Emergency contraception

What is emergency contraception?

Emergency contraception can prevent pregnancy after unprotected sex or if your contraceptive method has failed. For example, a condom has split or you've missed a pill.

There are 2 types:

  • emergency contraceptive pill (sometimes called the morning after pill)
  • IUD (intrauterine device, or coil)

There are 2 kinds of emergency contraceptive pill. Levonelle has to be taken within 72 hours (3 days) of sex. ellaOne has to be taken within 120 hours (5 days) of sex. Both pills work by preventing or delaying ovulation (release of an egg). Emergency contraception is best taken as soon as possible to be effective.

The IUD can be inserted into your uterus up to 5 days after unprotected sex, or up to 5 days after the earliest time you could have ovulated. It may stop an egg from being fertilised or implanting in your womb.

Emergency contraception does not protect against sexually transmitted infections (STIs).

Emergency contraception self-help guide

Find out more about how to get emergency contraception and where to get it.

Self-help guide

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At a glance: facts about emergency contraception

Emergency contraception is effective at preventing pregnancy if it's used soon after unprotected sex. Less than 1% of women who use the IUD get pregnant, whereas pregnancies after the emergency contraceptive pill are not as rare. It’s thought that ellaOne is more effective than Levonelle.

The sooner you take Levonelle or ellaOne, the more effective it'll be.

Levonelle or ellaOne can make you feel sick, dizzy or tired, or give you a headache, tender breasts or abdominal pain.

Levonelle or ellaOne can make your period earlier or later than usual.

If you’re sick (vomit) within 2 hours of taking Levonelle, or 3 hours of taking ellaOne, get medical advice as you'll need to take another dose or have an IUD fitted.

If you use the IUD as emergency contraception, it can be left in as your regular contraceptive method.

If you use the IUD as a regular method of contraception, it can make your periods longer, heavier or more painful.

You may feel some discomfort when the IUD is put in – painkillers can help to relieve this.

There are no serious side effects of using emergency contraception.

Emergency contraception does not cause an abortion.

Non-urgent advice: Contact a doctor or nurse if:

you've used emergency contraception and:

  • you're concerned about any symptoms
  • you think you might be pregnant
  • your next period is more than 7 days late
  • your period is shorter or lighter than usual
  • you have any sudden or unusual pain in your lower abdomen

Sudden or unusual pain in your lower abdomen (stomach) could be a sign of an ectopic pregnancy. This is rare but serious, and needs immediate medical attention.

The emergency contraceptive pill

How does the emergency pill work?

Levonelle

Levonelle contains levonorgestrel, a synthetic version of the natural hormone progesterone. In a woman’s body, progesterone plays a role in ovulation and preparing the uterus for accepting a fertilised egg.

It’s not known exactly how Levonelle works, but it’s thought to work primarily by preventing or delaying ovulation. It does not interfere with your regular method of contraception.

ellaOne

ellaOne contains ulipristal acetate, which stops progesterone working normally. It prevents pregnancy mainly by preventing or delaying ovulation.`

Levonelle and ellaOne do not continue to protect you against pregnancy. This means that if you have unprotected sex at any time after taking the emergency pill you can become pregnant.

Even if you're starting or continuing another method of hormonal contraception, it may not be effective immediately. You'll need to use condoms or avoid sex until the contraception is working effectively. Your doctor or nurse will tell you when you can start hormonal contraception and how long you'll need to take extra precautions to prevent pregnancy.

Levonelle and ellaOne are not intended to be used as a regular form of contraception. However, you can use emergency contraception more than once in a menstrual cycle if necessary.

How will it affect my period?

After taking the emergency contraceptive pill, most women will have a normal period at the expected time. But you may have your period later or earlier than normal.

If your period is more than 7 days late, or is unusually light or short, contact your GP as soon as possible to check for pregnancy.

Who can use the emergency pill?

Most women can use the emergency contraceptive pill. This includes women who cannot usually use hormonal contraception, such as the combined pill and contraceptive patch. Girls aged under 16 years old can also use the emergency contraceptive pill.

The World Health Organisation (WHO) does not identify any medical condition that would mean a woman shouldn’t use Levonelle.

The manufacturer of ellaOne advises that it should not be used by women who:

  • are allergic to any of the components of the drug
  • have severe asthma that is treated with steroid tablets (glucocorticoids)
  • have certain rare hereditary problems with lactose metabolism

ellaOne may not be effective in women who are taking liver enzyme-inducing medication.

Breastfeeding

Levonelle can be taken while breastfeeding. Although small amounts of the hormones contained in the pill may pass into your breast milk, it is not thought to be harmful to your baby.

The safety of ellaOne during breastfeeding is not yet known. The manufacturer recommends that you do not breastfeed for one week after taking this pill.

What if I'm already using the pill, patch, vaginal ring or contraceptive injection?

You may need to take the emergency pill if you either:

Levonelle

You should take your next contraceptive pill, apply a new patch or insert a new ring within 12 hours of taking Levonelle.

You should then continue taking your regular contraceptive pill as normal.

You will need to use additional contraception, such as condoms, for:

  • the next 7 days if you use the patch, ring, combined pill (except Qlaira), implant or injection
  • 9 days for the combined pill Qlaira
  • the next 2 days if you use the progestogen-only pill

ellaOne

You'll need to wait at least 5 days before taking your next contraceptive pill, applying a new patch or inserting a new ring if you've taken ellaOne.

