FPA Emergency contraception 09-06 - overdalepractice.com contraception.pdf · If you act...

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Helping you choose the method of contraception that is best for you

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Questions & AnswersDoes emergency contraception cause an abortion?...........3 Where can I get emergency contraception?.........................4 Method 1:The emergency contraceptive pill............5 What is the emergency pill?......................................................5 How do I take it?.........................................................................5 How does the emergency pill work?......................................5 How effective is the emergency pill?.......................................5 Who can use the emergency pill?............................................6 What are the side effects?.........................................................6 How will the emergency pill affect my next period?...........6Do I need to see a doctor or nurse after I’ve taken the pill?................................................................................6Can the emergency pill fail?....................................................7 What if I vomit within two hours of taking the pill?..............7 How will I know if the emergency pill has worked?..........7 Are there any risks if the emergency pill fails?....................8 Will the emergency pill protect me from pregnancyuntil my next period?..................................................................8Can I continue to use regular contraceptive pills or the patch after the emergency pill?.................................8How many times can I use the emergency pill?..................9Can someone else get the emergency pill for me?................9

EmergencycontraceptionIf you have had unprotected sex, that is, sexwithout using contraception, or when you thinkyour contraception might have failed, you can useemergency contraception.There are twomethods of emergency contraception:� hormonal emergency contraception (known as

the emergency contraceptive pill), and

� the copper IUD.The IUD is the most effective.

FPA Emergency contraception 09-06 11/9/06 16:58

If you act quickly, emergency contraception willusually prevent pregnancy.

Does emergency contraception causean abortion?No. Emergency contraception may stop ovulation,or fertilisation of an egg, or stop a fertilised eggfrom implanting in the womb. Medical researchand legal judgement are quite clear thatemergency contraception (the pill or an IUD)prevents pregnancy and is not abortion.Abortion can only take place after a fertilised egg

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How can I buy the emergency pill from a pharmacist?......9Can I get emergency pills in advance?.................................10Method 2: The copper IUD............................................10What is the copper IUD?........................................................10How does the IUD work?.......................................................11How effective is a copper IUD?.............................................11Who can use an IUD?..............................................................11What are the disadvantages of using an IUD for emergency contraception?......................................................11How is the IUD put in?...........................................................12How will I know that the IUD is still in place?..................12When will I get my next period?..........................................13Are there any risks if the emergency IUD fails?................13Do I need to see a doctor or nurse after the IUD is fitted?..............................................................................13Will the IUD protect me from pregnancy until my next period?...............................................................................14Where can I have the IUD removed?..................................14How do I find out about contraception services?............14Sexually transmitted infections..............................................15How fpa can help you..............................................................16A final word................................................................................16

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has implanted in the womb. People who believelife begins when the egg is fertilised may not wishto use the emergency contraception methodsoutlined in this leaflet.

Where can I get emergencycontraception?You can get the emergency pill and the emergencyIUD free from:� any general practice that provides

contraceptive services

� a contraception clinic

� any young person’s clinic or Brook clinic

� any sexual health clinic

� some genitourinary medicine (GUM) clinics.

You can also get the emergency pill free from:� most NHS walk-in centres (in England only)

� some pharmacies (there may be agerestrictions)

� most NHS minor injuries units

� some hospital accident and emergencydepartments (phone first to check).

You can buy the emergency pill from:� most pharmacies if you are 16-years-old or over

� some privately run clinics, such as bpas andMarie Stopes.

The price will vary but at the pharmacy it will costaround £26.

All the advice and treatment you receive isconfidential – wherever you receive it.

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Method 1:The emergencycontraceptive pillWhat is the emergency pill?The emergency contraceptive pill is a tabletcontaining progestogen, a hormone which is similarto the naturalprogesteronewomen producein their ovaries.

How do I take it?You will be given one pill to take. It should be takenwithin three days (72 hours) of having unprotectedsex. It is more effective the sooner it is taken.

How does the emergency pill work?The emergency pill is most likely to stop an eggbeing released (ovulation) or delay ovulation. Itmay also stop a fertilised egg settling in yourwomb (implanting).

