Morning After Pill Emergency Contraceptive: Your Options in Australia

A morning after pill emergency contraceptive lowers the chance of pregnancy after sex without contraception, or when a condom breaks or pills are missed. In Australia there are two kinds of emergency pill, both sold by pharmacists, and a copper IUD that a doctor or nurse can fit. This guide explains how each morning after pill emergency contraceptive works, how long you have, and when to see a doctor.

Key takeaways

• Take an emergency pill as soon as you can: one kind works up to three days after sex, the other up to five.
• The copper IUD is the most effective option and can stay in as ongoing protection for years.
• Emergency pills delay the release of an egg; they do not end a pregnancy that has already started.
• A Medio doctor can talk through your options by phone and refer you for an IUD where needed.

What Emergency Contraception Is

Emergency contraception is a way to lower the chance of pregnancy after sex without contraception, or when the usual method fails. A morning after pill emergency contraceptive works mainly by delaying the release of an egg, and it is not an abortion: it cannot end a pregnancy that has already begun.

Effectiveness is highest for the copper IUD, then ulipristal, then levonorgestrel. The price of morning after pills varies by type and by pharmacy, and only the IUD needs a visit to a doctor or nurse.

When Emergency Contraception Is Needed

Emergency contraception is needed as soon as possible after unprotected sex whenever a pregnancy is not wanted. The sooner a morning after pill emergency contraceptive is taken, the better it works, so there is no reason to wait until the morning. It is worth taking even if you think you are at a safe time of your cycle, because ovulation is hard to predict. The pill is a single dose, and it is safe to take an emergency pill again later in the same cycle if needed; doing so is never an abortion. The pharmacist or doctor will check which type to use, because the two pills should not be mixed within a few days of each other. If it has been more than three days, ulipristal or a copper IUD still works up to five days. If the price of morning after pills is a worry, ask the pharmacist which type suits you and what it costs. After five days, see a doctor about a pregnancy test, your options and regular contraception.

Some people need a doctor's advice before choosing: anyone who has had sex without contraception more than once since their last period, anyone who is breastfeeding, and anyone who would like the IUD. The pharmacist can still help on the day and point you to a doctor or family planning service if needed.

What Causes Morning After Pill Emergency Contraceptive?

The need for a morning after pill emergency contraceptive is usually caused by a gap in contraception, not by anything you did wrong. Common reasons are a condom that broke or slipped, missed or late contraceptive pills, vomiting or severe diarrhoea while on the pill, a contraceptive injection more than two weeks overdue, or sex without any contraception. Sex that you did not consent to is another reason, and support is available at any hour through 1800RESPECT, as well as through a doctor or a sexual assault service.

Some medicines, such as certain epilepsy treatments and the herbal remedy St John's wort, lower the effectiveness of levonorgestrel, and a higher body weight may do the same, so the pharmacist may suggest a larger dose of levonorgestrel or a different method. Whatever the reason, the chance of pregnancy after unprotected sex depends on where you are in your cycle, and ovulation can come early or late. A copper intrauterine method avoids most of these limits and lowers the chance of pregnancy more than any pill. People often ask how much is the morning after pill before choosing, and the pharmacist can explain the cost of each type. If you are not sure whether a missed pill counts, the pharmacist can check the rules for your type with you.

The Two Kinds of Morning After Pill

The two emergency pills in Australia are levonorgestrel and ulipristal, and both are single tablets sold by pharmacists. Levonorgestrel is a progestogen, from the same hormone family as many regular contraceptive pills. It is licensed for up to 72 hours following unprotected sex, works better the sooner it is taken, and is sometimes used a little later on a doctor's or pharmacist's advice. Levonorgestrel is the cheaper and more widely stocked emergency contraceptive pill, and you can start or restart regular contraception straight after it, using condoms for the next seven days.

Ulipristal works for up to 120 hours, or five days, and is more effective than levonorgestrel later in that window, because it can still postpone ovulation when the egg is close to being released. After ulipristal, wait five days before starting or restarting hormonal contraception, and use condoms in the meantime. If you are breastfeeding, the pharmacist may suggest levonorgestrel, or advise expressing and discarding milk for a week after ulipristal. Neither pill harms an existing pregnancy or protects against infections passed on during sex, and neither prevents a pregnancy from sex later in the same cycle. Both are swallowed with water, with or without food, and the pharmacist can give you the tablet to take there or at home.