You should use additional contraception, such as condoms, while waiting to restart your contraceptive method and then for:

  • the next 7 days if you use the patch, ring, combined pill (except Qlaira), implant or injection
  • 9 days for the combined pill Qlaira
  • the next 2 days if you use the progestogen-only pill
What are the side effects of using the emergency pill?

Taking the emergency contraceptive pill has not been shown to cause any serious or long-term health problems. However, it can sometimes have side effects. Common side effects include:

  • abdominal (tummy) pain
  • headache
  • irregular menstrual bleeding (spotting or heavy bleeding) before your next period is due
  • feeling sick
  • tiredness

Less common side effects include:

  • breast tenderness
  • dizziness
  • headache
  • vomiting

Get medical advice if you vomit within 2 hours of taking Levonelle, or 3 hours of taking ellaOne. You'll need to take another dose or have an IUD fitted.

Does the emergency pill interact with other medicines?

The emergency contraceptive pill may interact with other medicines. These include:

  • the herbal medicine St John’s Wort
  • some medicines used to treat epilepsy
  • some medicines used to treat HIV
  • some medicines used to treat tuberculosis (TB)
  • medication such as omeprazole (an antacid) to make your stomach less acidic

ellaOne cannot be used if you are already taking one of these medicines, as it may not be effective.

Levonelle may still be used, but the dose may need to be increased. Your doctor or pharmacist can advise on this.

There should be no interaction between the emergency pill and most antibiotics. Two enzyme-inducing antibiotics (called rifampicin and rifabutin), used to treat or prevent meningitis or TB, may affect ellaOne while they’re being taken and for 28 days afterwards.

If you want to check that your medicines are safe to take with the emergency contraceptive pill, ask your GP or a pharmacist. You should also read the information leaflet that comes with your medicines.

Can I get the emergency contraceptive pill in advance?

You may be able to get the emergency contraceptive pill in advance of having unprotected sex if you:

  • are worried about your contraceptive method failing
  • are going on holiday
  • cannot get hold of emergency contraception easily

Ask your GP or nurse for further information on getting advance emergency contraception.

How effective is the emergency contraceptive pill?

Both Levonelle and ellaOne are effective only if taken before the release of an egg from the ovary (ovulation). The sooner you take Levonelle or ellaOne, the more effective it will be.

ellaOne has been slightly more effective than Levonelle in clinical trials.

If you vomit within 2 hours of taking Levonelle or 3 hours of taking ellaOne, get medical advice as you will need to take another dose or have an IUD fitted.

The IUD (coil) as emergency contraception

How does the IUD work?

The intrauterine device (IUD) is a small, T-shaped contraceptive device made from plastic and copper. It’s inserted into the uterus by a trained health professional. It may prevent an egg from implanting in your womb or being fertilised.

If you’ve had unprotected sex, the IUD can be inserted up to 5 days afterwards, or up to 5 days after the earliest time you could have ovulated to prevent pregnancy.

You can also choose to have the IUD left in as an ongoing method of contraception.

Who can use the IUD?

Most women can use an IUD, including women who have never been pregnant and those who are HIV positive. Your GP or clinician will ask about your medical history to check if an IUD is suitable for you.

You should not use an IUD if you have:

  • an untreated STI or a pelvic infection
  • certain abnormalities of the womb or cervix
  • any unexplained bleeding from your vagina – for example, between periods or after sex

Women who have a heart condition should speak to their GP or cardiologist before having an IUD fitted.

Pregnancy and breastfeeding

The IUD should not be inserted if there is a risk that you may already be pregnant.

The IUD can be used safely if you’re breastfeeding, but the risk of complications during insertion is slightly higher.

What are the side effects of the IUD?

Complications after having an IUD fitted are rare, but can include pain, infection, damage to the womb or expulsion (the IUD coming out of your womb). If you use the IUD as an ongoing method of regular contraception, it may make your periods longer, heavier or more painful.

Does the IUD interact with other medicines?

The emergency IUD will not react with any other medication.

How effective is the IUD?

The IUD is more effective than the emergency pill at preventing pregnancy after unprotected sex.

Trials suggest the failure rate for the IUD as emergency contraception is lower than 1%. This means less than 1 woman in 100 using the IUD as emergency contraception will get pregnant.

The IUD must be fitted by a healthcare professional within 5 days (120 hours) of having unprotected sex or, if it's possible to estimate when you ovulate, up to 5 days after you ovulate.

Where can I get emergency contraception?

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

  • a GP practice that provides contraception (some GP practices may not provide the IUD)
  • a contraception clinic
  • a sexual health clinic
  • some genitourinary medicine (GUM) clinics
  • some young people's clinics

You can also get the emergency contraceptive pill free from:

The doctor or nurse you see may ask:

  • when you have had unprotected sex in your current menstrual cycle
  • the date of the first day of your last period and the usual length of your cycle
  • details of any contraceptive failure (such as how many pills you may have missed and when)
  • if you've used any medications that may affect your contraception

If you're aged 13 or over, you can get contraception from the majority of pharmacies in Scotland, usually free of charge.

If you are not eligible for NHS Scotland services, you can buy the emergency contraceptive pill from most pharmacies. The cost varies, but it will be around £30 to £35.

Bridging (short-term) contraception

You can get an initial 3-month supply of the progestogen-only pill as well as emergency contraception at pharmacies. Speak to your pharmacy for further information.

Contraception for the future

If you're not using a regular method of contraception, you might consider doing so to lower the risk of unplanned pregnancy.

Read about the different types of contraception

Last updated:
04 November 2022

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