Emergency contraception is also called post-coital contraception. It is a way of preventing pregnancy after unprotected sex, or when other contraception has failed, e.g. due a failed condom.
It is not intended for use as a regular method of preventing pregnancy.
There are two main types of emergency contraception:
- the emergency contraceptive pill (ECP), which is available as levonorgestrel tablets (e.g. Levonelle-1) and ulipristal (EllaOne)
- the copper intrauterine contraceptive device (IUD)
You have up to 72 hours after unprotected sex to take the levonorgestrel (e.g. Levonelle-1) and up to 5 days (120 hours) to take the ulipristal tablet (EllaOne).
You have up to five days after ovulation to have an IUD fitted.
The ECP is most effective at preventing pregnancy (95% effective) if taken within 24 hours of unprotected sex. Within 25 to 48 hours, the effectiveness falls to 85%, and within 49 to 72 hours it is only 58% effective.
A copper IUD inserted within five days of unprotected sexual intercourse has almost 100% effectiveness.
You can use emergency contraception
- if you have had unprotected sex on any day of your monthly cycle
- if a barrier method, such as a condom, diaphragm or cervical cap, was used incorrectly or became dislodged
- if your IUD came out, either partially or completely
If you missed taking your regular contraceptive pill
- if you missed a dose of your regular oral contraceptive pill, or took it late, the action you should take depends on the type of pill you use. It also depends on how late you are in taking the pills, or how many you missed.
- check the product information for your pill or ask your pharmacist or other health professional for advice. You may need to use additional protection, such as a condom, for a while. You may also need to consider using emergency contraception if you have had unprotected sex in the previous seven days.
Intrauterine contraceptive device
This device is inserted through the cervix and into the uterus (womb). It works by preventing fertilised eggs from attaching to the womb lining. It can be fitted by your doctor or at a Family Planning Clinic.
Emergency contraceptive pill
The ECP can prevent pregnancy by delaying ovulation, stopping sperm from fertilising an egg already released, or preventing a fertilised egg from becoming attached to the womb lining.
It does not have any effect on a fertilised egg that has already become attached to the womb lining, and cannot interrupt an established pregnancy.
A levonorgestrel tablet (Levonelle-1, Levonorgestrel-1, NorLevo-1, Postella-1, Postinor-1 or Postrelle-1) is taken within 72 hours, preferably within 12 hours, of unprotected sexual intercourse. Depending on the brand of tablet, you may need to take a single dose of levonorgestrel as soon as possible after unprotected sex; or one dose as soon as possible and a second dose exactly 12 hours later – check with your pharmacist about dosing.
Ulipristal acetate (EllaOne) must be taken within 120 hours (preferably within 24 hours) of unprotected intercourse.
[DOCTOR OR FAMILY PLANNING CLINIC ONLY]
A copper IUD needs to be inserted and removed by a trained doctor or nurse.
How can you get the ECP?
The levonorgestrel ECP and ulipristal ECP can be sold by pharmacists; you do not need a prescription. Pharmacists will take you to a private area where you can talk about the ECP.
The ECP can also be obtained from family doctors and family planning or sexual health clinics.
Who can get the ECP?
The ECP may be sold to any woman over the age of 16.
Supply under the age of 16 is at the discretion of the pharmacist and should comply with relevant jurisdictional legislation.
The pharmacist is required to record the supply of the ECP. Every pharmacy is different in how your personal information is documented.
The pharmacist will refer you to your doctor or a family planning clinic in some situations, such as if you:
- are pregnant or think you might be
- have a period that is more than five days late, is unusually light or heavy, or is painful
- are at risk of contracting a sexually transmitted infection
- need to consider long-term contraception
- are taking medication that can reduce effectiveness of the ECP
- are an adolescent
- have an allergy to medications or the oral contraceptive pill
- have other symptoms like pain or bleeding
- the ECP sometimes causes nausea and vomiting
- if you vomit within 3 hours of taking the ulipristal ECP and 2 hours of taking the levonorgestrel ECP, you should see your pharmacist, doctor or Family Planning Clinic for advice and further tablets
- other possible side effects include tender breasts, headaches, lower abdominal pain, dizziness and fatigue
- your next period may be later or earlier than usual, or there may be spotting or irregular bleeding before your period occurs
- the ECP does not protect against pregnancy if you have more unprotected sex after taking the ECP
- the ECP does not protect against sexually transmitted infections
- the ECP can be used at any time during your menstrual cycle, and can be used more than once in the same cycle; however, it is not an appropriate method for regular contraception
- if you are breastfeeding it is recommended that you bottle feed your infant for the following 3 to 7 days, especially with the ulipristal tablet and depending on the brand of ECP used and your pharmacist’s advice. It is important to still express your milk
- it is also recommended to take a pregnancy test 3 weeks after having the pill and to consult a doctor during this time
- the ECP is not 100% effective and if your next period is more than 5 days late you should carry out a pregnancy test
- using the ulipristal ECP with regular hormonal contraception could reduce the effectiveness of both contraceptives – ask your doctor or pharmacist how long you should wait after taking the ulipristal before taking any regular hormonal contraception. During this time you should use barrier methods of contraception
- do not use ulipristal and levonorgestrel tablets together