Emergency Contraception

What is emergency contraception?

Emergency contraception (EC) is used to reduce the risk of pregnancy after unprotected sex.
There are 3 kinds of emergency contraception available in Australia:

• insertion of a copper intra-uterine device (IUD) within 120 hours (5 days) of unprotected sex, which also provides very effective longterm contraception
• a 30mg single dose ulipristal acetate emergency contraceptive pill (UPA-ECP) licensed for use up to 120 hours (five days) after unprotected sex
• a 1.5mg single dose levonorgestrel emergency contraceptive pill (LNG-ECP), licensed for use up to 72 hours (three days) after unprotected sex

How does it work?

The copper IUD works by affecting sperm movement, preventing fertilisation of the egg and may also prevent implantation of a fertilised egg.
Both types of emergency contraceptive pill (ECP) work by stopping or delaying the release of an egg by the ovary (ovulation). The ECP is sometimes called the morning-after pill, but this is incorrect. Although it’s more effective the sooner it’s taken, it can be taken up to five days after unprotected sex.

ECPs do not prevent implantation of a fertilised egg.

If the ECP is accidentally taken during pregnancy it does not cause harm to the developing embryo or foetus.

The ECP does not cause an abortion.

Why would I need emergency contraception?

You could use EC if there was a risk of unintended pregnancy.

This would include:

• unprotected sex
• sexual assault
• contraceptive failure (e.g. the condom breaks or you are on the Pill and have missed more than one pill)

If you are not sure whether you are at risk of pregnancy phone SHINE SA’s Sexual Healthline or talk to your local pharmacist, doctor or SHINE SA.

How effective is it?

The copper IUD is the most effective form of EC. It is more than 99% effective if used within 120 hours of unprotected sex. Contact SHINE SA or see your doctor for more information.

The ECP should be taken as soon as possible and is most effective if taken within 24 hours of unprotected sex.

UPA-ECP is more effective than LNG-ECP and can be taken up to 120 hours after unprotected sex.

LNG-ECP is most effective if taken within 72 hours of unprotected sex but may still have some effect up to 96 hours, if there is no alternative EC available. Some pharmacists may not supply the LNG-ECP if you had unprotected sex over 72 hours ago as this is against the recommendations in the product information and you may need a prescription from a doctor.

How do I get emergency contraception?

The copper IUD can be inserted at SHINE SA, by gynaecologists and some GPs. You may need an appointment before the insertion.

The ECP is available over the counter at pharmacies. You can also get it at SHINE SA clinics, Adelaide Sexual Health Centre, Pregnancy Advisory Centre and many public hospital emergency departments.

Your GP can also provide you with a prescription for ECP if you don’t feel comfortable talking to a pharmacist. You can ask your GP to provide a script to have ready in case you need to use it in the future. Your GP may also provide a sexual health check.

What does it cost?

Prices vary. The cost depends on where you get it and the type of EC.

How do I take the ECP?

Take the tablet as soon as possible. If vomiting occurs less than 3 hours after taking either ECP another dose should be taken.

Since some medications, including certain anti-epileptic medications, can reduce the effectiveness of the ECP. Be sure to discuss any medications you are taking with the pharmacist or doctor.

Non-prescription medications such as St John’s Wort can also affect the ECP.

What are the possible side effects?

The ECP can occasionally cause nausea, breast pain, headaches and spot bleeding. Side effects usually stop within two days. If you are worried about any side effects, see a doctor.

Taking the ECP will not affect a pregnancy or harm a developing foetus.

When will I have my next period?

For most people the next period will come at the normal time. For some people their periods may be early and for others their period may be up to a week late.

Do I need a pregnancy test?

If your period is more than a week late or light or unusual in any way you should have a pregnancy test.

Also, if you start a new form of contraception which may alter your period you should have a pregnancy test in 4 weeks.

If you have any other concerns or would like to discuss ongoing contraception you should see your doctor or contact SHINE SA’s Sexual Healthline for advice.

Who can take the ECP?

Almost anyone can take ECP, but it is important for the pharmacist or doctor to know if you have any allergies or serious medical conditions.

Can I take the ECP more than once?

You can take the ECP more than once per cycle. If you have further unprotected sex you should take the ECP again as the previous dose is not effective. If you need to use the ECP more than once per cycle you should use the same type of ECP taken in the current cycle, as switching between LNG-ECP and UPA-ECP in the same cycle can reduce the effectiveness of both.

Do I need to start contraception?

ECPs do not provide ongoing contraception and only delay ovulation. It is important to keep using other contraception such as condoms for the rest of the cycle until the next period in case of ovulation after taking the ECP.
Taking the ECP does not reduce the risk of pregnancy if you have further unprotected sex, so it’s a good idea to consider ongoing contraception.

You can contact SHINE SA or your doctor to discuss your options.

Can I continue my current contraception?

It is not recommended to take a progestogen-containing method of contraception within 5 days of UPA-ECP as it may reduce the effectiveness of the UPA. This includes all oral contraceptive pills, vaginal ring, contraceptive implant and injection.

With LNG-ECP, it is possible to continue your hormonal method of contraception immediately after taking it. You can contact SHINE SA or your doctor to discuss your options.

Is it safe to take emergency contraception when breastfeeding?

It’s safe to use the LNG-ECP and UPA-ECP while breastfeeding. Some guidelines recommended discarding breast milk for 7 days with UPA.

Where on balance UPA-ECP is considered the best option, breastfeeding can be continued uninterrupted, as the risk to the infant is low. For those wishing to avoid the highest infant exposure breast milk can be expressed and discarded for 24 hours after taking UPA EC.