The morning after pill
The emergency contraceptive pill is also referred to as the 'morning after' pill. It's one of the options used to help prevent pregnancy after unprotected sex, or in the case of failed contraception such as a split condom or missed birth control pill.
The sooner you take the pill after having unprotected sex, the more likely it is to be effective. The morning after pill is intended for emergency use and should not be used for regular contraception. Speak to your GP or family planning clinic for advice on the different methods for regular contraception.
It’s important to note that the emergency contraceptive pill does not protect you against sexually transmitted infections (STIs), so you should take separate measures to look after your sexual health. These can include going for regular sexual health check-ups and using barrier forms of contraception, such as condoms.
You can access the emergency contraceptive pill from Boots pharmacies after having a private chat with a pharmacist in store (subject to eligibility criteria and pharmacist availability. Charges apply). In some areas, it can also be available free of charge in pharmacies through a local NHS service. Ask in store if this applies to your area. You may be able to get the morning after pill free of charge, if it is prescribed to you by your GP, or a family planning clinic.
How does the morning after pill work?
There are two types of emergency contraceptive pill which contain different active ingredients that prevent a pregnancy becoming established.
Products containing the active ingredient levonorgestrel, which is a synthetic version of the hormone progesterone, include Levonelle One Step*, Boots Emergency Contraceptive* and generic levonorgestrel. Levonorgestrel is thought to work by stopping the release of an egg (ovulation) and preventing sperm from fertilising an egg that has already been released. It must be taken within 72 hours (three days) of unprotected sex to help prevent pregnancy.
Ulipristal acetate is the active ingredient in ellaOne*. It stops progesterone from operating as usual and also functions by stopping or delaying the release of an egg. It should be taken within 120 hours (five days) of having unprotected sex to avoid pregnancy.
It’s important to remember that the sooner you take the emergency contraceptive pill, the more effective it will be.
If you're already using a regular form of contraception such as the contraceptive pill, ask your pharmacist or GP for advice on how to take your regular contraceptive after using emergency contraception, and whether you should use additional contraception.
Who can use the emergency contraceptive pill?
You’ll need to have a private chat with a pharmacist in store, your GP or nurse, and they’ll be able to advise if the morning pill is suitable for you and whether one type is more suitable. You shouldn’t take the morning after pill if you’re allergic to an ingredient it contains. The emergency contraceptive pill may not be suitable for you if you have certain medical conditions or take medicines that could interact with it. Your healthcare professional will be able to advise you on this. These include medicines used to treat HIV, tuberculosis or epilepsy, certain less commonly used antibiotics (rifampicin and rifabutin) and herbal remedies containing St John’s Wort. Ask your GP or pharmacist for advice about which medicines the emergency contraceptive pill can be taken with.
Over the counter Levonelle One Step and other levonorgestrel-containing-products are suitable for women aged 16 years old and over. However, they may be prescribed by a doctor or a nurse to younger women. EllaOne is suitable for women of childbearing age, including adolescents.
Very small amounts of the active ingredient in Levonelle and other levonorgestrel-containing products can appear in breast milk. You can take the tablet straight after a feed and avoid breastfeeding for at least eight hours to reduce the amount of the active ingredient your baby may take in your milk. Although there is limited evidence, it's thought that the hormone isn't harmful for your baby.
It’s unknown whether it’s safe to take ellaOne while breastfeeding, so the manufacturer advises you shouldn’t breastfeed for at least a week after taking the pill. You can maintain your milk supply during that time, by expressing using a breast pump then throwing away the expressed breast milk.
What to do if you’re sick after taking the morning after pill?
If you’re sick (vomit) usually within three hours of taking the morning after pill, the pill may not work and you may need one more tablet. Check the patient information leaflet which comes with your medicine for details and speak to your pharmacist, GP or family planning clinic immediately for advice.
What are the side effects of the morning after pill?
Like all medicines, the morning after pill can have side effects, though not everyone experiences them. Short-term side effects may include:
• Stomach pain
• Shifts in your following menstruation cycle – you may get your period earlier, later or you may experience more discomfort than normal
• Feeling sick or being sick (vomiting)
Read the patient information leaflet for the full list of side effects.
You should seek advice from your GP if your next period is more than five days late, shorter or lighter than usual, if you’re experiencing lower abdominal pain or if you think you may be pregnant. If you think you might be pregnant, you should take a pregnancy test to check.
What’s an IUD and how does it differ from the emergency contraceptive pill?
The intrauterine device (IUD or coil) also prevents pregnancy after unprotected sex or if contraception has failed. It works by preventing an egg implanting into your womb or being fertilised. The small T-shaped device can be placed in the uterus up to five days after unprotected sex to prevent pregnancy. It can be fitted at your GP surgery or a family planning clinic.
The emergency IUD is the most effective method of emergency contraception, with less than one per cent of women who use it becoming pregnant. This means it’s more effective than the morning after pill at preventing pregnancy, but some women can find it invasive.
Can I get the morning after pill if I’m under 16?
Yes, you can get the emergency contraceptive pill if you’re under 16. EllaOne is suitable for women of childbearing age – this includes adolescents under 16 years old - without prescription. So you can access it after a confidential conversation with your pharmacist. Your GP can also prescribe any type of emergency contraceptive, free of charge, even if you're under the age of 16. Other options to access it include family planning clinics, sexual health or genitourinary medicine clinics, some young people’s clinics and NHS walk-in centres.
Your pharmacist, nurse or GP will ask you questions to check if the morning after pill is suitable for you. The only time they may need to tell someone else is if they believe you’re at risk of harm, such as abuse.
• If you’ve had unprotected sex or your contraception has failed and you’d like to prevent pregnancy, one of your options is the emergency contraceptive pill
• Ask your GP, pharmacist or nurse which emergency contraceptive method is the most suitable for you
• If you’re not using regular contraception, speak to your GP or nurse, or visit your local sexual health clinic to discuss the options available
*Always read the label