Emergency contraception: your options

Contact a pharmacist or sexual health service today if you have had sex without contraception, or think your method failed. Emergency contraception works best when you seek it promptly. You can ask about it after a condom problem or missed pills; explain what happened and when.

The options and their timing

The copper IUD is the most effective emergency contraception. A trained doctor or nurse fits it into the womb, and it can stay in place as ongoing contraception. Emergency pills are another option; the main types used in the UK contain levonorgestrel or ulipristal acetate.

Option	NHS time window after sex
Copper IUD	Within 5 days (120 hours)
Levonorgestrel pill	Within 3 days (72 hours)
Ulipristal acetate pill	Within 5 days (120 hours)

Seek help promptly. Tell the service about every recent episode of sex without reliable contraception. If you think you are beyond a listed window, still ask promptly: CDC guidance allows a clinician to consider a copper IUD later in some circumstances, based on ovulation timing. An app estimate cannot decide that for you.

US clinical advice differs from the NHS pill windows. CDC considers emergency pills within 5 days and reports that ulipristal is more effective than levonorgestrel at 3–5 days. The FDA information for levonorgestrel says within 72 hours (3 days). Ask a pharmacist or clinician which option is suitable where you live.

Where to get it

In the UK, emergency contraception is free from most NHS sexual health clinics and GP surgeries. Emergency pills are also free from most pharmacies and some NHS walk-in centres. Copper-IUD fitting needs an appointment with a trained clinician, so say that you need emergency contraception when contacting the service.

In the US, levonorgestrel emergency contraception is available over the counter without a prescription. Ulipristal acetate requires a prescription. Ask a reproductive health service about an emergency copper IUD. Elsewhere, a pharmacist or local sexual health service can advise on access.

Weight and medicines can affect the choice

Tell the pharmacist about medicines and herbal remedies, including treatments for epilepsy, HIV or TB, griseofulvin and St John’s wort. With some medicines, an IUD may be advised instead of a pill. Mention steroid treatment for asthma too, as this can affect which pill is suitable.

Weight can also affect pill effectiveness. CDC says levonorgestrel might be less effective than ulipristal in women with obesity. WHO says women with obesity must not be denied emergency contraception. Ask about the available options promptly; do not rule yourself out because of a weight cut-off in an online article.

Emergency pills prevent or delay ovulation. Emergency contraception does not interrupt an established pregnancy. It does not protect against STIs, so ask the sexual health service about testing if you are concerned about exposure.

Afterwards: contraception, testing and getting help

An emergency pill does not protect against pregnancy from later sex. Ask for advice again if you have sex without contraception afterwards; emergency contraception may be needed again.

Ask the pharmacist for a clear plan for your usual contraception and any temporary barrier protection. Hormonal contraception taken around ulipristal can reduce its effectiveness, and the restart advice differs by emergency pill. Follow the advice for your product. There is no single restart timetable for all emergency pills.

Ask when to do a pregnancy test. The NHS says most tests can be used from the first day of a missed period, or at least 21 days after the last unprotected sex if you do not know when the next period is due. CDC advises a test if there is no withdrawal bleed within 3 weeks after emergency pills. Follow any testing plan your clinician gives you.

Contact a pharmacist or sexual health clinic today in the UK, or a pharmacist or clinician in the US and elsewhere, if you vomit soon after an emergency pill. Explain which pill you took and when you were sick, and follow the leaflet. Advice about replacing a pill depends on those details.

Call 999 now (UK) or 911 (US), or your local emergency number, for sudden severe abdominal pain with marked dizziness or fainting.

Get urgent medical advice now from a GP or NHS 111 (UK), or an urgent medical service (US and elsewhere), for lower abdominal pain, unusual vaginal bleeding or shoulder-tip pain when pregnancy is possible, even without a positive test. These can be warning signs of an ectopic pregnancy. Do not wait for the planned pregnancy test.