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Morning After Pill: Pills To Prevent Pregnancy

Morning After Pill

The ‘Morning after Pill’ is frequently referred to as emergency contraception (EC). It is used to prevent pregnancy after unprotected sex. This pill prevents pregnancy by delaying the ovulation cycle and does not induce abortion. These pills are recommended to take sooner after sexual intercourse for better efficacy.

The 4 methods of emergency contraception include- ECPs with Ulipristal acetate (UPA), ECPs with Levonorgestrel (LNG), combined oral contraceptives, and copper-bearing intrauterine devices (IUD). 

Here we will describe how to get the morning-after pill for free.

How Does EC Work?

The ‘Morning after’ pill works by temporarily delaying or stopping egg release from the ovary. It might also prevent sperm from reaching the egg released from the ovary, thereby delaying ovulation. 

However, it should be noted that this pill doesn’t work against Sexually Transmitted Diseases (STDs) and also in cases when fertilisation has already taken place.

Are These Pills Effective?

Morning after pill contraceptive pill is most effective if taken within the first  72 hours (3 days) after having unprotected sex, it shows around 89% of effectiveness is plan B (Morning after pill) if you take within a day.  Pills can be taken up to 5 days after intercourse, but the sooner you take them after sex, the more effective. It is estimated to prevent 85% of pregnancies that would otherwise have occurred. Approximately 25% of women aged between 15 and 44, who currently use contraception, reported using the pill as their method of choice.

Examples Of Birth Control Pills

Most commercially oral contraceptives contain combinations of progestin and estrogen with varying doses in each brand. 

These pills come in a 28-pack, of which most drugs in each cycle are active, i.e., contain hormones, and the remaining drugs are inactive, i.e., they don’t contain hormones. Several combination pills include –

  • Monophasic contraceptive pills – are used in 1-month cycles and provide the same dose of estrogen and progestin. During the last week of the period cycle, you can take (or skip) the inactive pills and still have menses. These are more preferred over multiphasic contraceptive pills due to ease of use and the same hormonal levels. Additional benefits include –

⮚ Improves bone health and density

⮚ Risk related to uterine and ovarian cancer is reduced.

  • Multiphasic contraceptive pills – are used in 1-month cycles and provide varying levels of estrogen and progestin. You can take or skip the inactive pills during the last week of the cycle, and you still have menses.
  • Extended-cycle contraceptive pills – used in 13-week cycles. Active pills can be taken for 12 weeks, and during the last week of the cycle, you can take or skip the inactive pills and have your period. As a result, you have your period only three to four times per year.

Additional Advantage Include 

⮚ Prevention of excess bleeding due to uterine fibroid

⮚ Menstrual migraines are also prevented

⮚ Pain due to endometriosis is relieved

Monophasic Pills
Progestin Estrogen Brand Name
Desogestrel Ethinyl estradiol Apri, Desogen, Azurette
Levonorgestrel Ethinyl estradiol Aviane, Alesse, Levora
Norethindrone Ethinyl estradiol Brevicon, Nortrel, Ovcon
Drospirenone Ethinyl estradiol Ocella, Yasmin
Multiphasic Pills
Progestin Estrogen Brand Name
Norethindrone Ethinyl estradiol Aranelle, Estrostep, Tri-Sprintec
Desogestrel Ethinyl estradiol Cyclessa, Cesia
Levonorgestrel Ethinyl estradiol Enpresse, Trivora
Extended Cycle Oral Contraceptives
Progestin Estrogen Brand Name
Levonorgestrel Ethinyl estradiol Seasonale, Lybrel, Seasonale, Quasense

What Is The Most Well-known Contraception Pill?

Combination pills are well-known contraceptives of all.

  • Pills containing levonorgestrel and Ethinyl estradiol are considered a first-line treatment by doctors.
  • After consuming Norethindrone, people might experience androgenic side effects, such as excess hair growth and acne
  • According to the FDA, Drospirenone might increase the risk of blood clots.
  • Desogestrel may help reduce excess hair growth and acne better than other options.

How Much To Take?

For oral Emergency contraception, use-

Levonorgestrel 1.5 mg orally, as a single dose taken as soon as possible and within 96 hours (4 days) of unprotected sexual intercourse

or

Ulipristal 30 mg orally, as a single dose, taken as soon as possible and within 120 hours (5 days) of unprotected sexual intercourse.

Drug Interactions Of Birth Control Pills

Following drugs might reduce the effect of emergency contraceptives 

  • Antibiotics (cephalosporins, Rifampin, chloramphenicol, sulpha drugs)
  • Anticonvulsants (Phenytoin, barbiturates, carbamazepine, topiramate)
  • HIV drugs (Nelfinavir, Ritonavir)
  • Others (Benzodiazepines, Phenylbutazone, Griseofulvin) 

Yes, a Follow-up pregnancy test is recommended. 

  •  If the next cycle is more than 7 days late or is lighter than usual
  • 3 weeks after the last unprotected sex, if levonorgestrel or ulipristal has been used more than once in a menstrual cycle

 

Do we need a prescription for EC pills?
ECPs are readily available over the counter at most pharmacies without any prescription. Only one type of pill, i.e., ECP with Ulipristal acetate (ella®), is available by prescription.
Can I Use Emergency Contraception Pills More Than Once a Month?
ECPs with Ulipristal acetate (UPA) should be taken only once in your cycle. At the same time, you can use ECPs with Levonorgestrel (LNG) more than once.
Who can use these pills?
Any girl or woman who has attained the reproductive age might require emergency contraceptives to avoid unwanted pregnancy. 

How To Get The Morning After Pill Free Supply

There are a number of ways of getting the morning after pill for free (both Levonelle and ellaOne).

The free morning-after pill can be obtained:

  • On prescription, prescribed by a doctor or any other qualified prescriber e.g. nurse in most GP surgeries or via out of hours service
  • From NHS walk-in centres. Find centre.
  • Most sexual health or genitourinary medicine (GUM) clinics. Find sexual health clinic.
  • from Brooks centres: free emergency contraception service for under 25. Find Brooks centre.
  • From a pharmacy via NHS service

The morning after pill is free from the pharmacy

In some areas, it is possible to get the morning after pill from the pharmacy as a part of a local NHS service, without seeing GP.

With many pharmacies open late and easily accessible, getting the morning after pill for free from the pharmacy can be a good option. Patients need to note however that:

  • Not all pharmacies provide the morning-after pill for free
  • Those that do provide free emergency contraception service require a trained pharmacist to be present at the premises, therefore there may be times when free service may not be available
  • specifications for free emergency contraception service may differ depending on the location of the pharmacy. As part of this NHS service Levonelle (or ellaOne in some areas) may be offered to all patients aged 16+, and patients under 16 years of age (Fraser competent)

Finding your local pharmacy and contacting them directly to see if free service for the morning after pill is offered would be the best course of action.

Both Levonelle and ellaOne can be purchased from most pharmacies (including large chain pharmacies such as Boots, Lloyds and Tesco) after consultation with the pharmacist.

Levonelle is licensed from the age of 16, whereas ellaOne has no age restrictions.

To read more about emergency contraception visit the NHS website.

Conclusion

The ‘Morning after’ Pill prevents pregnancy after unprotected sex by delaying or stopping ovulation. This pill does not work if pregnancy has already occurred or in case of sexually transmitted diseases. This pill is safe to use and is more effective if taken sooner after sexual intercourse. It has no serious or long-term complications, and it doesn’t induce abortion. However, it is advised to consult a healthcare professional in case of any medical history.