How effective is the emergency pill?It is very effective and is more effective the soonerit is taken after sex. However, it is not as effectiveas using other methods of contraception regularlyand does not protect you against sexuallytransmitted infections.

Of the pregnancies that could be expected tohave occurred if no emergency contraception hadbeen used the emergency pill will prevent:� up to 95 per cent if taken within 24 hours

� up to 85 per cent if taken between 25–48 hours

� up to 58 per cent if taken between 49–72 hours.

If the emergency pill is taken after 72 hours it isnot known how effective it will be.

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Who can use the emergency pill?Most women can use the emergency pill.Thisincludes women who are breastfeeding and womenwho can’t use estrogens – the hormone that is usedin the combined pill and the contraceptive patch.However, if you are taking certain prescribedmedicines, or complementary medicines such as St John’s Wort, you will need special advice and the dose of the emergency pill may need to beincreased or you may need to use the copper IUD.

What are the side effects?� There are no serious short- or long-term effects

from using the emergency pill.

� Some women may feel sick, dizzy or tired,or may get headaches, breast tenderness or abdominal pain.

� A very small number of women will vomit.

� It can disrupt your periods (see page 6).

How will the emergency pill affect mynext period?� Your period is likely to either come on time or be

a few days early or late. For some women it canbe up to a week late or sometimes even longer.

� You may have some irregular bleeding betweentaking the emergency pill and your next period.This can range from spotting to being quite heavy.

Do I need to see a doctor or nurse afterI’ve taken the pill?Not usually, but do go and see a doctor or nurse if:� you think you may be pregnant

� your next period is more than seven days late

� your period is shorter or lighter than usual

� you have any sudden or unusual pain in yourlower abdomen.

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These could be signs of an ectopic pregnancy – apregnancy that occurs outside the womb, usually ina fallopian tube. Although this is not common, it isvery serious.

You should also see a doctor or nurse if:� you want to talk about using regular contraception

� you are worried that you might have caught a sexually transmitted infection.

Can the emergency pill fail?The emergency pill is very effective and should betaken as soon as possible after unprotected sex.However, in some women it fails and they becomepregnant even though the pill was taken correctly.

You may also become pregnant if you:� delay taking the emergency pill

� vomit within two hours of taking the pill

� have had unprotected sex at another time, eithersince your last period or since taking theemergency pill.

What if I vomit within two hours oftaking the pill?Speak to your doctor, nurse or pharmacist.Theymay give you another pill and a medicine to stopyou vomiting again, or suggest having a copper IUDfitted (see page 10). If you vomit later than twohours, don’t worry, the pill will have been absorbed.

How will I know if the emergency pill hasworked?If you have taken the pill correctly and your nextperiod seems normal, it is unlikely that you will bepregnant. After you have taken the emergency pill it is recommended that you do a pregnancy test to make sure you are not pregnant if:� you think you feel pregnant

� you have not had a normal period within three

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weeks of taking the emergency pill

� you do not have a bleed when you have theseven day break from using the contraceptivepatch or combined pill or when you take theplacebo tablets with ED combined pills.

A pregnancy test result will be accurate if the testis done from three weeks after the last time youhad unprotected sex.

Are there any risks if the emergency pillfails?The emergency pill has not been shown to affect a pregnancy or harm a developing baby. As withany pregnancy there is a small chance that anectopic pregnancy may occur. If you think that youmay be pregnant it is important to seek advice assoon as possible to check that you do not have anectopic pregnancy (see pages 6 and 7).

Will the emergency pill protect mefrom pregnancy until my next period?No.The emergency pill will not protect you frompregnancy if you have unprotected sex again. Seekadvice – you can use emergency contraception again.

Can I continue to use regularcontraceptive pills or the patch afterthe emergency pill?Yes. If you needed emergency contraceptionbecause you forgot some of your regular pills ordid not use the patch correctly, you should take a contraceptive pill again, or apply a new patchwithin 12 hours of taking the emergency pill.Youwill need to use an additional contraceptivemethod, such as condoms, for :� seven days with the patch and the combined pill

� two days with the progestogen-only pill.

