Condom failure? Been stealthed? Or just didn't use protection for whatever reason? Accidents do happen and sadly sometimes a sexual partner can accidentally (or otherwise) put you at risk of an unplanned pregnancy, an STI or both!
When Un Protected Sexual Intercourse (UPSI) happens in someone with a uterus, the Morning After Pill or another Emergency Contraception (EC) option can be a crucial option for preventing an unintended pregnancy. But you must act quickly.
What is Emergency Contraception & how does it work?
Emergency contraception is a method used to prevent pregnancy after unprotected sex or contraceptive failure. It is not intended to replace regular contraceptive methods but serves as a backup option.
There are two main types of emergency contraception available in Australia:
1. Emergency Contraceptive Pills (Morning After Pill):
Also known as the "morning-after pill," these pills can be taken up to 120 hours after unprotected intercourse. There are 2 types available in Australia; levonorgestrol 1.5mg and ulipristal.
Ulipristal is the most effective and should be the first medication option.
Mechanism: Emergency Contraceptive Pills (ECPs) primarily work by delaying ovulation, preventing the release of an egg from the ovary.
Effectiveness: When taken within 72 hours, ECPs can reduce the risk of pregnancy by up to 85%. Their effectiveness decreases the longer you wait after unprotected intercourse.
In a recent study it was found that Ulipristal (the most effective type of emergency contraception medication) is not widely available in Australian pharmacies.
If you can't access this in your community, we can help.
2. Copper IUD:
A copper IUD can be inserted by a trained healthcare provider up to five days after unprotected sex. It can be kept in or removed after the next period arrives and you know that you have not become pregnant.
Mechanism: The copper IUD prevents sperm from fertilising an egg and may also prevent implantation if fertilisation has already occurred.
Effectiveness: The copper IUD is over 99% effective when inserted within five days of unprotected sex and can provide ongoing contraception for up to 10 years, depending on the model of device.
Availability and Access in Australia
Pharmacies:
Over-the-counter: Emergency contraceptive pills are available without a prescription at most pharmacies. You can ask the pharmacist for "the morning-after pill". There are 2 types; levonorgestrol EC 1.5mg ( several brands available) and ulipristal (Ellaone™). Ulipristal is the most effective and can be taken up to 120 hours after unprotected sex. Unfortunately this is the one that has been shown to be more difficult to get and is more expensive. If your pharmacy doesn't stock ulipristal, we can help.
Consultation: Pharmacists can provide confidential advice on how to use ECPs and what to expect. If we send Emergency Contraceptive Pills directly to you, we will provide you with all the information you need. However, getting the medication is time critical.
Healthcare Providers:
Prescription and insertion: If you prefer the copper IUD, you will need to visit a healthcare provider, such as a general practitioner (GP) or a family planning clinic, for a prescription and insertion. If you live in the greater Sydney area, you can visit us in Chatswood, where we will always accommodate you for a copper IUD as Emergency Contraception.
Online Services:
Telehealth consultations: Clinic66online offers telehealth consultations for emergency contraception and STI screening tests. You can receive a prescription for ECPs and have them delivered to your home if you wish ( but the clock is ticking!), or go to your local pharmacy to collect. Any local pathology provider will be able to do the tests that we order for you.
When to Use Emergency Contraception
Emergency contraception should be considered if:
You had unprotected sex. We consider the withdrawal method or “pull out” to be UPSI as it is not reliable.
Your contraceptive method failed e.g. the condom broke or you missed a birth control pill.
You were sexually assaulted and no contraception was being used.
Myths and Facts
Myth 1: Emergency contraception causes abortion
Fact: Emergency contraception works by preventing pregnancy before it occurs. It does not terminate an existing pregnancy.
Myth 2: Emergency contraception affects future fertility
Fact: There is no evidence that using emergency contraception affects your ability to conceive in the future. If you have a copper IUD fitted this will prevent pregnancy but only while it is in place.
Myth 3: Emergency contraception is only for young women
Fact: Emergency contraception is safe and effective for women of all reproductive ages.
What to Expect After Taking Emergency Contraception
Side Effects:
You may experience minor symptoms such as nausea, fatigue, headache, breast tenderness, and changes in your next menstrual period if you have taken pills. After a copper IUD has been fitted, your periods may get longer or more painful.
Follow-up:
Menstrual changes: Your next period may be earlier or later than expected. If your period is more than a week late, take an over the counter pregnancy test. If you are pregnant and not sure what to do, we can help you understand your options.
If you experience severe abdominal pain or other concerning symptoms, seek medical advice.
What about STI's!?
If you've had unprotected sex, you should also be concerned about your exposure to Sexually Transmitted Infections (STI's). STI 'Screening' following contact with any new partner is both wise and responsible.
Common STI's include chlamydia and gonorrhea
Less common STI's can include the blood borne viruses such as HIV, Hepatitis B and syphilis.
We can explain the tests you may need to take, and provide you with pathology request forms that you can fulfil locally.
Is it possible that you've been exposed to HIV?
PEP (or Post Exposure Prophylaxis) for HIV may also be needed? If you think you need PEP, then you can have a telehealth consultation with one of our S100 qualified doctors and they can prescribe for you ASAP. Alternatively, you can attend your local Emergency Department immediately, as they have access to this medication on site.
Make an online appointment with one of our doctors!
If you have had unprotected sex and need emergency contraception, don't wait. Our online clinic offers confidential consultations and easy access to emergency contraceptive pills.
Schedule an appointment today to discuss your options with one of our doctors and get the support you need. Click here to get started
Authored by Dr Emma Boulton July 2024
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