The morning-after pill and other emergency contraceptives

This will depend on where you are in your cycle.

You’re not fertile every single day of your cycle. You’re only fertile for an average of 6 days each cycle, during your ovulatory phase—this is from about five days before ovulation until 24 hours after ovulation occurs. While an egg can only be fertilized by sperm for 12–24 hours after ovulation, sperm can survive in the cervix for up to five days after entering your body, potentially leading to a pregnancy.

This means that there are several days in your cycle during which, even if you have unprotected intercourse, you’re not at risk of getting pregnant.

Whether you need emergency contraception or not will depend on where you are in your cycle when you have intercourse.

The morning-after pill works by blocking or delaying ovulation. It stops the production of the LH hormone, which then prevents the egg from being released into the fallopian tubes. If ovulation does not occur, sperm can’t come in contact with an egg.

The morning-after pill is more effective in the pre-ovulatory part of your fertile window (before ovulation has occurred). If you ovulate before taking the pill, it’s significantly less likely to work. This is why it should be taken as quickly as possible after unprotected intercourse.

There are currently two types of morning-after pills on the market sold under different brand names:

• Levonorgestrel, which is a single-tablet, progestin-only pill (progestin is a form of synthetic progesterone). It’s the most commonly used, and it’s highly effective if taken up to 96 hours after sexual intercourse (the sooner you take it, the more effective it will be). In most countries, it’s available over-the-counter from a pharmacist without a prescription.
• Ulipristal acetate, also known as the anti-progestin pill, is considered the most effective type of emergency contraceptive pill. It can work if taken up to 120 hours after sex (again, the sooner, the better). It’s available by prescription in more than 50 countries.

Generally, there are no severe or long-term side effects from taking the emergency contraceptive pill, but it can cause:

• Fatigue
• Nausea
• Vomiting (if it occurs within 2 hours of taking the pill, talk to a healthcare provider, as you may need another dose)
• Breast pain
• Headache
• Mid-cycle bleedings
• Changes to your next period – it can be earlier, later, or more painful than usual
• Anovulatory cycles
• In some cases, the appearance of cysts has been reported.

Remember to talk to your medical practitioner if your symptoms don’t go away after a few days, if you experience very heavy bleeding, or if your next period is more than 7 days late, as it can be a sign of pregnancy.

The morning-after pill is not intended for regular use as a form of birth control. According to the World Health Organization, frequent use of emergency contraception can lead to increased side effects, such as menstrual irregularities.

Talk to a healthcare professional for advice on more appropriate and effective birth control methods for your needs.

Keep in mind that the morning-after pill does not provide continuous protection against pregnancy. If you have unprotected sex at any time after taking the pill (and you are in your fertile window), you can still become pregnant.

The intrauterine device (IUD) is a small, T-shaped plastic and copper device that is inserted into your uterus by a doctor or nurse.

Copper IUDs are the most effective form of emergency contraception. Unlike the morning-after pill, they can prevent pregnancy both before and after ovulation.

They work by either a) preventing sperm from fertilizing an egg or b) preventing a fertilized egg from implanting in the uterus. You can choose to leave the IUD in as an ongoing birth control method.

The IUD should not be inserted if there is a chance that you may already be pregnant. Side effects are rare but can include pain, spotting, infection, uterine damage, IUD expulsion through the vagina, and heavier, longer, or more painful periods if you continue to use it as your birth control method.

⚠️ Please note that hormonal IUDs, which differ from copper ones, do not work as emergency contraception ⚠️

Talk to your OBGYN or primary care provider for more information about your options and how to make emergency contraception as effective and safe as possible.

If you want to learn more about identifying the fertile window in your cycle, check my free webinar “Fertility Awareness Methods and how they can help me understand my cycle“.