The Morning After Pill - We Present the Facts, Debunk the Myths

Will anything ever change in this matter? Are we able to transform certain thought patterns that have been instilled in us since childhood?

Kasia Koczułap, aka @kasia_coztymseksem on Instagram, says it loudly: "You don't have to want a child to have sex." You can, and should, enjoy intercourse, regardless of your reproductive plans.

Sex is not only for reproduction, but also for establishing intimate relationships with a partner, building bonds, and celebrating being together .

A few words about contraception

There are many types of contraception that are designed to protect against unwanted pregnancy. We can divide them by type (for example, hormonal methods - single- and double-component pills; mechanical methods , such as popular and widely available condoms; chemical methods , such as vaginal suppositories) or duration of action (including: long-term methods , such as a contraceptive implant, and permanent methods , such as tubal ligation, which is illegal in Poland ). Regardless of the chosen option, only abstinence gives us a 100% guarantee of protection against fertilization. According to the Pearl Index, an index determining the effectiveness of a given method, the most effective are intrauterine devices and the previously mentioned implant (which, due to poor availability and not very affordable price, is rarely chosen by menstruating people). The most frequently chosenmethods of contraception are still condoms and hormonal pills (single- and double-component).

If we are aware that the effectiveness of the contraception we are using is impaired (let the first one throw the contraceptive pill who has never forgotten to take it!) and unprotected intercourse has occurred, we can prevent unwanted pregnancy. What to do in such a situation? Where to seek help? Make some tea, sit comfortably and put your feet under a warm blanket. We sit quietly next to you and present everything you should know about emergency contraception , or the morning-after pill.

How does the morning-after pill work?

Emergency contraception can be used, for example, when a condom has broken or slipped off during intercourse, or when a person taking birth control pills has forgotten to take their dose at the right time (which increases the risk of unwanted pregnancy). The morning-after pill is designed to prevent an egg from being released into the fallopian tubes and an embryo from implanting in the lining of the uterus.

There are currently two types of morning-after pills available on the Polish market:

• Escapelle – should be used within 72 hours (3 days) of unprotected intercourse. Contains levonorgestrel, which blocks the multiplication of endometrial cells, making it difficult for the embryo to implant.
• ellaOne – this pill should be taken within 120 hours (5 days) after intercourse. Its main ingredient is ulipristal acetate, which affects the activity of progesterone, delaysovulation and thus makes fertilization more difficult.

The morning-after pill can be taken on any day of the menstrual cycle , but it should be taken as soon as possible after unprotected intercourse. It is worth remembering that none of the pills has an early abortion effect, which means that they do not terminate an ongoing pregnancy or negatively affect the development of an implanted embryo. A pill that has already been taken does not protect during subsequent sexual intercourse either.

Intimate gel - morning after pill

Emergency contraception is completely safe and does not affect fertility. In 2014, the European Commission, following a recommendation from the European Medicines Agency, announced that the morning-after pill can be taken safely without a prescription. Unfortunately, Poland and Hungary are exceptions in the European Union (and in Europe, Russia) – in these countries, the pill can only be purchased after presenting a prescription.

Morning-after pill – effectiveness

The pill is most effective when taken within 24 hours of unprotected intercourse. If you vomit within 3 hours of taking emergency contraception, you should take another pill “afterwards” because the first one may not have been absorbed.

The effectiveness of ellaOne is 97.9%. How do we know? In a study conducted among people who had unprotected sex and took the pill within 48 to 120 hours, 2.1% of them got pregnant. According to the product characteristics enclosed with the Escapelle pill, the effectiveness (when taken within 72 hours of intercourse) is 84%. Remember: the sooner you take the pill, the more effective it will be.

Ambiguous data suggest that the effectiveness of the morning-after pill may decrease with increased BMI (body mass index). However, there is no specific answer to this question, and research on the effectiveness of emergency contraception will certainly continue. Importantly, the pill is safe for all people, regardless of body weight. However, it is worth taking an interest in which conditions may weaken its effect or what possible unpleasant (temporary) effects may appear after taking it.

Morning After Pill – Possible Side Effects

As with any medication, emergency contraception can have side effects . The most common side effects (occurring in 1 in 10 people) include:

• nausea,
• vomiting,
• stomachache,
• headaches and dizziness,
• muscle pain,
• general fatigue.

Uncommon side effects (affecting up to 1 in 100 people) include:

• diarrhea,
• genital bleeding,
• skin lesions,
• fever.

