What is Emergency Contraception?
Emergency contraception (EC) is used to reduce the risk of pregnancy after unprotected sexual activity. There are 3 kinds of emergency contraception available in Australia:
- A 1.5mg single dose levonorgestrel emergency contraceptive pill (LNG-ECP), licensed for use up to 72 hours (three days) after unprotected sex
- A 30mg single dose ulipristal acetate emergency contraceptive pill (UPA-ECP) licensed for use up to 120 hours (five days) after unprotected sex
- Insertion of a copper intra-uterine device (IUD) within 120 hours of unprotected sex, which also provides very effective long-term contraception
How does it work?
Both types of emergency contraceptive pill (ECP) work mainly by stopping or delaying the release of an egg by the ovary (ovulation). The ECP is sometimes called the morning-after pill, but this is incorrect. Although it’s more effective the sooner it’s taken, it can be taken up to five days after unprotected sex.
ECPs do not prevent implantation of a fertilised egg.
If the ECP is accidentally taken during pregnancy it does not cause harm to the developing embryo or foetus.
The ECP does not cause an abortion.
The copper IUD works by affecting sperm movement, preventing fertilisation of the egg, and may also prevent implantation of a fertilised egg.
Why would I need Emergency Contraception?
You could use EC if there was a risk of unwanted pregnancy. This would include:
- unprotected intercourse
- sexual assault
- contraceptive failure (e.g. the condom breaks or you are on the Pill and have missed two or more consecutive hormonal pills)
If you are not sure whether you are at risk of pregnancy phone SHINE SA’s Sexual Healthline or talk to your local pharmacist, doctor or women’s health nurse.
How effective is it?
The ECP should be taken as soon as possible and is most effective if taken within 24 hours of unprotected sexual intercourse.
LNG-ECP is estimated to prevent approximately 85% of pregnancies if taken within 3 days of unprotected sex, but still offers some effectiveness up to 96 hours, if there is no alternative EC available.
UPA-ECP is more effective than LNG-ECP and can be taken up to 120 hours after unprotected sex.
The copper IUD is the most effective form of EC. It is more than 99% effective if used within 5 days of unprotected sexual intercourse. The procedure to have a copper IUD can be difficult to access and may be more expensive than using the ECP. Contact SHINE SA or see your doctor for more information.
How do I get Emergency Contraception?
The ECP is available over the counter at pharmacies. You can also get it at SHINE SA clinics, Clinic 275, Pregnancy Advisory Centre and many public hospital emergency departments.
Some pharmacists may not supply the LNG-ECP if you had unprotected sex over 72 hours ago as this is against the recommendations in the product information.
What does it cost?
Prices vary. The cost depends on where you get it and the type of ECP. UPA-ECP may be more effective but is also more expensive.
How do I take Emergency Contraception?
Take the tablet as soon as possible.
If vomiting occurs less than 2 hours after taking LNG-EC, or less than 3 hours after taking UPA-ECP, another dose should be taken.
Since some medications, including certain anti-epileptic medications, can reduce the effectiveness of the ECP, be sure to discuss any medications you are taking with the pharmacist or doctor.
Non-prescription medications such as St John’s Wort can also affect the ECP.
What are the possible side effects?
The ECP can occasionally cause nausea, breast pain, headaches and spot bleeding. Side effects usually stop within two days. If you are worried about any side effects see a doctor.
Taking the ECP will not affect a pregnancy or harm a developing foetus.
When will I have my next period?
For most people the next period will come at the normal time. A few may be early and up to 20% may be up to a week late.
Do I need a pregnancy test?
If your period is more than a week late, or light or unusual in any way, you should have a pregnancy test.
Also if you start a new form of contraception which may alter your period you should have a pregnancy test in 4 weeks.
If you have any other concerns or would like to discuss ongoing contraception you should see your doctor or contact SHINE SA’s Sexual Healthline for advice.
Who can take the ECP?
Almost anyone can take one of the ECPs but it is important for the pharmacist or doctor to know if they have any allergies or serious medical conditions.
Can I take the ECP more than once?
You can take the ECP more than once per cycle. If you have further unprotected sex you should take the ECP again as the previous dose is not effective. If you need to use the ECP more than once per cycle you should use the same type of ECP taken in the current cycle, as switching between LNG-ECP and UPA-ECP in the same cycle can reduce the effectiveness of both.
Do I need to start contraception?
ECPs do not provide ongoing contraception and may delay ovulation. It is important to keep using other contraception such as condoms for the rest of the cycle until the next period in case of ovulation after taking the ECP.
Taking the ECP does not reduce the risk of pregnancy if you have further unprotected sex, so it’s a good idea to consider ongoing contraception.
It is not recommended to take a progestogen-containing method of contraception within 5 days of UPA-ECP as it may reduce the effectiveness of the UPA. This includes all oral contraceptive pills, vaginal ring, and the contraceptive implant and injection. With LNG-ECP, it is possible to start a hormonal method of contraception immediately after taking it.
You can contact SHINE SA or your doctor to discuss your options.
Can I continue my current contraception?
If you are taking the ECP due to missing a contraceptive pill it is possible this will reduce the effectiveness of taking UPA-ECP. The LNG-ECP is not affected by taking a contraceptive pill in the last 7 days.
Is it safe to take Emergency Contraception when breastfeeding?
It’s safe to use the LNG-ECP when you are breastfeeding. It will not decrease your milk supply. If you use the UPA-ECP you will need to express and discard your breast milk for 7 days.