Emergency contraception at a glance

At present there are two methods and three forms of emergency

contraception; the copper coil IUD, ellaOne pill and Levonelle pill. All have
advantages and disadvantages. The best form in terms of percentage of
pregnancies prevented is the copper intrauterine device.

An emergency IUD can be fitted up to five days (120 hours) after unprotected
sex or within five days of ovulation (in a 28 days cycle up to day 19)
whichever comes later. Patients should be warned that they may get some
light bleeding and period type pain following insertion. There is a small risk of
uterine perforation as well as a risk of infection. The women should get her
next period as expected following insertion of the IUD.
All women should see the GP after 3-4 weeks following insertion of the IUD to
check that they are not pregnant and to discuss long term contraceptives.
The IUD can of course be used as the LARC and would therefore protect the
women against future pregnancies for the next five years.

The Levonelle has been around longer than the ellaOne. It is a pill containing
progesterone thatch be used up to 72 hours post unprotected sexual
intercourse. There can be some spotting or irregular bleeding from taking the
levonelle and the women's next period. The period may it self come a little
early or late. Levonelle is less effective than IUD, it can fail however the
safety profile in terms of effect on a fetus is better known than the ellaOne. It
does not protect the women from future pregnancies and if the women has
unprotected sex again she would need a further dose of Levonelle. In terms
of additional contraceptive women should be asked to take their regular
contraceptive pill (i.e. COCP) within 12 hours of taking Levonelle and to use
additional contraception for 9 days (two days for POP). Levonelle can be
bought over the counter in the pharmacy.

EllaOne is a tablet that contains ulipristal acetate which is selective

progesterone receptor modulator that delays or inhibits ovulation. It is
effective for 120 hours post unprotected sex. Its use is cautioned in patients
who have liver disease or severe asthma (women should also be told to avoid
breastfeeding for up to 36 hours post pill ingestion). Side effects include
period pain, mood swings and muscle and back pain. It is not effective if the
women vomits with THREE hours of ingestion of the tablet. Unlike the
Levonelle if the women has further unprotected sex during cycle then they
can NOT HAVE A FURTHER dose of ellaOne (or have it in a cycle where
Levonelle has been taken) so the only option remaining to the women would
be the IUD.
EllaOne has to be prescribed and is NOT available over the counter.
In terms of the regular contraception the women should be advised that they
should take their regular form of contraception within 12 hours of taking the
ellaOne. Additional contraception should be used for 14 days with the COCP
(16 days for Qlaira) or for 9 days with the POP.

Women who take the Levonelle or the ellaOne should see the GP for a
pregnancy txt of their period is more than seven days late, is shorter or
lighter than usual, or they have acute lower abdominal pain.