This article covers everything you know about the morning-after pill.
All the information in this article is updated for 2020.
And here is what you’ll learn in this article:
- What is a morning-after pill
- When and how to take it.
- The brands that are currently available on the market in South Africa
- How and where to buy it.
- What to expect after taking it.
So without wasting time, let’s get started.
Table of Contents
- What is a morning after pill, anyway?
- Here’s how the morning after pill works
- This is the ONLY time you can take a morning-after pill.
- Top 2 morning after pill brands available in South Africa (and prices)
- The ONLY correct way to take the emergency contraceptive pill.
- Does a morning-after pill work?
- Morning after pill: 10 of the most common side effects
- Warning: 5 Crucial Things You Should Know Before Taking A Morning-After Pill
- Now it’s your turn…
What is a morning after pill, anyway?
Morning after pill is a name commonly used for a tablet taken after unprotected sex to prevent pregnancy.
It is also known as an emergency contraceptive pill.
The pill is available over-the-counter in South Africa (i.e. accessible without a doctor’s prescription).
It is sold on the market as Norlevo, Plan B or Escapelle – more on these later.
Each emergency contraceptive pill contains a key ingredient called Levonogestrel – a synthetic hormone used in some birth control methods.
In his book, Science and Political Controversy, David Newton notes that Levonorgestrel was first manufactured in the 1960s. And it only started being used as a birth control method in the 1980s.
Levonorgestrel is also in the list of World Health Organization’s List of Essential Medicines, he essential medicines needed in a primary health system.
Levonorgestrel belongs to a class of drugs known as progestogens, which are a group of hormones.
Hormones are chemical substances that are produced by the body organs to control other organs.
Image credit: Major Differences
Think of hormones as messengers.
Messengers who are sent around the body to specific organs and cells to exert a particular function. Or pass a message.
By nature, hormones are available in your body.
And as a woman, hormones play a critical role in preparing your body for pregnancy.
On a monthly basis, your body prepares itself for pregnancy. It first builds up the wall of your uterus. Making it thicker for it to be able to carry a fertilised egg.
From there, it releases an egg (a fertilisation process known as ovulation).
The released egg will get in contact with sperm from your sexual partner. If fertilisation happens, a fertilised egg is the result. And that is the start of the prenatal development (development of the baby).
Progestogens are one of the significant role players in this whole process.
Here’s how the morning after pill works
In all honesty, no one has a clear understanding of how it works.
That’s strange, right?
But it is believed to work:
- By preventing the release of an egg from the ovary.
- Or preventing fertilisation of the egg by sperm (male reproductive cells).
- It may also work by changing the lining of the uterus (womb) to prevent the development of a pregnancy.
- Prevent the transport of sperm and ova.
LIKE A VISUAL EXPLANATION? WATCH THE VIDEO BELOW
Here are other useful resources:
- Mechanism of action: How do levonorgestrel-only emergency contraceptive pills (LNG ECPs) prevent pregnancy?”
- How do levonorgestrel-only emergency contraceptive pills prevent pregnancy? Some considerations
This is the ONLY time you can take a morning-after pill.
But when can you take it?
You can take the morning-after pill if:
- You had unprotected sex, and you are not using any form of contraception.
- The condom came off or broke while you were having sex.
- The vaginal diaphragm slipped out of place, or you removed it too early.
- You were forced to have sex.
- You missed at least two or three active birth control pills in a row.
- You forgot to insert your ring or apply your patch.
- Your partner didn’t pull out in time during sex – a process known as coitus interruptus
- You have another reason to think your birth control pill might not have worked.
If you use the pill correctly after you have unprotected sex, you’ll be less likely to fall pregnant.
Top 2 morning after pill brands available in South Africa (and prices)
In South Africa, you can buy a morning-after pill over-the-counter, without a doctor’s prescription. As of writing this article, the cost of each morning after pill pack is about R75.
And there are 2 brands currently registered with the MCC and available on the market.
Namely Norlevo and Escapelle.
Norlevo is made by Actor pharma and it comes with 2 tablets in a box.
Each tablet has 0.75mg Levonorgestrel as the active ingredient. With Norlevo, you can either take one tablet immediately and then take another one after 12 hours. Or take two pills at once.
Escapelle is manufactured by Gedeon Richter. And It comes in a box with just one tablet containing 1.5mg of Levonorgestrel.
So which one to take between the 2?
It’s your choice.
You can either take the 1.5 mg single levonorgestrel dose (Escapelle). Or two of the 0.75 mg doses of levonorgestrel taken 12 hours apart (Norlevo).
The ONLY correct way to take the emergency contraceptive pill.
The emergency contraceptive pill should be taken as soon as possible. Within 72 hours after unprotected sexual intercourse.
It is most effective if taken within the first 24 hours.
If you vomit less than 2 hours after you take it, take another dose immediately.
You must continue using your regular method of birth control.
