Emergency Contraception (EC)

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EC can be used to reduce the risk of pregnancy after unprotected sex.

What is EC?

There are 2 types of EC available in Australia.

EC pill

This pill is the most commonly used form of EC. It contains a dose of the hormone progestogen and is taken after sexual intercourse to reduce the risk of pregnancy.
Copper intrauterine contraceptive device (IUD)

A copper IUD can be used as EC as well as ongoing contraception.

How does EC work?

In the case of the EC pill,it works by

delaying or preventing ovulation (the release of an ovum (egg) from the ovary)

In the case of the copper IUD,it

interferes with sperm movement and changes the lining of the uterus (womb) to prevent implantation of the fertilised ovum

How effective is EC?

Overall the EC pill is about 85% effective if taken in the first 3 days (72 hours) after unprotected sexual intercourse.

While it may be used up to 5 days(120 hours) after unprotected sexual intercourse,some research shows it may be less effective after 4 days(96 hours), so the earlier it is taken, the better.

An IUD as ECion is 99% effective in preventing a pregnancy if inserted any time within 5 days of unprotected sexual intercourse.

What are the advantages of the EC?

the EC pill is available from most pharmacists without a prescription
EC can be used following sexual contact when:
- contraception was not used
- contraception failed, eg a condom breaks or contraception pills are missed
- sex was forced

What are the disadvantages of the EC pill?

cost – the EC pill costs between $25 - $45 from a pharmacist
some pharmacists do not supply the EC pill making it harder to access
provides one time protection against pregnancy –has no ongoing contraceptive benefit

What are the possible side effects of the EC pill?

Side effects are rare but occasionally women report:

a delay in the arrival of the next period, or the period may come early

Other side effects are rare but occasionally women report:

nausea and vomiting
headaches and dizziness

Is the EC pill suitable for all women?

The EC pill is suitable for all women who are at risk of unintended pregnancy.

Women using certain medications may need to adjust the dose to ensure the EC pills are effective. Check with a pharmacist if you are using other medications.

Do I need EC even though I am taking oral contraception, “The Pill”?

“The Pill” may not be effective if:

a pill is late or missed

EC may be required if you miss pills and sexual activity occurs without a condom being used. EC should particularly be considered when pills are missed in the first week of the cycle, ie the first 7 active hormone pills taken after the 7-day break on the inactive (sugar) pills.
vomiting occurs within 2 hours of taking a pill
you have severe diarrhoea
certain medications are taken

Detailed missed pill information is available at the end of this factsheet.

If you are concerned about any of the above situations and the need for EC,check with the pharmacist, your doctor or health professional as soon as possible.

What do I need to know about taking EC?

EC needs to be taken as soon as possible after unprotected sexual intercourse. It is available from:

pharmacies(without prescription)
sexual health and family planning clinics
other health care facilities such as a hospital's Emergency Department (this can be important in small country towns where there are no other services)

When attending a service for EC a few questions will be asked by the health care provider.

How is the EC pill used?

The EC pill is packaged in either a 1 or 2 tablet dose. The dose of hormones is the same in either packet and they are both equally effective.

EC pills are available from pharmacies and have several different names including Postinor, Levonelle or NorLevo. They all work the same but may vary in price. You can ask if a cheaper one is stocked.

If you are supplied with a 2 tablet pack, the 2 tablets may be taken at the same time.

What do I need to know about what happens after using use the EC pill?

Most women using the EC pill find that their period arrives within 7 days of the expected time frame. If you have not had a period within 2 weeks after using the EC pill it is important to have a pregnancy test.

If your next period is in any way unusual (lighter,heavier,shorter,longer) it is also important to check for pregnancy test.

The EC pill only provides protection against pregnancy on a 'once of'f' ' basis. If necessary,it is safe to take the EC pill more than once in a single menstrual cycle.However,using a relaible form of contraception is the best ongoing protection against unplanned pregnancy.

Taking the EC pill does not protect against sexually transmitted infections (STIs).

You may need to be tested for STIs following unprotected sexual intercourse.Chlamydia, the most common STI, can be tested by a simple urine test available at sexual health and FPQ clinics or your local doctor.

What about contraception afterwards?

This can be a good time to discuss your ongoing use of contraception or review your current method. A health professional at a FPQ clinic or your GP can discuss a method suitable for you. Information about all methods of contraception is available on the FPQ website, www.fpq.com.au.

Advance supply of EC pills can be made available. Discuss options with a health professional.

Where can I get an IUD for EC?

A copper IUD needs to be fitted by an experienced doctor and can be difficult to obtain in these circumstances. A copper IUD can be inserted within 5 days of unprotected sexual intercourse.

Contact FPQ for further information.

MISSED A PILL? HOW LATE ARE YOU?

Less than 24 hours?
That is, less than 48 hours since you took an' active' pill.

Example: You took Monday's Pill at 9am,forget your pill on Tuesday and it is now 7am on Wednesday.

Take the late pill now and further pills as usual. That’s all.
You are still protected from pregnancy.

More than 24 hours?
That is, more than 48 hours since you took an 'active' pill.

Example: You took Monday's Pill at 9am,forget your pill on Tuesday and it is now 11am on Wednesday.

Where in the pill cycle have you missed pill(s)?

Any of the first 7 active hormone pills after the week of 'inactive' pills?

Take the most recently missed pill now.

Take further pills as usual (even if this means 2 pills in a day).

You will not be protected from pregnancy until you’ve taken 7 active pills in a row. Use condoms or no sex until you have taken 7 consecutive' active' pills.

If you’ve had any sexual intercourse without using a condom in the last 5 days, Emergency Contraception is recommended.

Any of the middle 7 'active' hormone pills

Take the most recently missed pill now.

Take further pills as usual (even if this means 2 pills in a day).

You will not be protected from pregnancy until you’ve taken 7 'active' pills in a row.

Use condoms or no sex until you have taken 7 consecutive 'active' pills.

Last 7 days of hormone pills before the week of 'inactive' pills?

Take the most recently missed pill now.

Take further pills as usual (even if this means 2 pills in a day).

You will not be protected from pregnancy until you’ve taken 7 active pills in a row. Use condoms or no sex until after you have taken 7 consecutive 'active' pills.

AND skip 'inactive' pills in this pack. Go straight onto first hormone pills in next pack.

Any of the 'inactive' pills?

No precautions required.

You are still protected form pregnancy as long as you haven’t missed any 'active' hormone pills.

Note:

The above Missed Pill information does not apply to the pill called Qlaira®.

Follow the manufacturer’s instructions for missed pills if you are taking Qlaira®.

Disclaimer

Family Planning Queensland (FPQ) has taken every care to ensure that the information contained in this publication is accurate and up-to-date at the time of being published. As information and knowledge is constantly changing, readers are strongly advised to confirm that the information complies with present research, legislation and policy guidelines. FPQ accepts no responsibility for difficulties that may arise as a result of an individual acting on the advice and recommendations it contains.

Funded with assistance by Queensland Health