Emergency Contraception is prescribed for women where there is a risk of pregnancy occurring, i.e. that unprotected sex took place near the estimated date of ovulation.
However, many women will not have regular menstrual cycles or will not be aware of their ovulation patterns. Therefore it is advisable to use Emergency Contraception if unprotected sex has occurred regardless of where you are in the menstrual cycle.
Morning After Pill
There are two types of hormonal contraception
- Levonorgestrel – brand names Prevenelle and Norlevo
- Ulipristal acetate – brand name ellaOne
The Levonorgestrel dose is one pill that contains a hormone similar to one of the hormones (progestogen) in the contraceptive pill. This must be taken within 72 hours of unprotected sex. The earlier the pill is taken, the more effective it is. Minor side effects such as nausea and breast tenderness may occur but they settle within about 24 hours.
Ulipristal acetate is also given as one pill. It contains a hormone that is slightly different to those in contraceptive pills. It is taken within 5 days of unprotected sex. It is more effective than the levonorgestrel and maintains its effectiveness throughout the 5 days.
Both of these pills are suitable for almost everyone. Minor side effects such as nausea and breast tenderness may occur but they settle within about 24 hours. There may be some cycle disruption so vaginal bleeding may happen and the next period can be eiither early or delayed.
How does the Morning After Pill work?
- Ovulation (release of an egg) may be delayed.
- Slows down the passage of the egg through the fallopian tube.
- Slows down the passage of sperm.
- Creates hormone changes in the lining of the womb so that a fertilised egg cannot attach itself and passes unnoticed out of the body in the menstrual flow.
- Failure rate depends on where the woman is in her cycle and how soon after intercourse the pill is taken.
What are the possible risks?
Since there has been little or no research into the possible effects of the Morning After Pill on a pregnancy should the treatment fail, medical opinion remains uncertain as to the risk of foetal abnormalities in such circumstances. Evidence from studies done on the Contraceptive Pill has been put forward to suggest a possible risk of congenital heart defects and limb deformities when women continue to take the Pill while pregnant. However the morning after pill is a single dose of medication. On present evidence, several bodies such as the International Planned Parenthood Federation and the World Health Organisation have expressed the view that an increased risk of foetal abnormalities has not been proven.
- It is only effective for one episode of unprotected sex per cycle
This is just an outline. All packets of pills carry instructions and details of side effects. If you have any questions or worries, contact us at the Dublin Well Woman Centre.
The Emergency Coil is a coil that contains copper.
- The coil is the most effective form of emergency contraception. It may be fitted up to five days after unprotected sex or up to five days after expected date of ovulation whichever is the longer interval.
How does the Emergency Coil work?
If the coil is inserted into the womb within 5 days of unprotected sex, it can slow down the movement of sperm preventing fertilisation. If fertilisation does occur, the presence of the coil can stop the implantation of a fertilised egg.
What are the advantages?
- Many studies show no failures.
- Women who have had children can keep it in for future birth control.
What are the disadvantages?
- Insertion can be painful and unsuccessful.
- There can be heavy bleeding and cramping after insertion.
- It is unsuitable for women who have had vaginal infections in the recent past.
- It is unsuitable in a small number of other instances – this can be discussed with the nurse and doctor.