Or consult your doctor immediately and get a daily birth control pill.
Does a morning-after pill work?
How effective is the morning-after pill?
The emergency contraceptive pill should be taken within 24 hours after unprotected sex.
According to a study in the American Journal of Obstetrics and Gynecology:
- If you take it within 72 hours, the chances of you being pregnant are reduced by 87% – 90%.
- Whereas the chances drop by 72% -87% should you take the pill between 72 – 120 hours.
The morning-after pill is not as effective as your regular contraception. It is only for emergencies.
So don’t take it as your primary form of birth control pill. That’s why it’s called a “morning-after pill.”
Morning after pill: 10 of the most common side effects
The emergency contraceptive pill has its long list of side effects. Like with any other medication.
In this case, I will only be covering the common ones.
And remember, you might or might not experience.
So here are the most common side effects you might experience:
- Having extreme tiredness
- Soreness or tenderness of your breasts, often with a feeling of fullness.
- Delay of your menses for more than seven days.
- Having a runny stomach (Diarrhoea)
- Pain in the lower part of your stomach
- A headache
- Having the urge to vomit
- Irregular bleeding and spotting
If any of these side effects become worse, please inform your doctor immediately.
Warning: 5 Crucial Things You Should Know Before Taking A Morning-After Pill
As I have noted above, you may have unusual bleeding but it should disappear within no time.
So before you take the emergency pill, there are a few things I would like to share with you.
And I think they are crucial.
So here they are:
#1 Ectopic pregnancy is possible:
Did you know? You can still fall pregnant, even after taking the emergency contraceptive pill.
Yes, that is possible. And if you become pregnant, there’s a possibility that it might be an ectopic pregnancy.
But what is an ectopic pregnancy?
According to WebMD:
“In a normal pregnancy, your ovary releases an egg into your fallopian tube. If the egg meets with a sperm, the fertilised egg moves into your uterus to attach to its lining and continues to grow for the next 9 months. But in up to 1 of every 50 pregnancies, the fertilised egg stays in your fallopian tube. In that case, it’s called an ectopic pregnancy or a tubal pregnancy.
So how do you know if it’s ectopic pregnancy?
If you have a sharp pain on the lower part of the stomach.
Or have a pain in your pelvic area, you should consult your doctor or any other healthcare provider immediately.
READ MORE: What to Know About Ectopic Pregnancy
Getting help fast is paramount. That can reduce the risk of you having severe bleeding and preserve your fertility.
#2 If you have a liver problem, it’s a no-no.
If you have a severe liver problem, it is not recommended to take the morning-after pill.
Because the liver plays a crucial role in clearing levonorgestrel out of your body.
Image credit: Medscape
Your body dislikes medicines.
It regards it as a foreign substance.
If you have a dysfunctional liver, the drug will stay in your body longer.
In turn, you can end up with more undesirable side effects.
#3 Lactose intolerant individual or any other malabsorption conditions:
If you have one of the following malabsorption conditions:
- Crohn’s diseases
- Celiac disease
- Lactose intolerance
- Intestinal damage or any other malabsorption syndrome
The morning-after pill might not work.
Because in malabsorption conditions, your intestines aren’t able to absorb specific nutrients into the bloodstream.
As such, malabsorption of the morning-after pill will lead to its ineffectiveness.
#4 Your Menstrual Cycle can be unusual:
After taking the pill, your periods are usually regular and happen at the expected date. But there is a possibility that your next one will be delayed or have it earlier than usual.
When taking a morning-after pill, you are introducing a high dose of levonorgestrel. As a hormone, levonorgestrel plays a control role on your monthly menstrual cycle.
So the moment you take it, it will come in and disturb the natural flow of things.
#5 Emergency contraceptive pill interacts with other drugs:
If you are taking any other medicines, especially the ones below:
- Antifungals (e.g., ketoconazole)
- Barbiturates (e.g., phenobarbital)
- Epileptic drugs (that contain oxcarbazepine, phenytoin or carbamazepine)
- ARVs ( e.g. indinavir, nevirapine),
- Antibiotics such as penicillins (e.g., amoxicillin) and tetracyclines (e.g., doxycycline),
- TB drugs such as rifampin,
- St. John’s wort,
- And more.
Most of these drugs interact with the levonorgestrel and may lessen the effectiveness.
Some of the drugs increase or reduce the metabolism of the pill, making it more or less effective.
Please keep in mind that this is not a complete list of drugs that interact with the pill.
If you are taking any chronic medication, I suggest you inform your healthcare professional. He or she will then tell you if the morning-after pill is the best choice.
Now it’s your turn…
It is clear now that a morning-after pill should only be used in emergency cases.
It is also clear that it is not suitable for everyone. And is not as effective as conventional forms of contraception.
Now that you’ve read about the morning-after pill, I would like to hear from you.
Have you ever used a morning-after pill and how was your experience?
Or maybe you have a question about it.
Either way, leave a comment below.