What is it?

Emergency contraception may be used after having unprotected sex (see below: 'Who Needs It?'). As the name implies, it is meant to be used only in emergencies, as it is not an on-going or long-term method of contraception*.

The emergency contraceptive pill is a dose of female hormones. There are three methods but in Australia the 'progesterone only' method is mainly used.
A. The "progesterone only" method.
Two pills containing Levonorgestrel** are taken, which is similar to taking a large quantity of the mini-pill. The brand names currently on the market for progesterone only emergency contraception are Postinor -2 and Levonelle -2. this may change in the future.
B. The combined pill or Yuzpe method, containing oestrogen and progesterone. This has been available for decades and is a high dose of "the (combined) pill". It is not used very often now that the progesterone only method is available.
C. IUD insertion***
It is only used as emergency contraception in special circumstances because usually it is used as a long-term method of contraception. Also, it may not be suitable for some women.

Emergency contraception should be taken within 72 hours of unprotected intercourse (sex). However, it can be taken up to 120 hours after unprotected intercourse but it is probably less effective after 72 hours. It will not cover any pregnancy risk that may have occurred earlier in the menstrual cycle.

It does not provide any on-going contraception and no protection against sexually transmissible infections (STIs).

Who needs it?
If a woman has had vaginal sex with a man and:
· she has not used any contraception
· a diaphragm has dislodged
· a condom has broken or slipped off
· she has had inadequate cover on the pill, eg missed pills, or is taking antibiotics, without using extra protection
· 'withdrawal' is used as a 'method' of contraception (the man withdraws his penis before he ejaculates/cums inside the vagina)

Where do I get it?
Progesterone only emergency contraception is available over the counter from pharmacies without a prescription. Family Planning clinics, hospital casualty departments and some doctors still provide emergency contraception directly.

How does it work?
Emergency contraception mostly works to prevent or delay ovulation. It may also stop a fertilised egg from implanting (sticking) to the wall of the uterus.

How effective is hormonal Emergency Contraception?
It can be 95% effective in preventing a pregnancy if taken in the first 12 hours. After this, its ability to prevent a pregnancy decreases over time.

When to take hormonal Emergency Contraception?
The World Health Organisation recommends taking progesterone only emergency contraception:
As soon as possible. Progesterone only emergency contraception pills can be taken together**** or 12 hours apart, depending on the instructions from the provider.
It should be started within 120 hours of unprotected intercourse, but preferably as soon as possible.

What are the possible side effects?
· Some women may have spotting or bleeding within the first week of taking emergency contraception; most women will have their next period within 7 days of when it is usually due.
· If the combined pill is started after taking emergency contraception then a period may be delayed.
· Research suggests that emergency contraception will not harm a continuing pregnancy.
· Nausea and vomiting are uncommon with the progesterone only method. If the combined method is used, anti nausea tablets should be provided.
(If vomiting does occur within two hours of taking a dose of emergency contraception, the dose must be repeated. If no anti nausea tablet was taken with the first dose, it should be used with the repeat dose.)

What should be done next?
· After taking emergency contraception, you should think about what contraception you would like to use in the future to prevent an unplanned pregnancy. A discussion with your doctor or family planning practitioner will provide you with the information you need.
· It is important to have a pregnancy test and sexually transmissible infection screen at your doctor, or family planning clinic. Some STIs do not give women or men symptoms but can cause long term complications, e.g. infertility. This is why a screen for infections is important. Pregnancy testing should be performed about 3 weeks after taking the emergency contraception, especially if the next period is more than 7 days late, is in any way unusual or is associated with more pain than usual.
· The combined pill or mini pill can be used for contraception straight after hormonal emergency contraception.

* FPV information pamphlets on on-going and long-term contraception are also available.

** The brand name currently on the market for progesterone only emergency contraception is Postinor 2. this may change in the future but the method will still be the same.

*** See the IUD pamphlet for further information.

**** The recent WHO research suggests that it is just as effective taking the two pills at the same time.

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Last updated:20/02/2007
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