Article updated December 2018
Accidents happen in life from time to time and mistakes often need rectifying. But there are few mishaps with more serious implications than opening oneself to the possibility of falling pregnant.
Even the most conscientious of people can suffer an accident or make a misjudgment that leads to the possibility of conception. This may include those individuals who have:
- Not used contraception during intercourse
- Used a condom that has split or come off
- Failed to withdraw as intended
- Missed their contraceptive pill
A fast and effective solution to such occurrences is an emergency contraceptive – otherwise known as the ‘morning after pill’. Provided that the medication is taken a short period of time after the unprotected sex has taken place, emergency contraceptives can be a simple and hassle-free way to ensure that a woman does not fall pregnant.
At Express Pharmacy, we now stock two emergency contraceptives. Not surprisingly, we are regularly asked which option is best and so in this article we will compare and contrast Levonelle and ellaOne. If you have ever wondered "how does ellaOne work"; "how does Levonelle work"; or "do these contraceptions work after ovulation", then read on.
EllaOne is considered to be the most effective morning after pill on the market. The active ingredient is a chemical called ulipristal acetate, which comes in the form of a single tablet. EllaOne is a medicine known as a selective progesterone receptor modulator.
During the typical menstrual cycle, progesterone is produced once the egg has matured and been released from the ovaries - serving to prevent the release of any more eggs into the fallopian tubes. Within ellaOne, ulipristal mimics this process and encourages the body to believe that ovulation has already occurred - preventing the egg's release for five days.
EllaOne is considered to be 95% effective when taken within five days of unprotected intercourse, offering a significantly longer window for treatment than Levonelle. It is important to say, however, that those not wishing to fall pregnant should take ellaOne as soon as possible after sex, rather than allowing the full 120 hours to elapse.
A drawback of ellaOne is that it may only be taken once during a single menstrual cycle, and may disrupt long-term contraception such as the combined pill during the cycle.
The result of this is that it is not always possible to continue sexual activity as normal during the subsequent menstrual cycle due to the increased likelihood of pregnancy.
EllaOne side effects
Whilst usually rare and not considered serious, there are a few potential side effects to be aware of when taking ellaOne. These may include:
- Irregular bleeding after ellaOne
- Stomach pains
Should you take any other prescription medications for health conditions, it is important to seek the advice of a pharmacist or GP before taking ellaOne.
Does ellaOne work after ovulation?
EllaOne works by delaying the release of an egg from the ovaries and so if you have unprotected sexual intercourse the day of or in the immediate days after ovulation, ellaOne is no longer an effective form of contraception. It is for this reason that a GP or pharmacist will ask questions about a woman's menstrual cycle before prescribing the morning after pill. Nevertheless, ellaOne success rates are extremely high when used appropriately by women who have unprotected sex ahead of ovulation.
Levonelle is the most widely used emergency contraception pill on the market today. Although it is considered to be less effective than ellaOne and may only be taken within 72 hours of unprotected intercourse, it is a cheaper and more flexible option.
Levonelle contains the active ingredient levonorgestrel. It is recommended that Levonelle is ingested within 12 hours of unprotected sex for maximum effectiveness, but it is possible to take the medication with some reliability up to 3 days after intercourse. Levonelle success rate figures are as follows:
- Up to 95% effective when taken within the first 24 hours after intercourse
- Up to 85% effective when taken within the first 48 hours after intercourse
- Up to 58% effective when taken within the first 72 hours after intercourse
An added benefit of Levonelle is that it is possible to take tablets more than once during the same menstrual cycle if you should require it. And unlike ellaOne, which can inhibit some forms of contraceptive pill, Levonelle allows women to continue using their usual pill-based contraception effectively throughout the remainder of the month.
Levonelle side effects
Much like ellaOne, side effects are rare with Levonelle. For those women who do experience some mild problems, the most common of these are:
- Stomach pains
It should be mentioned that neither ellaOne nor Levonelle have any effectiveness against the contraction of sexually transmitted infections (STIs). Emergency contraceptions should never be taken as a replacement for protected sex and if unsure as to the likelihood of an STI being contracted, a condom should always be used.
Comparing emergency contraception
The morning after pill – in the form of Levonelle or ellaOne – is not the only form of emergency contraception that can be used. The Intrauterine Device (IUD), known as the copper coil, is another solution that can be used up to 5 days after sexual intercourse.
The release of copper into the womb prevents fertilisation and implantation of the egg. One of the benefits of the IUD is that it can be inserted up to 120hrs after unprotected sex or after ovulation, helping to prevent pregnancy even after an egg has been released into the fallopian tubes[i].
The IUD is also commonly used as continuous form of contraception and is both an effective form of standard contraception and the most effective method of emergency contraception.
Who can use the morning after pill?
The emergency pill is deemed to be both effective and suitable for the majority of women – including those who are unable to use hormonal contraception. It is suitable for girls under 16 who have unprotected sex.
Exceptions to this include those women who may be allergic to the ingredients in ellaOne or Levonelle. If you have severe asthma or take any medicines that are known to interact with the emergency pill, you should also seek medical advice. This includes those using:
- Epilepsy, HIV or TB medicines
- Acid reflux medicines such as omeprazole
- Antibiotics such as rifabutin or rifampicin
- The herbal medicine St John’s Wort
Article updated December 2018