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Emergency contraception

If you have had unprotected sex, that is, sex without using contraception, or when you think your contraception might have failed, you can use emergency contraception. There are two methods of emergency contraception:

  • Hormonal emergency contraception (known as the emergency contraceptive pill), and
    The copper IUD. The IUD is the most effective.

If you act quickly, emergency contraception will usually prevent pregnancy.

Does emergency contraception cause an abortion?

No. Emergency contraception may stop ovulation, or fertilisation of an egg, or stop a fertilised egg from implanting in the womb. Medical research and legal judgement are quite clear that emergency contraception (the pill or an IUD) prevents pregnancy and is not abortion. Abortion can only take place after a fertilised egg has implanted in the womb. People who believe life begins when the egg is fertilised may not wish to use the emergency contraception methods outlined in this leaflet.

Where can I get emergency contraception?

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

  • Any general practice that provides contraceptive services

  • Any family planning clinic

  • Any young person's clinic or Brook clinic

  • Any sexual health clinic

  • Some genitourinary medicine (GUM) clinics.

You can also get the emergency pill 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 if they provide this service).

You can buy the emergency pill from:

  • Most pharmacies if you are 16-years-old or over

  • Some privately run clinics, such as bpas and Marie Stopes.

The price will vary but at the pharmacy it will cost around £26.

All the advice and treatment you receive is confidential – wherever you receive it.

Method 1: The emergency contraceptive pill

What is the emergency pill?
The emergency contraceptive pill is a tablet containing progestogen, a hormone which is similar to the natural progesterone women produce in their ovaries.

How do I take it?
You will be given 1 pill to take. It should be taken within 3 days (72 hours) of having unprotected sex. It is more effective the sooner it is taken.

How does the emergency pill work?
The emergency pill is most likely to:

  • Stop an egg being released (ovulation)

  • Delay ovulation.

It may also stop a fertilised egg settling in your womb (implanting).

How effective is the emergency pill?
It is very effective and is more effective the sooner it is taken after sex. However, it is not as effective as using other methods of contraception regularly and does not protect you against sexually transmitted infections.

Of the pregnancies that could be expected to have occurred if no emergency contraception had been used the emergency pill will prevent:

  • Up to 95% if taken within 24 hours

  • Up to 85% if taken between 25–48 hours

  • Up to 58% if taken between 49–72 hours.

If the emergency pill is taken after 72 hours it is not known how effective it will be.

Who can use the emergency pill?
Most women can use the emergency pill. This includes women who are breastfeeding and women who can’t use estrogens – the same hormone that is used in the combined pill or the contraceptive patch. However, if you are taking certain prescribed medicines, or complementary medicines such as St John’s Wort, you will need special advice and the dose of the emergency pill may need to be increased. Or you may need to use the copper IUD (see Method 2: The copper IUD).

What are the side effects?

  • There are no serious short- or long-term effects from using the emergency pill

  • Some women may feel sick, dizzy or tired, or may get headaches, breast tenderness or abdominal pain

  • A very small number of women will vomit

  • It can disrupt your periods (see How will the emergency pill affect my next period?).

How will the emergency pill affect my next period?

  • Your period is likely to either come on time or be a few days early or late.  For some women the period can be up to a week late or sometimes even longer

  • You may have some irregular bleeding between taking the emergency pill and getting 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 the pill?
Not usually, but do go and see a doctor or nurse if:

  • You think you may be pregnant

  • Your next period is more than 7 days late

  • Your period is shorter or lighter than your usual period

  • You have any sudden or unusual pain in your lower abdomen.

These could be signs of an ectopic pregnancy – a pregnancy that occurs outside the womb, usually in a fallopian tube. Although this is not common, it is very serious.

You should also see a doctor or nurse if:

  • You want to talk about using regular contraception

  • Yyou are worried that you might have caught a sexually transmitted infection.

Can the emergency pill fail?
The emergency pill is very effective and should be taken as soon as possible after unprotected sex.  However in some women it fails and they become pregnant even though the pill was taken correctly.  You may also become pregnant if you:

  • Delay taking the emergency pill

  • Vomit within 2 hours of taking the pill

  • Have had unprotected sex at another time, either since your last period or since taking the emergency pill.

What if I vomit within 2 hours of taking the pill?
Speak to your doctor, nurse or pharmacist. They may give you another pill and a medicine to stop you vomiting again, or suggest having a copper IUD fitted (see Method 2: The copper IUD). If you vomit later than 2 hours, don’t worry, the pill will have been absorbed.

