Alternative to taking the pill

A mechanical method of post-coital contraception is the insertion of a copper coil (intrauterine device). This can be used up to 5 days after sexual intercourse or in case of contraindications to the morning-after pill. The reliability is >95%. As a foreign body in the uterus, the coil causes an inflammatory reaction of the mucous membrane, which prevents the implantation of a fertilized egg. In addition, the released copper ions cause a decrease in sperm motility.

Preparations

Levonorgestrel It must be taken no later than 72 hours after sexual intercourse (according to the drug approval). The best effects are seen within the first 24 hours or between 24-48 hours after. The morning-after pill can be one tablet of 1.5g levonorgestrel, or two tablets of 0.75g each, taken at 12-hour intervals.

Ulipristal = The longer after pill Ulipristal (trade name: ellaone) has only been on the market since mid-2009 and is approved for use up to 120h, i.e. 5 days after sexual intercourse. A single dose of 30mg Ulipristal is taken. Studies show similar results as the conventional morning-after pill.

Breastfeeding

Levonorgestrel (the morning-after pill) can be taken during breastfeeding because the transition to breast milk is very slight. However, it is recommended that the tablet be taken immediately after breastfeeding, so that the interval until the next breastfeeding is about 6 hours. There is no information yet on the compatibility of Ulipristal (morning after pill) with breast milk, so that it is recommended to stop breastfeeding for 36 hours.

Combination with the contraceptive pill

To be sure that it has worked, a pregnancy test should be taken about four weeks after using the morning after pill. If you experience vomiting or diarrhea after taking the emergency contraceptive pill, you should consult your gynecologist again, as you may need to take the emergency contraceptive pill again.

Interactions

Antibiotics, St. John’s wort, drugs that cause the pH value of the stomach to rise (= proton pump inhibitors), antispasmodic drugs, the HIV drug ritonavir (AIDS) and diseases of the intestines that make it difficult to absorb nutrients (= malabsorption disorder, e.g. in Crohn’s disease) reduce the effectiveness of the morning-after pill.