Spotlight On: Emergency Contraception…The Morning After Pill and Copper Coil

Contraception and its many different forms are a talking point for women across the country. With so many different types on the market, coupled with the fact that every woman’s body is different, we take a closer look at all the options that are available to you.  Last week, we explained all the basic facts that you need to know about the male and female condoms including how they work and how effective they are. Now, we will take a look at emergency contraception - the Morning After Pill and the Copper Coil. __________________________________________________ Ooops…. Although we are now all very well-informed about contraception, accidents do happen, condoms can tear, pills can be forgotten.  A recent study in Ireland in 2010 showed that a whopping 21% of women have had sex without contraception. What are the chances of me getting pregnant? Any time you have sex without using contraception, there is a chance that you might become pregnant.  Depending on when you ovulate, this risk could be as high as 30%.  At other times of the cycle it is lower, but, as we never know when we are going to ovulate, it is always better to be safe than sorry! Ok, I don’t want to hear the patter of tiny feet just yet, what can I do? At the moment in Ireland there are three options for emergency contraception: there are two types of hormonal tablets and also a copper coil can be fitted as an emergency contraceptive. Ah the Morning-After Pill! I've heard of that… There are two types of “morning-after pills” or hormonal emergency contraceptive tablets on the Irish market today.  Your doctor or pharmacist will advise you on which one is best suited to your needs.  The most commonly used of these tablets contains a hormone called Levonorgestrel (such as Levonelle or Norlevo),  the other type contains Ulipristal Acetate (brand name Ella One). There are lots of differences between the two tablets but the main difference is that Levonorgestrel has to be taken within 72 hours of the unprotected sex, and Ulipristal has to be taken within 120 hours of unprotected sex.  Be aware that Ulipristal is more expensive than Levonorgestrel. How effective is the Morning-After Pill? With both types of pill, the sooner you take the pill after sex the more effective they will be. Overall, Levonorgestrel is 95% effective if taken within 24 hours, but this drops to 85% if taken between 24-48 hours, and drops further after 48 hours. Ulipristal has been shown to be as effective as Levonorgestrel at preventing unwanted pregnancy.  However some studies have shown that, if a woman takes it more than 24 hours after unprotected sex, Ulipristal may be more effective than Levonorgestrel. How does the Morning-After Pill work? It's not known exactly how Levonorgestrel works, but it may stop you from ovulating (releasing an egg).  Ulipristal works in a number of ways to stop you from ovulating and it will also stop the lining of the womb from building up and may induce you to have a period. How do I take the Morning-After Pill? Each type of morning-after pill is just one tablet, this should be taken as soon as possible after unprotected sex.  Take it with a glass of water.  If you vomit within three hours of taking it, inform your doctor or pharmacist as you may need to take it again.  If you are on the pill or other type of contraception, talk to your doctor or pharmacist and they will advise you on how to continue taking your contraception safely.  Ulipristal may make your Pill less effective for the remainder of the pack, so you may be told to use additional contraception until your next period. What are the side effects? Side effects are not common, but both types of pill can make you feel nauseous, dizzy or tired. They may also give you a headache or pain in your abdomen.   Your breasts may feel tender. After taking the pill, your period may arrive earlier or later than normal. If you become pregnant despite taking the morning-after pill, there is a higher chance that the pregnancy could occur outside the womb (this is an ectopic pregnancy). Who can take it? Most women can use Levonorgestrel including those who cannot usually use other hormonal contraception, but it will only be given to you if you are within 72 hours of unprotected sex.  Some medications such as tablets for epilepsy may interfere with how effective Levonorgestrel is.  Ulipristal is not suitable if you are breastfeeding, if you are on certain medications, or if this is not your first episode of unprotected sex this month. How do I get the Morning-After pill? The Levonorgestrel morning-after pill is now available nationwide across the counter without prescription. Most pharmacies will provide you with a consultation with the pharmacists to ensure you understand all that is involved with taking the pill.  If you have a medical card, you should attend your GP for a prescription. The Ulipristal pill is only available on prescription in Ireland at present. Is it true you can only take the Morning-After pill three times in your life?  Is it a chemical abortion?  Will it make you infertile? The answer to all of these questions is NO!  The morning-after pill can be taken as often as needed, but, bear in mind, there is a 5% failure rate, so it is better to be on a form of regular contraception with a lower failure rate.  It is not a chemical abortion, as the pill does not interfere with an established pregnancy, but rather prevents the pregnancy from taking place.  It will not make you infertile, however, if you acquire a sexually transmitted infection from unprotected sex this could affect your fertility - nothing to do with the morning-after pill though. Pregnancy is not in the plan right now; so what is the most effective form of emergency contraception? The copper coil is the most effective form. It can be inserted as an emergency contraceptive.  This is effective up to 120 hours after unprotected sex or up to five days after ovulation.  This is the most effective form of emergency contraceptive and is almost 100% effective.  Some types of copper coils can be left in for ongoing contraception.  This procedure may be uncomfortable, and is not offered by all GP surgeries in Ireland.  However, if you would like to have this procedure performed, talk to your GP who will either perform the procedure or will be able to refer you to have it done.