pill normally. In the meantime, you should use additional contraception to avoid pregnancy:

  • For 2 days you should use additional contraception, if you are only using progesteron-pill;

  • For 7 days you should use additional contraception, if you are using ring, patch or combined pill, except Qlaira;

  • For 9 days you should use additional contraception, if you are using combined pill Qlaira;

If you have doubts, how to proceed in those cases, it is better to contact your doctor or pharmacist and ask how long you should keep using additional contraception after you take the emergency pill.

If you are under 16 years old

If you are under 16 years old, you can also use morning-after pill. There are contraception services, which are for free and confidential. Doctors and nurses will help you and will not tell your parents, as long as they believe you understand all the information and if your case it is not abuse or some risk of harm. There are guidelines to talk to people under 16 and you should be encouraged to talki to your parents but not forced. 

Which are the side-effects of using morning-after pills?

The possible side-effects of taking emergence pills are not much different than usual side-effects of regular contraception pills. They are not so serious and do not last longer. Nevertheless, these possible effects can be present:

  • Dizziness;
  • Fatigue;
  • Headache;
  • Nausea or vomiting;
  • Abdominal pain;
  • Small vaginal bleeding;
  • Pain or heaviness on your breasts;
  • Changes in your menstrual cycle
  • Lower abdominal pain or cramps;

If you still feel these symptoms above  for more than a few days, you should talk to you doctor. 

Can I use morning-after pills as a regular contraception method?

Morning-after pills is an emergency method to avoid unwanted pregnancy. You should not use it as a regular contraception method because if you use more than two times in a month it can become less effective and harmful for your body. There are, in the market, many possible contraception methods, which protect you for a long period, as follow:

  • Intrauterine device (IUD);
  • Intrauterine system (IUS);
  • Contraceptive implant;
  • Contraceptive Injection
  • Combined Pills;
  • Progesterone-only Pills;
  • Female condoms;

Please talk to your doctor in order to discuss the best option of regular contraception method for you.

Is it necessary to get a prescription for me to be able to get morning-after pills?

In UK, it is not necessary to get prescription to have emergency pills. However, there are some controversy and public debate, whether it is necessary or not to have prescription to buy these pills. Some of the points against selling pills without a prescription, are as follows:

  • Long term effects of using the emergency pills are not proven or studied;

  • This can increase unsafe sex, especially with teenagers;

  • There are also some discussions about moral conscience, a kind of aggression against the human embryos;

They have also some critics, which support the idea of this medicine to be kept without a prescription, which are:

  • In most of the countries, the rate of unsafe sex did not increase after the liberation of emergency pill without prescription;

  • This medicine can prevent a great number of unwanted pregnancies and possible abortions, which is more dangerous for women’s body;

  • This method is not an abortion pill,  in contrast with, for example mifepristone, this drug can terminate an established pregnancy, which is the fertilized egg that already began to develop;

Besides some controversy, this method is safe and quite affordable for every woman to prevent an unwanted pregnancy and going through abortion. According to some studies, if the woman takes the pill within 72 hours after sexual intercourse, the protection is more than 75% efficient. The most important thing is that the woman needs to know all the side-effects and restrictions that come when using emergency pills, as well as, she needs to understand the risks and responsibility it takes. 

Sources:

  • https://www.nhs.uk/conditions/contraception/emergency-contraception/
  • http://api-healthline.net/2013/04/morning-after-pill-over-the-counter.html#more-508