How will I know if the emergency pill has worked?
If you have taken the pill correctly and your next period seems normal, it is unlikely that you will be pregnant.  After you have taken the emergency pill it is recommended that you do a pregnancy test to make sure you are not pregnant if:

  • You think you feel pregnant

  • You have not had a normal period within 3 weeks of taking the emergency pill

  • You do not have a bleed when you have the 7 day break from using the contraceptive patch or combined pill or when you take the placebo tablets with ED combined pills.

A pregnancy test result will be accurate if the test is done from 3 weeks after the last time you had unprotected sex.

Are there any risks if the emergency pill fails?
The emergency pill has not been shown to affect a pregnancy or harm a developing baby. As with any pregnancy there is a small chance that an ectopic pregnancy may occur. If you think that you may be pregnant it is important to seek advice as soon as possible to check that you do not have an ectopic pregnancy (see Do I need to see a doctor or nurse after I've taken the pill?).

Will the emergency pill protect me from pregnancy until my next period?
No. The emergency pill will not protect you from pregnancy if you have further unprotected sex. If this happens you should seek advice.  You can use emergency contraception again.

If I'm using regular contraceptive pills or the patch, can I continue to use this after the emergency pill?


Yes. If you needed emergency contraception because you forgot some of your regular pills or did not use the patch correctly, you should take a contraceptive pill again, or apply a new patch within 12 hours of taking the emergency pill. You will need to use an additional contraceptive method, such as condoms, for:

  • 7 days with the patch and the combined pill

  • 2 days with the progestogen-only pill.

How many times can I use the emergency pill?
You can take the emergency pill as many times as you need to. You can take it more than once in any one menstrual cycle. It is not dangerous to do this but it may disrupt your periods. However, using the emergency pill is not as effective as using other methods of contraception. If you want advice on any method of contraception you can speak to the fpa helpline or ask your doctor, nurse or pharmacist.

Can someone else get the emergency pill for me?
No. You need to get the emergency pill from the doctor, nurse or pharmacist yourself. Someone else will only be given the emergency pill on your behalf in exceptional circumstances.

How can I buy the emergency pill from a pharmacist?
If you are 16 or over, you can ask the pharmacist for emergency contraception.  The pharmacist will need to ask you some questions as there are some circumstances when they may not be able to sell you the emergency pill. This may be the case if:

  • It has been more than 72 hours since you had unprotected sex

  • If you have had unprotected sex more than once in this 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. The pharmacist should be able to tell you where you can go.

Can I get emergency pills in advance?
Yes, if you are worried about your contraceptive method failing, you are going on holiday, or you cannot get emergency contraception easily. Ask your doctor or nurse about this.

Method 2: The Copper IUD

What is the copper IUD?
An IUD is a small plastic and copper device that is put into your womb by a specially trained  doctor or a nurse.

An IUD can be fitted up to 5 days after unprotected sex at any time in the menstrual cycle provided this is the only unprotected sex that has occurred since the last period. If you have had unprotected sex more than once since the last period then an IUD can be fitted up to 5 days after the earliest time you could have released an egg (ovulation).

If the IUD cannot be fitted immediately you may be advised to take the emergency pill in the meantime.

How does the IUD work?
It may stop an egg being fertilised or implanting in your womb.

How effective is a copper IUD?
The IUD is the most effective method of emergency contraception. It will prevent up to 98% of pregnancies expected to occur if no emergency contraception had been used.

Who can use an IUD?
Most women can use an IUD for emergency contraception. An IUD may be suitable if:

  • You want to use the most effective method of emergency contraception

  •  It is over 72 hours since you had unprotected sex and too late for the emergency pill

  • You do not want to, or cannot, take progestogen

  • You want to use the IUD as an ongoing method of contraception.

What are the disadvantages of using an IUD for emergency contraception?

  • It is not as easily available as the emergency pill

  • Not all women can use the IUD (for example, women who have certain problems with their cervix or womb)

  • There is a small chance of getting an infection in your womb within the first 20 days after the IUD is put in. If you have been at risk of getting a sexually transmitted infection you may have screening tests done at the time the IUD isfitted and you may also be given some antibiotics. This will help to reduce the chance of getting a pelvic infection

  • An IUD might go through (perforate) your womb or cervix when it is fitted. This may cause pain, but often there are no symptoms. If this happens, the IUD may need to be removed by surgery. Perforation is uncommon when the IUD is fitted by an experienced doctor or nurse.

  • The IUD can be pushed out by your womb (expulsion).

How is the IUD put in?
The doctor or nurse will examine you internally to check the position and size of your womb before they put in an IUD.

Fitting an IUD takes about 15–20 minutes. It can be uncomfortable or painful for some women, and you might want to have a painkiller beforehand or a local anaesthetic. You may get a period-type pain and some light bleeding for a few days after the IUD is fitted. Painkillers can help with this.