The Copper IUD as Emergency Contraception

The copper IUD is the most effective emergency contraception, preventing more than 99 in 100 expected pregnancies when it is fitted within five days after unprotected sex. It is a small device placed in the uterus that stops an egg being fertilised or implanting. Unlike an emergency pill, the IUD is not affected by body weight, other medicines or vomiting, and it works later in the cycle than a pill can, within the time limit. Once in, the IUD becomes ongoing contraception for five to ten years, depending on the type, and it contains no hormones. It can be taken out at any time, and fertility returns once the IUD is removed.

The catch is access: an IUD has to be fitted by a trained doctor or nurse at a clinic or family planning service, so call early to find an appointment within the five days. Taking an emergency pill on the way is reasonable if the IUD fitting may be delayed, and the doctor will advise which pill. Fitting an IUD can cause cramping for a day or two, and a check is advised a few weeks later. Most people can use an IUD, including those who have never had a baby; the doctor checks for infection risk and pregnancy before fitting it. As emergency contraception, it suits people who want a long term method anyway.

How to Prevent Morning After Pill Emergency Contraceptive

The best way to avoid needing an emergency pill is a regular method that suits you and protects against an unplanned pregnancy. Long acting methods, the implant, the hormonal IUD and the copper intrauterine device, last from three to ten years and are the most effective, because there is nothing to remember. The hormonal IUD releases a small amount of levonorgestrel, the same hormone as one of the emergency pills, at a far lower daily level. The pill, the vaginal ring and the injection work well when used on time, and condoms also protect against sexually transmitted infections. A doctor, nurse or pharmacist can explain each method and its cost, and many methods can be started straight after levonorgestrel.

Keeping an emergency contraceptive pill at home, bought ahead from a pharmacist, means you can take it straight away if a condom breaks or you have unprotected sex, rather than waiting for a pharmacy to open. A levonorgestrel pill keeps for a long time in the cupboard, but check the expiry date. If you rely on the pill, a daily alarm and knowing the missed pill rules for your type lower the risk, as does asking a pharmacist or doctor what to do if you are sick.

Knowing how the morning after option works helps too. An emergency pill works by delaying ovulation, so it is less effective than a regular method and does not cover sex later in the cycle. If you have needed it more than once, a doctor or family planning clinic can help you find a method that suits you, and the morning-after cost adds up over a year in a way that a long acting method does not. A levonorgestrel pill taken now and then is safe, but it is a backup, not a plan. Talking it through is also a chance to check your sexual health and whether a test is due.

Getting Emergency Contraception With or Without a Prescription

Emergency contraception pills are available from any pharmacist in Australia without a prescription, and there is no age limit set by law, though the pharmacist checks that the pill is right for you. The pharmacist asks a few private questions, usually in a consultation room, about when you had unprotected sex, your cycle, other medicines and breastfeeding, so they can suggest the right pill. This is the usual way to get emergency contraception, many pharmacies open late or at weekends, and the pharmacist can also talk about regular contraception.

A doctor can also write a prescription for either pill, which some people prefer if they are seeing a doctor anyway. A prescription does not usually make the pill cheaper, and the morning-after cost from a pharmacist is similar either way; ulipristal costs more than levonorgestrel. Family planning services and sexual health clinics can supply emergency pills, fit IUDs and test for sexually transmitted infections, sometimes at low cost. If you travel or live far from a pharmacy, a pharmacist can supply one in advance to keep at home.

A Medio doctor can talk through emergency contraception by phone in a telehealth consult, check which option suits you and, where the doctor thinks it right, send a prescription as an eScript to your chosen pharmacy, or a referral for a copper IUD. Medio's doctors consult by phone, so an IUD fitting itself always happens in person with another provider. If a consult would come later than a pharmacy visit, go to the pharmacy first, because timing matters more than where the pill comes from.

Warning Signs After Emergency Contraception

Most people have no problems after emergency contraception, and side effects such as nausea, headache, tiredness, breast tenderness or light bleeding pass within a few days. Your next period may come up to a week early or late. Do a pregnancy test three weeks after unprotected sex, or sooner if your period is more than seven days late, unusually light or different in any way. See a doctor promptly, or go to an emergency department, for severe pain low in the tummy or on one side, or shoulder tip pain, as these can be signs of a pregnancy outside the uterus; call 000 if you faint or collapse.

