Emergency Contraception

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

What is emergency contraception?

There are 2 types of emergency contraception available in Australia.

Emergency contraception pill

This pill is the most commonly used form of emergency contraception. It contains a dose of the hormone progestogen and is taken after sexual intercourse to reduce the risk of pregnancy. It is most effective if taken within 24 hours of unprotected sex, but can be used for up to 5 days after sexual intercourse.
Copper intrauterine contraceptive device (IUD)

An IUD can be used as emergency contraception if inserted within 5 days of unprotected sexual intercourse.

How does emergency contraception work?

It works by:

delaying or preventing ovulation (the release of an ovum (egg) from the ovary)
changing the lining of the uterus (womb) to prevent implantation of the fertilised ovum

How effective is emergency contraception?

If taken correctly, ie in the first 24 hours after unprotected sexual intercourse, the emergency contraception pill is 85%-90% effective. It may be used up to 5 days (120 hours) after intercourse, but the effectiveness decreases the longer you leave it. After 5 days the effectiveness decreases to 60%.

An IUD as emergency contraception is 98% effective in preventing a pregnancy.

What are the advantages of the emergency contraception?

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
the emergency contraception pill is available from most pharmacists without a prescription

What are the disadvantages of the emergency contraception pill?

provides protection against pregnancy for only one act of sexual intercourse – other forms of contraception are required in preventing pregnancy where ongoing sexual activity is occurring
some pharmacists do not supply the emergency contraception pill – in particular, there may be difficulties in some locations for young people requesting the emergency contraception pill
cost – the package costs between $25 - $45 from a pharmacist
needs to be taken as soon as possible after sexual intercourse

What are the possible side effects of the emergency contraceptive pill?

Side effects are rare but occasionally women report:

nausea and some women experience vomiting
breast tenderness, headaches and dizziness
a delay in the arrival of the next period, or the period may occur early

Is the emergency contraception pill suitable for all women?

The emergency contraception 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 emergency pills are effective. Check with a pharmacist if you are using other medication.

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

“The Pill” may not be effective if:

a pill is late or missed

Emergency contraception may be required if you miss pills and sexual activity occurs without a condom being used. Emergency contraception should particularly be considered when pills are missed in the first week of the cycle, ie, the first 7 hormone pills taken after the 7-day break on the sugar pills.
vomiting occurs within 2-3 hours of taking a pill
you have severe diarrhoea
certain medications are taken

If you are 24 hours or more late for any pills seek further advice as soon as possible, particularly if you think you may need emergency contraception. Missed pill information is available in the Family Planning Queensland (FPQ) factsheet, Combined Oral Contraceptive Pill (The Pill).

If you are concerned about any of the above situations, check with your doctor or health professional.

What do I need to know about taking emergency contraception?

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

pharmacies
sexual health and family planning clinics
other health care facilities such as a hospital’s Accident & Emergency Department (this can be important in small country towns where there are no other services)

When attending a service for emergency contraception a few questions will be asked by the health care provider about whether any other medications are being used and to check that you are not pregnant already.

How is the emergency contraception pill used?

The emergency contraception 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.

Emergency contraception 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 emergency contraception pill?

More than half the number of women using the emergency contraception pill find that their next period arrives more or less at the time expected. However it is possible that it may arrive earlier or occasionally be delayed. If you have not had a period within 2-3 weeks after using the emergency contraception pill it is important to have a pregnancy test.

The emergency contraception pill only provides protection against pregnancy on a ‘once off’ basis. If unprotected intercourse does occur again during a menstrual cycle, it can, if necessary, be taken more than once. However for future instances where protection from pregnancy is required, the use of condoms, or another form of contraception, is highly recommended.

Taking the emergency contraceptive pill does not provide any protection from sexually transmitted infections (STIs). You may need to consider making an appointment for screening for STIs after taking the emergency contraceptive pill. 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 will be able to discuss a method suitable for you. Information about all methods of contraception is available on the FPQ website www.fpq.com.au.

Where can I get an IUD for emergency contraception?

An IUD needs to be fitted by an experienced doctor and can be difficult to obtain in these circumstances. An IUD can be inserted within five days of unprotected 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.

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.

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

Any of the first 7 active hormone pills after the week of inactive (sugar) 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 unprotected sex in the last 5 days, Emergency Contraception is recommended.

Any of the middle 7 active hormone pills

Last 7 days of hormone pills before the week of inactive (sugar) 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. AND skip inactive (sugar) pills in this pack. Go straight onto first hormone pills in next pack.

Any of the inactive (sugar) pills?

No precautions required. You are still protected form pregnancy as long as you haven’t missed any active hormone pills.

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