Emergency Contraceptive Pill: What It Is, When, and How to Use It

The emergency contraceptive pill, named for its use the day after sexual intercourse, is one of the methods of emergency contraception.

In this article, you will find answers to frequently asked questions by female patients, such as "What is the emergency contraceptive pill and how does it work?", "Where can I obtain the emergency contraceptive pill?", and "What should I be aware of when using the emergency contraceptive pill?"

What is the Morning-After Pill?

The morning-after pill is an emergency contraceptive available without a prescription at pharmacies. It typically comes in a single-use package and contains active ingredients such as ulipristal acetate and levonorgestrel. This pill is a convenient option often used when unprotected sexual intercourse occurs or when contraceptive measures fail during intercourse. For example, it is commonly the first choice in cases like condom breakage, condom slippage, displacement of an intrauterine device (IUD), or forgetting to take birth control pills.

What is the Purpose of the Morning-After Pill?

Its purpose is to prevent unplanned pregnancy by providing emergency protection immediately after intercourse. This helps prevent unplanned pregnancies that could result from accidents during intercourse or unprotected sex. Additionally, emergency contraception can avert potential adverse outcomes related to unplanned pregnancies. The morning-after pill is among the most preferred emergency protection methods, typically used as a single dose. It works by affecting ovulation or implantation in women. Due to its over-the-counter availability and easy access at pharmacies, it is a widely chosen option for emergency contraception.

How Does the Morning-After Pill Provide Protection?

Understanding the mechanism and usage of these medications is essential for proper use. The most common emergency contraceptive on the market, which contains the active ingredient ulipristal acetate, works by affecting the binding of the hormone progesterone. Depending on the timing of use, it may impact estrogen levels, reduce endometrial thickness, and delay ovulation. This prevents the fertilized egg from attaching to the endometrium, the release of an egg for fertilization into the fallopian tube, or the movement of sperm towards the egg.

How is the Morning-After Pill Used?

The variety of these medications may vary by country, and thus their mechanisms of action may differ depending on the active ingredients. However, the common feature of all these medications is that, when taken early, they prevent unwanted pregnancies through different mechanisms. In Turkey, the most frequently used emergency contraception method is the single-dose pill containing ulipristal acetate. Some medications may recommend intermittent use in two doses.

When Should the Morning-After Pill Be Used?

One of the biggest misconceptions about the morning-after pill is the belief that it should be taken one day after unprotected intercourse. However, these pills are most effective when taken immediately after intercourse, or as soon as possible. According to available data, they can prevent pregnancy if taken within the first 72 hours, but taking them at the earliest opportunity significantly reduces the chance of pregnancy. The usage method may vary depending on the active ingredients. Generally, it is offered as a single pill in a box, branded on both sides of the blister pack. In some cases, two doses may be recommended, where two pills taken at intervals provide emergency contraception.

How Long is the Morning-After Pill Effective?

Vomiting, one of the side effects of these pills, can negatively impact patients. Anti-nausea medications, or antiemetics, should not be taken with the pill, as vomiting can reduce its effectiveness and additional emergency contraception may be needed. Vomiting within three hours of taking the pill, in particular, may require an additional dose. The morning-after pill is taken as soon as possible after intercourse to prevent pregnancy. Depending on the phase of the menstrual cycle, it can prevent fertilization or the implantation of a fertilized egg by hormonal or structural means. For this reason, it is difficult to determine the exact duration of effectiveness, but it should be taken within three days after intercourse.

What Are the Side Effects of the Morning-After Pill?

After taking the morning-after pill, common or rare side effects may occur. Bleeding between periods and delays in the menstrual cycle can cause concern about the possibility of pregnancy or failure of the contraception. Morning-after pills directly affect ovulation timing, potentially altering the menstrual cycle. Due to changes in the uterine lining to prevent implantation, spotting or light bleeding is normal. This bleeding, which lasts a few days, is unrelated to implantation bleeding or menstrual bleeding. Light spotting is an expected effect, and it may help to read the pill’s information leaflet to be prepared for potential side effects. Notable side effects include:

• Headache
• Nausea
• Vomiting
• Painful periods
• Cramps
• Menstrual sensitivity
• Fatigue
• Abdominal pain
• Mood changes
• Acne
• Tiredness
• Breast tenderness
• Bleeding between periods
• Delayed periods by a few days

These are common and expected side effects. The main purpose of the morning-after pill is to prevent pregnancy before it occurs or to prevent a fertilized egg from attaching to the uterus. However, it should be noted that these pills do not prevent an established pregnancy and are not used for induced abortion. Therefore, if a pregnancy is confirmed, their use is ineffective. Additionally, morning-after pills taken after unprotected intercourse do not provide protection against sexually transmitted infections.

Precautions After Using the Morning-After Pill

It is important to be informed about the pill and understand its purpose before using it. Some people mistakenly believe that the morning-after pill is useful for preventing sexually transmitted infections or as a method of induced abortion, which is incorrect. The morning-after pill is most effective when taken within three days of intercourse and prevents pregnancy before it occurs. It is not a long-term contraceptive method and is primarily an emergency option. Therefore, a long-term contraceptive method should be used within a few days after taking the morning-after pill, and it is advisable to consult a healthcare provider. Frequent use of the morning-after pill, or using it regularly after every unprotected intercourse, can lead to significant health issues due to hormonal changes. Long-term use may disrupt menstrual cycles, and hormonal shifts from these pills can cause serious problems. Consulting a doctor before transitioning to long-term contraceptives is recommended, as high doses of hormones in some pills may reduce the effectiveness of regular birth control methods. Birth control pills, in particular, may be less effective if used with the morning-after pill.

Following emergency contraception, a doctor’s examination is not mandatory unless there are unusual conditions. However, in some cases, excessive bleeding, missed periods, severe menstrual pain, significant nausea, and vomiting may occur. These are rare but unexpected situations that may be a sign of a significant side effect or an underlying issue. In such cases, a doctor’s consultation is essential.

You can consult your doctor to discuss emergency contraception after unprotected intercourse, get examined for possible side effects after using the morning-after pill, or receive advice on other contraceptive methods.