The rarest side effects of the morning-after pill (those that occur in less than 1 in 1,000 people):

• hives, rash,
• pelvic pain,
• facial swelling,
• photophobia.

Before taking the chosen pill "after coitus", you should of course read the leaflet, which contains all the most important information about its action, use and additional protection. It is also worth visiting a doctor to dispel any doubts about the action of a given emergency method.

• Escapelle pills should not be used in case of allergy to the main ingredient of the drug (levonorgestrel). It is strictly not recommended to take it in case of severe liver disorders (e.g. Crohn's disease) and hereditary galactose intolerance.
• ellaOne should not be taken if you are allergic to ulipristal acetate. The characteristics provided by the manufacturer of the drug also include information that the use of the ellaOne pill is not recommended for people with asthma and taking steroids. There is also a lack of clear studies that would give the green light to people struggling with severe liver disorders.

The morning-after pill can temporarily reduce the effectiveness of birth control pills. After taking it, you can continue taking your medication on your own schedule, but you should combine the pill with a mechanical method of contraception, such as a condom, until you have a withdrawal bleed or menstruation.

You can learn more about withdrawal bleeding here .

The morning-after pill – who can prescribe it?

In Poland, ellaOne was available without a prescription from April 2015 to July 2017, but a law was later passed under which the morning-after pill can only be purchased upon presentation of a prescription.

Emergency contraception in Poland can be prescribed by any doctor , even a dentist, but it is worth knowing that he has the right to refuse to write a prescription, but on condition that you indicate another specialist from whom you will receive help. There is no need to conduct an examination before prescribing emergency contraception, but sometimes doctors ask for a pregnancy test to rule out a possible developing pregnancy. There is also no need to perform any additional tests, such as cytology or ultrasound.

First of all, you should go to a gynecologist or a primary care physician. However, what should you do if your physician refuses to write you a prescription? In such a situation, you can contact the Women's Physicians initiative , where you can get help in obtaining a prescription and the pill as quickly as possible. Even in the doctor's office where you were refused a prescription, it is a good idea to ask for the reason for the refusal in writing - this will allow you to file an official complaint later and take appropriate action to reduce the number of such situations in the future.

Morning-after pill – where to buy?

In Poland, the morning-after pill is available in pharmacies with a prescription. In most European Union countries, morning-after pills can even be purchased without a prescription in a drugstore (this information may be useful on a holiday abroad). It is worth buying a pill and keeping it for a time when you might need it - it will certainly save you nerves and stress if you actually need to take it. However, emergency contraception should not be overused - if you take the pill several times a month, it may affect the functioning of your hormonal system.

Knowing that you have this pill and can use it at any time has a calming effect on people who are paralyzed by fear of unwanted pregnancy. It may sound like a "whim" to some, but remember to refrain from such easy judgments. We do not know the situation of every person, and the motivations behind the decisions we make (including immediate protection against unwanted pregnancy) are an individual matter for each of us.

If you live near the border with another country, it is worth checking out how to buy a pill in a neighboring country. In the Czech Republic, you can buy the morning-after pill in any pharmacy without a prescription, basically right away – sex and contraception are not taboo subjects there. In Italy, on the other hand, morning-after pills are available without a prescription, even for minors.

However, if you cannot buy a tablet in another country and you want to have it in reserve, during your next visit to a doctor (remember: even a dentist!) who understands the situation, you can ask him to write you a prescription. Then you will always have the tablet at hand and in situations when time is of the essence, you will be able to breathe easy.

Remember! You can get emergency contraception for free throughthe foundation Jeszcze . There you will find two options for contacting a doctor: by phone or online (email). The specialist will issue you a prescription, which you will pay for at the pharmacy using the code you received.

How much does the morning-after pill cost?

In Poland, emergency contraception costs from a few dozen to even 200 PLN - the discrepancy you can encounter in this matter is large. In other countries, the amount you have to pay for the morning-after pill can be as much as around 50 euros. Emergency contraception is not subject to reimbursement in our country.

You will never be alone!

Being aware of the availability of emergency contraception and fully understanding how it works is essential – it gives you a sense of security and peace of mind if other methods of preventing pregnancy fail. You don’t have to explain your decisions to anyone – but remember that the morning-after pill is only for emergencies and essentials. If you don’t plan on having children or the fear of an unwanted pregnancy affects the quality of your sex life, talk to your gynecologist about other methods of contraception. Together, you will choose one that is right for you, your needs, preferences and lifestyle.

As always, we encourage you to talk, ask questions and dispel any doubts with us. We are here to help! <3