The Morning After Pill: 11 FAQs You Might be Afraid to Ask

After a night of romance, you feel a bit hesitant as you approach the pharmacist the next morning to ask for a morning-after pill (we totally understand). Knowing more facts about the morning-after pill might help calm your nerves.

Let’s begin with some basic facts:

• The morning-after pill is indicated for the prevention of an unwanted pregnancy after unprotected sex. 
• There are two common types of drugs in this category, one is Levenogestrel (example brand names: Postinor-2 & Escapelle), the other is Ulipristal (brand name: Ella). 
• Both drugs are categorised as a Group C poison in Malaysia and can be purchased at your local pharmacies and clinics. 

1. When should I take the pill?

Postinor-2 or Escapelle should be taken within 72 hours (days) from the episode of unprotected sex. Ella should be taken within 120 hours (5 days) from the episode of unprotected sex. The sooner you take it, the more effective it is.

2. What happens if I take the pill late?

If you take the pill late (i.e. >3 days for Postinor-2/Escapelle, >5 days for Ella)  the chances of pregnancy are high. You will need to get advice from a doctor in this case. To avoid these circumstances, you have to take the pill as early as possible. Always bear in mind that taking the pill as sooner you take it, the more effective it is.

3. How effective is the pill?

The morning-after pill does not give you a 100% prevention of pregnancy. Most of the pills can prevent pregnancy up to a success rate of about 90%.

4. What are the side effects of the pill?

The most common side effects of both types of drugs are similar. They include nausea, vomiting, abdominal pain and headache. Rare side effects include fatigue, breast tenderness and menstrual bleeding disturbance.

5. Will I gain weight from taking this pill?

Postinor-2 and Escapelle contain Levenogestrel as an active ingredient. Levenogestrel is a type of female hormone, progesterone. This hormone is known to cause an increase in appetite, but not an increase in body weight. So as long as you do not snack or eat unhealthily, you should not experience significant weight gain. Ulipristal (Ella) is not associated with weight gain.

6. Is this morning-after pill better than a regular hormonal contraceptive?

Morning after pill is only used for a ‘just in case’ basis as an emergency solution to prevent an unwanted pregnancy. If you are sexually active, a regular hormonal contraceptive which is taken daily is better and safer as it can prevent pregnancy as well as to regulate your hormones.

7. How frequent can I take the pill?

Pharmacists would generally advise you not to take more than twice a month. Frequent intake of the morning-after pill can disrupt your hormonal cycle and causes irregular menstrual bleeding. So if you have the need to take it regularly, consult a doctor or pharmacist to switch to a regular daily hormonal contraceptive instead.

8. What if I vomit after taking the pill?

If you vomit within 2 hours of taking this pill, the pill might not be present in your body anymore. In this case, you will need to take another pill immediately. To avoid nausea and vomiting, you may take the pill after food.

9. How will the pill affect my next period?

Your period will likely come 3-5 days earlier than expected. However, if your period is delayed for more than 5 days, a pregnancy might have occurred, please consult a doctor in this case.

10. How does the pill actually work?

Levonorgestrel makes it difficult for the sperm to reach the egg to cause fertilization. It can also make the fertilized egg more difficult to implant itself on the uterus lining. Ella, also works similarly. However, Ella is also able to delay and inhibit ovulation thereby preventing the ovum (egg) from availing itself to the sperm.

11. Can I use this pill for an abortion?

No. You cannot use the morning-after pill for an abortion. It can be only used within 3 or 5 days after unprotected sex. Always get a consultation from a doctor if you suspect any sign of pregnancy.