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How many times can I use theemergency pill?You can take the emergency pill as many times as you need to and more than once in any onemenstrual cycle. It is not dangerous to do this butit may disrupt your periods. However, using theemergency pill is not as effective as using othermethods of contraception. Speak to the fpahelpline or your doctor, nurse or pharmacist for advice on contraception.

Can someone else get the emergencypill for me?You need to get the emergency pill from thedoctor, nurse or pharmacist yourself. Someone elsewill only be given it on your behalf in exceptionalcircumstances.

How can I buy the emergency pill froma pharmacist?If you are 16 or over, you can ask the pharmacistfor emergency contraception.The pharmacist willneed to ask you some questions as there are somecircumstances when they may not be able to sellyou the emergency pill.This may be the case if:� it has been more than 72 hours since you had

unprotected sex

� you have had unprotected sex more than oncein this menstrual cycle

� you think that you might already be pregnant

� you are taking certain prescribed orcomplementary medicines

� you have certain health conditions.

In these circumstances you will need to see a doctor or nurse.

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Can I get emergency pills in advance?Yes, if you are worried about your contraceptivemethod failing, you are going on holiday, or youcannot get emergency contraception easily. Askyour doctor or nurse about this.

Method 2:The copper IUDWhat is the copper IUD?An IUD is a small plastic and copper device that is put into your womb by a trained doctor or a nurse. It can be fitted up to five days afterunprotected sex at any time in the menstrual cycleprovided this is the only unprotected sex that hasoccurred since your last period.

If you have had unprotected sex more than oncesince your last period then an IUD can be fitted upto five days after the earliest time you could havereleased an egg (ovulation).

If the IUD cannot be fitted immediately you maybe advised to take the emergency pill in themeantime.

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How does the IUD work?It may stop an egg being fertilised or implanting in your womb.

How effective is a copper IUD?The IUD is the most effective method of emergencycontraception. It will prevent up to 99 per cent ofpregnancies expected to occur if no emergencycontraception had been used.

Who can use an IUD?Most women can use an IUD for emergencycontraception. An IUD may be suitable if:� you want to use the most effective method

of emergency contraception

� you do not want to, or cannot, take progestogen

� you want to use the IUD as an ongoing methodof contraception.

What are the disadvantages of using anIUD for emergency contraception?� It is not as easily available as the emergency pill.

� Not all women can use the IUD (for example,women who have certain problems with theircervix or womb).

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� There is a small chance of getting an infection in your womb within the first 20 days after theIUD is put in. If you have been at risk of gettinga sexually transmitted infection you may havescreening tests done at the time the IUD isfitted and you may also be given someantibiotics.This will help to reduce the chance of getting a pelvic infection.

� An IUD might go through (perforate) yourwomb or cervix when it is fitted.This may causepain, but often there are no symptoms. If thishappens, the IUD may need to be removed bysurgery. Perforation is uncommon when the IUDis fitted by an experienced doctor or nurse.

� The IUD can be pushed out by your womb(expulsion).

How is the IUD put in?The doctor or nurse will first examine you internallyto check the position and size of your womb.

Fitting an IUD takes about 15–20 minutes. It canbe uncomfortable or painful for some women, andyou might want to have a painkiller beforehand or a local anaesthetic.You may get a period-type painand some light bleeding fora few days after the IUDis fitted. Painkillerscan help with this.

How will I knowthat the IUD isstill in place?An IUD has one ortwo threads attachedto the end that hang alittle way down fromyour womb into thetop of your vagina.

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The doctor or nurse will teach you how to feel thethreads to make sure the IUD is still in place. It isvery unlikely that it will come out, but if you cannotfeel the threads, or if you think you can feel the IUDitself, you may not be protected against pregnancy.See your doctor or nurse straight away and use anextra contraceptive method, such as condoms.

When will I get my next period?Your next period should come at about the sametime as you would normally expect it. If you havenot had a normal period within three weeks ofhaving the IUD fitted it’s recommended that youdo a pregnancy test.

Are there any risks if the emergencyIUD fails?The emergency IUD is highly effective. However,if it does fail and you become pregnant there is a risk that the IUD can cause a miscarriage or thatan ectopic pregnancy may occur. If you know thatyou are pregnant or think that you might be, it isimportant to seek advice as soon as possible.