How will I know that the IUD is still in place?
An IUD has one or two threads attached to the end that hang a little way down from your womb into the top of your vagina. The doctor or nurse will teach you how to feel the threads to make sure the IUD is still in place. It is very unlikely that an IUD will come out, but if you cannot feel the threads, or if you think you can feel the IUD itself, you may not be protected against pregnancy. See your doctor or nurse straight away and use an extra contraceptive method, such as condoms.

When will I get my next period?
Your next period should come at about the same time as you would normally expect it. If you have not had a normal period within 3 weeks of having the IUD fitted it’s recommended that you do a pregnancy test.

Are there any risks if the emergency IUD fails?
The emergency IUD is highly effective. However, if it does fail and you become pregnant there is a risk that the IUD can cause a miscarriage or that an ectopic pregnancy may occur. If you know that you are pregnant or think that you might be, it is important to seek advice as soon as possible.

Do I need to see a doctor or nurse after the IUD is fitted?

Yes. It is recommended that you see a doctor or nurse 3–4 weeks after the IUD is fitted, whether or not you have had a period. This is to:

  • Check you are not pregnant (if you have not had a normal period)

  • Discuss any problems

  • Rremove the IUD if this is what you want

  • Discuss your future contraception if you require this.

If you are ever worried about anything to do with your IUD do contact your doctor or nurse as soon as you can. You should see your doctor or nurse straight away if you think you are pregnant or have any of the following:

  • A sudden or unusual pain in your lower abdomen

  • A shorter, lighter or delayed period

  • An unusual or smelly discharge from the vagina

  • A high temperature.

These could be signs of an ectopic pregnancy or an infection, which can be serious.

Will the IUD protect me from pregnancy until my next period?
Yes. As soon as it’s fitted it will protect you against pregnancy and it will provide ongoing contraception until it is taken out. If you want to, you can carry on using this method as your regular contraception.

If you would like to use the IUD as a long-term method of contraception discuss this with your doctor or nurse. You will also find more information in our leaflet Your guide to the IUD.

When can I have the IUD removed?
If you do not want to keep the IUD as your regular method of contraception, it can be removed as soon as you are sure you are not pregnant (usually during your next period). This is done by a doctor or nurse, who gently pulls on the threads.

If you have not started to use a hormonal method of contraception (such as the contraceptive pill) you will need to use an extra contraceptive method, such as condoms, for 7 days before the IUD is taken out. This is because sperm can live inside your body for up to 7 days and could fertilise an egg once the IUD is removed.

How do I find out about contraception services?
Contraception is free for women and men of all ages through the National Health Service.

  • You can find out about all clinics from sexual health direct, run by fpa on 0845 310 1334 or visit the website www.fpa.org.uk

  • You can get lists of general practices from libraries, primary care trusts or health boards and some advice centres and helplines

  • You can get details of your nearest family planning or sexual health clinic from: local directories, health centre, hospital, midwife or health visitor, advice centre, NHS Direct on 0845 46 47 (NHS 24 in Scotland 0845 4 24 24 24), primary care trust or health board

  • Young people can also phone Brook on 0800 0185 023 or Sexwise on 0800 28 29 30 for details of the nearest young people’s clinic.

Sexually transmitted infections
Most methods of contraception do not protect you from sexually transmitted infections.

Male and female condoms, when used correctly and consistently, can help protect against sexually transmitted infections. Diaphragms and caps may also protect against some sexually transmitted infections. If you can, avoid using condoms containing Nonoxinol 9 (spermicidally lubricated), as this does not protect against HIV and may even increase the risk of infection.

How fpa can help you
sexual health direct is a nationwide service run by fpa. It provides:

  • Confidential information and advice on contraception, sexually transmitted infections, planning a pregnancy, pregnancy choices and sexual wellbeing

  • Details of family planning clinics, sexual health clinics and other sexual health services

  • A wide range of leaflets on individual methods of contraception, common sexually transmitted infections, abortion and planning a pregnancy.

fpa helplines

UK
helpline 0845 310 1334
9am to 6pm Monday to Friday

Northern Ireland
helpline 028 90 325 488 (Belfast) or
helpline 028 71 260 016 (Derry)
9am to 5pm Monday to Thursday, 9am to 4.30pm Friday

Scotland
helpline 0141 576 5088
9am to 5pm Monday to Thursday, 9am to 4.30pm Friday

or visit fpa's website
www.fpa.org.uk

A final word

This leaflet can only give you basic information about emergency contraception. The information is based on the evidence and medical opinion available at the time this leaflet was printed. Different people may give you different advice on certain points. All methods of contraception come with a Patient Information Leaflet which provides detailed information about the method.


Remember – contact your doctor, practice nurse or a family planning clinic if you are worried or unsure about anything.

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