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Sexual and Reproductive Health

Emergency contraception

emergency-contraception-1.png  

What is emergency contraception?

Emergency contraception (EC) helps prevent pregnancy if you've had unprotected sex or you're not sure if you're protected from pregnancy. EC should be used as soon as possible after unprotected sex.​

Forms of EC
Emergency Contraceptive Pills (ECPs) Copper Intrauterine Device (IUD)
  • 2 types: levonorgestrel and ulipristal acetate
  • can be used up to 5 days (120 hours) after unprotected sex
  • reduces the risk of pregnancy by 50 to 90% depending on type of pill used and how soon it is used after unprotected sex​
  • a small, soft, T-shaped device with a copper wire wrapped around it
  • can be put into the uterus up to 7 days after unprotected sex
  • reduces the risk of pregnancy after unprotected sex by 99%

  • EC doesn't protect you from sexually transmitted infections (STIs) and HIV.
  • Repeat use of ECPs is safe, but should not replace regular birth control as they do not work as well and can have more side effects.
  • The Copper IUD is the most effective form of EC and can be used as ongoing birth control. ​

When is EC used?

You can use EC to help prevent pregnancy if:

  • no birth control was used
  • there was sex you didn't consent to (sexual assault)
  • withdrawal (pulling out) was used
  • a condom broke, leaked, slipped, or fell off
  • your method of birth control wasn't used the right way (like missed birth control pills, patch, ring, or injection)
  • mistimed fertility awareness (sex occurred during fertile period)

If you use hormonal birth control (like birth control pills, birth control patch, birth control ring, or birth control injection) and need help deciding if you need EC, use the Sex & U Stay On Schedule tool.

Talk to a pharmacist or health care provider if you have any health concerns, are breastfeeding, or taking medicine.

Do a pregnancy test if you don't get your period within 3 weeks of using EC or if your period is different than normal.​

How do I choose which type of EC to use?

Copper IUD Levonorgestrel ECP (like Plan B®, NorLevo®, Next Choice®, or Option 2®) Ulipristal Acetate ECP (like Ella®)
What it is
  • may prevent an egg and sperm from joining and may prevent a fertilized egg from attaching to the uterus
  • works as birth control for 3 to 10 years after it’s put in
  • sometimes called the “morning after pill”
  • delays an egg from being released
  • doesn’t provide ongoing protection from pregnancy
  • can be used more than 1 time in a menstrual cycle
  • delays an egg from being released
  • doesn’t provide ongoing protection from pregnancy
  • can be used more than 1 time in a menstrual cycle
How to get it
  • need a prescription
  • put in by a health care provider (call your clinic to see if this is offered)
  • don’t need a prescription
  • you can get it at most drugstores and sexual health clinics
  • need a prescription
How well it works
  • most effective form of EC
  • decreases pregnancy risk by 99% if put in within 7 days of unprotected sex
  • may not be recommended if you’ve had unprotected sex earlier in the same cycle as you may already be pregnant
  • can be used in case of missed hormonal contraception
  • is more effective the earlier it’s taken after unprotected sex
  • works best if taken within 24 hours after unprotected sex
  • how well it works decreases significantly after 72 hours
  • decreases pregnancy risk by 50 to 90%, depending when it’s taken
  • don’t take with ulipristal acetate ECP because it won’t work as well
  • should not be used if you’ve used hormonal contraception or levonorgestrel ECP in the last 7 days
  • more effective than levonorgestrel
  • decreases pregnancy risk by about 85%
  • has same effectiveness if taken up to 5 days after unprotected sex
  • don’t take with levonorgestrel ECP because it won’t work as well
Weight​
  • effective regardless of weight
  • may not work as well for people who weigh more than 165 lbs. (75 kg) or with a body mass index (BMI) that’s more than 25
Safe while breastfeeding
  • yes
  • yes
  • yes, breastmilk should be expressed and discarded for 24 hours. Discuss with your health care provider.

What do I need to know about ECPs?

  • Different types of ECPs should not be taken together—this means don't take them at the same time or within 7 days of each other. They will not work as well when taken together.
  • There's a greater chance of getting pregnant if you use ECPs and then keep having unprotected sex in the same menstrual cycle.
  • If unprotected sex has happened more than 1 time in 24 hours, you only need 1 dose of ECPs.
  • Think about keeping an extra pack of ECPs at home.
  • You can take ECPs more than once in a menstrual cycle.
  • No matter how much you weigh, ECPs may still protect you from pregnancy and should be taken if you can't have a copper IUD put in.
  • Do not take ECPs if you have a confirmed pregnancy because they won't work.
  • If you throw up within 2 hours of taking ECP, contact your health care provider as you may need to take another dose.​

Levonorgestrel ECP

Take 1.5 mg (the full dose of levonorgestrel) as soon as possible after unprotected sex.

Levonorgestrel ECP does not provide ongoing protection from pregnancy. After you take it:

  • keep using your regular form of birth control at the usual time
  • you can start a new cycle of hormonal birth control (like birth control pill, patch, ring, or injection) or have a birth control implant or hormonal IUD put in on the same day or the next day
  • it will take 7 days for your hormonal birth control to start working. It's best not to have sex during this time. However, if you do, use an extra method (like a condom) every time.​

Ulipristal acetate ECP

Take 30 mg (the full dose of ulipristal acetate) as soon as possible after unprotected sex. Ulipristal acetate ECP does not provide ongoing protection from pregnancy.

Do not start hormonal birth control right away—it may prevent ulipristal acetate from working.

  • you can start using your new or regular form of hormonal birth control (like birth control pill, patch, ring, injection, or progestin-only pill) or have a hormonal IUD or birth control implant put in 5 days after taking ulipristal acetate.
  • after you start the birth control pill, patch, ring, or injection it will take 7 days to start working. This means you are not protected from pregnancy and must use an extra method (like a condom) or abstinence for 12 days after taking ulipristal acetate.
  • if you are starting a progestin-only pill (POP) it will take 2 days to start working. This means you are not protected from pregnancy and must use an extra method (like a condom) or don't have vaginal sex for 7 days after taking ulipristal acetate.​

What are the side effects of ECPs?

You may have light bleeding or spotting for a few days. This is not your period. You might have a change in the timing of your next period and it might be early, on time, or late.

Other side effects may include:

  • upset stomach (nausea)
  • throwing up
  • pain in the abdomen
  • dizziness
  • headache
  • sore breasts
  • feeling more tired than normal

What else is important to know about consent, sexual activity, and birth control?

  • You have the right to decide to have sex or not. Talk with your partner or partners about consent.
  • There’s an 85% chance of becoming pregnant within one year, if no birth control is used for vaginal sex.
  • Use a condom or barrier every time you have sex (oral, vaginal, anal). Condoms help prevent pregnancy, STIs, and HIV.
  • You can lower your risk of HIV by taking an HIV prevention pill every day. Many Albertans can get it for free. Visit HIV PrEP to find out more.
  • Transgender and gender diverse people who have a uterus can use hormonal birth control. It can help prevent pregnancy and make periods lighter and less painful.

Where can I find more information?

If you have questions, need to find a sexual health clinic near you, or want more information, call Health Link at 811 anytime, day or night, to talk to a registered nurse.

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