Do I need to see a doctor or nurse afterthe IUD is fitted?Yes. It is recommended that you see a doctor ornurse 3–4 weeks after the IUD is fitted, whetheror not you have had a period.This is to:� check you are not pregnant (if you have not

had a normal period)

� discuss any problems

� remove the IUD if this is what you want

� discuss your future contraception needs.

If you are ever worried about anything to do withyour IUD do contact your doctor or nurse assoon as you can.You should see your doctor ornurse straight away if you think you are pregnant

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or have any of the following:� a sudden or unusual pain in your lower abdomen

� a shorter, lighter or delayed period

� an unusual or smelly discharge from the vagina

� a high temperature.

These could be signs of an ectopic pregnancy or an infection, which can be serious.

Will the IUD protect me frompregnancy until my next period?Yes. As soon as it’s fitted it will protect you againstpregnancy and it will provide ongoing contraceptionuntil it is taken out. If you want to, you can carry onusing this method as your regular contraception.Youcan discuss this with your doctor or nurse.You willalso find more information in our leaflet Your guideto the IUD.

When can I have the IUD removed?If you do not want to keep the IUD as yourregular method of contraception, it can beremoved during your next period.

If removed at any other time you will need to use an additional contraceptive method, such ascondoms, for seven days before the IUD is takenout.This is because sperm can live inside yourbody for up to seven days and could fertilise anegg once the IUD is removed.

How do I find out about contraceptionservices?Contraception is free for women and men of allages through the National Health Service.� You can find out about all clinics from sexual

health direct, run by fpa on 0845 310 1334 or at www.fpa.org.uk

� You can find details of all services including

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general practices and pharmacies atwww.nhsdirect.nhs.uk. In England and Wales youcan call NHS Direct on 0845 46 47, in ScotlandNHS 24 on 08454 24 24 24 and in NorthernIreland you can call your local health board(details are in the phone directory or atwww.healthandcareni.co.uk).

� You can also get details of your nearestcontraception, genitourinary medicine (GUM) or sexual health clinic from a telephone directory,health centre, local pharmacy, hospital, midwife,health visitor or advice centre.

� You can get details of GUM or sexual healthclinics from the Sexual Health Line on 0800 567123 or at www.playingsafely.co.uk.

� You can find details of young people’s servicesfrom Brook on 0800 0185 023 or from Sexwiseon 0800 28 29 30, or at www.ruthinking.co.uk.

Sexually transmitted infectionsMost methods of contraception do not protect youfrom sexually transmitted infections.

Male and female condoms, when used correctlyand consistently, can help protect against sexuallytransmitted infections. Diaphragms and caps mayalso protect against some sexually transmittedinfections. If you can, avoid using condomscontaining Nonoxinol 9 (spermicidally lubricated),as this does not protect against HIV and may evenincrease the risk of infection.


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How fpa can help yousexual health direct is a nationwide service run byfpa. It provides:

� confidential information and advice on contraception,sexually transmitted infections, planning a pregnancy,pregnancy choices and sexual wellbeing

� details of family planning clinics, sexual health clinics andother sexual health services

� a wide range of leaflets on individual methods ofcontraception, common sexually transmitted infections,abortion and planning a pregnancy.

fpa helplines

Supported by the Department of Health. © fpa Registered charity number 250187.

UKhelpline 0845 310 13349am to 6pm Monday to Friday

Northern Irelandhelpline 028 90 325 4889am to 5pm Monday to Thursday, 9am to 4.30pm Friday

Scotlandhelpline 0141 576 50889am to 5pm Monday to Thursday, 9am to 4.30pm Friday

or visit fpa’s website www.fpa.org.uk

A final word

This leaflet can only give you basic information aboutemergency contraception.The information is based on theevidence and medical opinion available at the time thisleaflet was printed. Different people may give you differentadvice on certain points. All methods of contraception comewith a Patient Information Leaflet which provides detailedinformation about the method.

Remember – contact your doctor, practice nurse or a familyplanning clinic if you are worried or unsure about anything.


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