Spotting in the days after is common and does not show whether the pill has worked; only a test can show that. If you vomit within three hours of an emergency pill, speak to a pharmacist or doctor, as you may need another dose. After a copper IUD, see a doctor for fever, worsening pain or unusual discharge. Tell the pharmacist or doctor about any medication you take, because some lower how well ulipristal or levonorgestrel works. Sperm can survive for several days, so ovulation after sex can still lead to pregnancy. Begin or restart regular contraception as advised, and use condoms until the new contraception takes effect.

How Effective Emergency Contraception Is

Emergency contraception is effective, but no method of contraception is certain. The copper IUD is the most effective, with fewer than one pregnancy in 100 uses. Of the pills, ulipristal prevents more pregnancies than levonorgestrel, especially three to five days after unprotected sex, and both work better the sooner they are taken. When weighing the options, the questions that matter most are how long it has been since sex, whether you want ongoing contraception, your weight and your other medicines, and a pharmacist or doctor can go through them with you.

The pills work by postponing ovulation, so they cannot stop a pregnancy if the egg has already been released, and sperm can live for several days, which is why timing within the cycle matters. Body weight, some medicines, and starting hormonal contraception within five days after ulipristal can all reduce how well it works. None of these methods causes an abortion, and none affects a pregnancy that has already implanted.

Cost should not decide the method, but it is fair to ask about. The emergency pill price differs between the two pills, and ulipristal usually costs more; the emergency pill price also varies between pharmacies. For the IUD, ask the clinic about the cost of the device and the fitting, and about regular contraception afterwards.

Summary

A morning after pill emergency contraceptive works best taken soon after sex, and a copper IUD is the most effective choice of all. This guide covered what emergency contraception is, when it is needed, the two pills, the IUD, getting it with or without a script, warning signs and effectiveness. If you are unsure which morning after pill emergency contraceptive suits you, a Medio doctor can give advice by phone and, where the doctor thinks it right, send an eScript, a pathology request for a pregnancy test or a referral.

Frequently asked questions

How risky is the morning after pill?

Emergency pills are very safe for almost everyone, including people who cannot take the regular combined pill. Side effects of emergency contraceptives, such as nausea, headache, tiredness and spotting, are short lived, and serious problems are rare. They do not affect future fertility or harm a pregnancy that has already started. Other emergency contraception methods, such as the copper IUD, carry small risks at fitting. Emergency pills do not work well during ovulation or after it, and the main risk is relying on them instead of regular contraception.

How much does the morning after pill cost?

Prices vary between pharmacies and between the two types, and levonorgestrel is usually the cheaper one. Ask the pharmacist for the price before they dispense it; a generic version often costs less than a branded one. A doctor's script does not usually lower the price, and family planning or sexual health services may supply it at low cost.

Can a doctor help with morning after pill emergency contraceptive?

A Medio doctor can help by phone: they can talk through which option suits you and, where the doctor thinks it right, send an eScript for an emergency pill to your pharmacy, or a referral to have a copper IUD fitted. Because timing matters, go to a pharmacy if you cannot speak with a doctor soon.

How much does an Ella pill cost?

Ulipristal, the pill sold under that name, usually costs more than levonorgestrel, and its price varies between pharmacies, so ask the pharmacist. The higher price buys a longer window, up to five days, and a better effect later in it, which matters most if more than a day or two has passed since sex.

Can my boyfriend buy my morning after pill for me in Australia?

A pharmacist normally supplies an emergency pill only to the person who will take it, so a partner usually cannot buy it for you. The pharmacist needs to check timing, other medicines and whether it suits you. Your partner can come with you, and you can talk to the pharmacist about regular contraception at the same visit. In unusual situations the pharmacist may use their judgement.

Can I buy the morning after pill at Woolworths?

Supermarket shelves in Australia do not stock emergency pills: they are sold only by pharmacists, who keep them behind the counter. Some pharmacies sit inside shopping centres or next to supermarkets, and many open late. If you need emergency contraception today, most pharmacies can help, and you can also buy one ahead of time to keep at home.