When the morning after pill won't work

BY CANDIECE KNIGHT

Monday, January 14, 2019

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THE emergency contraceptive pill has taken on the name of 'morning after pill', perhaps because it is usually taken at just that time — the morning after unprotected sex when a woman wakes up and realises that she doesn't want to get pregnant. And while we know that the pill almost always will work, it is worth knowing when it won't. Pharmacist at New Knutsford Pharmacy, Shanice Francis, tells us about the few occasions on which the morning after pill might fail.

After three days of unprotected sex

“The time frame in which it's effective is within 72 hours of unprotected sex,” Francis says.

While the name suggests taking it the morning following the act, there is no need to wait that long, as the pill is more effective the sooner it is taken. The active ingredient in the pill is Levonorgestrel, an artificial hormone that works by preventing ovulation (if it hasn't already happened) and closing off the cervix to prevent the sperm from getting into the uterus. While some brands in other countries allow up to 120 hours (five days), those available locally only guarantee a certain amount of protection up to three days. An intrauterine device (IUD) such as the copper T can prevent a pregnancy if installed up to five days after sex, however.

If you are already pregnant

Francis is quick to add that, “The pill will not work if the person is already pregnant.”

This means that if you had sex two weeks ago and got pregnant, but had sex again last night, taking the pill today won't protect you from pregnancy, even if you overdose. The hormone in the morning after pill cannot cause an abortion. It has not been shown to have any significant impact on an existing pregnancy, no matter how many you take. The pills works by closing the gate, not by calling back the horse after it has already gone through.

If you throw up after taking it

One of the most common side effects of using the morning after pill, or any other hormonal preparation, is nausea. This means that it is not uncommon for a woman to throw up immediately after taking the pill. If this happens when taking either of the two pills in the packet, it is strongly advised that you take another dose.

If you have certain diseases

“Certain diseases as such as Crohn's disease might impair the efficacy,” Francis says.

The morning after pill may also be less effective and have adverse reactions in people with liver disease, or any other illness that inhibits how the body processes food and medicine, such as Porphyria. Allergic reactions may also occur.

If you are taking certain medications

“Epilepsy drugs, fungal drugs, antibiotics and even natural herbs like St John's wort may also cause the pill to be less effective,” Francis says.

Chemicals in some medications, and even natural herbs, can interfere with how the hormone in the pill works, and even how the other medications work. Be sure to read the leaflet in whichever emergency contraceptive pill you choose to see whether it clashes with any medication you are on.

11 per cent of the time

Even when taken correctly within 72 hours after sex, Levonorgestrel is still only proven to be 89 per cent effective in preventing pregnancy. It is not as reliable as contraceptives that are recommended for regular use such as the male condom, an IUD, the pill or the Depo Provera injection. The emergency contraceptive pill should therefore not be used as a regular method of birth control.


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