What is everyone after

The morning-after pill

After a breakdown in contraception, the morning-after pill can prevent an unwanted pregnancy. The drug is most effective when taken as quickly as possible. It can be bought at the pharmacy without a prescription.

The morning-after pill is available for emergencies if a contraception failure has occurred or if the contraception has been forgotten. If the mishap occurs a few days before or on the day of ovulation, there is a possibility of conceiving.

The male sperm cells can persist in the uterus and fallopian tubes for up to five days. If ovulation occurs during this time, fertilization is therefore possible up to five days after unprotected sexual intercourse, and in very rare cases up to seven days.

This is where the morning-after pill comes in: If ovulation has not yet taken place, the morning-after pill can inhibit or delay it for so long that fertilization is no longer possible because the sperm then "miss" the egg.

effect

There are different preparations with different active ingredients: either levonorgestrel or ulipristal acetate. Both active ingredients inhibit or delay ovulation. If they are taken in good time before ovulation, they can prevent fertilization of the egg.

To prevent ovulation, it is best to take the morning-after pill as soon as possible, preferably within 12 hours of unprotected sex. After that, their effectiveness will gradually decrease. Preparations with the active ingredient levonorgestrel are approved for use up to a maximum of 72 hours (three days) after unprotected sexual intercourse, the preparation with the active ingredient ulipristal acetate for a maximum of 120 hours (five days) afterwards. After more than 120 hours it is too late for the morning-after pill.

Preparations with levonorgestrel are effective if they are taken up to about two days before ovulation, the preparation with ulipristal acetate even on the day before ovulation. However, if ovulation is imminent or has already occurred, both preparations no longer work.

If, despite the correct intake of the morning-after pill, fertilization has taken place and the fertilized egg has lodged in the uterus, damage to the embryo is not to be expected according to the current state of knowledge.

Levonorgestrel has extensive and long-term experience in terms of effectiveness and safety. So far, there is only limited experience with the active ingredient ulipristal acetate. Therefore, any pregnancy that occurred after taking the preparation containing ulipristal acetate should be reported. The gynecologist or the pregnant woman can register at www.hra-pregnancy-registry.com/de/.

If the morning-after pill is taken during an existing pregnancy, the pregnancy will not be terminated. The morning-after pill is not a “demolition pill” (which it is often confused with).

Ingestion

The morning-after pill should be taken as soon as possible after unprotected sexual intercourse, if possible within 12 hours.

A tablet is taken once for all preparations. It is advisable to have a bite to eat beforehand (half a sandwich or something similar). If the stomach is empty, there is more of a risk of vomiting the tablet. If this happens within the first three hours after ingestion, a new morning-after pill must be obtained and taken as soon as possible to ensure that it remains effective.

The morning-after pill can be taken at any point in the menstrual cycle ‘.

Levonorgestrel and ulipristal acetate must not be taken together.

Contraindications and warnings

Women who are hypersensitive to levonorgestrel or ulipristal acetate or an excipient contained in the respective tablets must not take the "morning-after pill" in question.

If there are already signs of pregnancy (for example, a late menstrual period or morning sickness), it makes sense to first do a pregnancy test or seek advice from a gynecologist before taking a morning-after pill.

Women who have already had a fallopian tube inflammation, fallopian tube or ectopic pregnancy must clarify with their doctor whether the morning-after pill is an option for them.

The morning-after pill is also not recommended for severe liver dysfunction.

Taking the morning-after pill with the active ingredient levonorgestrel is not recommended if there is an increased risk of thrombosis (blood clots) in one's own or family history.

The active ingredient ulipristal acetate should not be used in severe asthma when glucocorticoids are ingested.

After ingestion

After ingestion, the menstrual period can shift and start sooner or later. If it does not occur within a week of the expected menstrual date, a pregnancy test should be taken and a doctor should be consulted. This also applies if there are other signs of a possible pregnancy despite taking the morning-after pill: unusually weak or heavy bleeding, abdominal pain, tightness in the chest or nausea.

Until the next menstrual period, it is necessary to use a non-hormonal contraceptive such as condoms.

If you are using the pill and have taken the morning-after pill with the active ingredient levonorgestrel because of a mistake in taking it, you should continue to take your normal contraceptive pill until the end of the cycle and also use a non-hormonal contraceptive, for example condoms, for seven days.

If you have taken the morning-after pill with ulipristal acetate, you should skip the contraceptive pill for five days and use other methods of contraception, for example with a condom.

Ask at the pharmacy or your gynecologist how the contraception will proceed.

security

Taken in good time before ovulation, the morning-after pill has a high probability of preventing pregnancy. However, the longer there is between unprotected sexual intercourse and taking the morning-after pill, the greater the period of time in which ovulation can still take place. That is why it is so important to take it as quickly as possible.

If other drugs such as certain antibiotics, anti-seizure drugs (anti-epileptic drugs) or HIV infections, anti-viral drugs (antivirals) or drugs containing St. John's wort are taken at the same time, the effectiveness of the morning-after pill may be reduced. Women who regularly take drugs or who have taken them until recently should raise this point at the pharmacy or seek medical advice before taking the morning-after pill.

Even being very overweight can possibly reduce the effectiveness of the morning-after pill, especially the preparation containing levonorgestrel. Affected women should seek advice from a doctor or a pharmacy about the most suitable method for them.

Side effects

After taking the morning-after pill, as with any other medication, undesirable effects are possible. These include headaches, nausea and abdominal pain in particular. Minimal or intermediate bleeding ("spotting"), breast tenderness and vomiting can also occur. Some women feel dizzy or light-headed after taking it, which may affect their ability to drive.

Anyone who is in pain or worries for other reasons should seek medical advice.

Where to get it

The morning-after pill is available in pharmacies without a prescription. Advice is also offered there. For example, it can be discussed whether a pregnancy may already exist, how likely fertilization is and whether there are contraindications or possible interactions with other drugs.

It happens that some pharmacies refuse to dispense the morning-after pill. In this case, you can turn to another pharmacy. Local pharmacy emergency services are available at night and on weekends, and information can be obtained from the Internet or by telephone. Information is also provided in the shop window displays in every pharmacy.

Morning-after pill and breastfeeding

The active substance levonorgestrel passes into breast milk. Therefore, preparations with this active ingredient should be taken immediately after breastfeeding if possible. After that, a break from breastfeeding of at least eight hours should be observed.

After taking the preparation with the active ingredient ulipristal acetate, it is recommended to stop breastfeeding for at least a week. During this time, it makes sense to express breast milk in order to maintain milk production. The expressed milk must be thrown away.

costs

The prices for the morning-after pill can fluctuate as there is no fixed retail price. Preparations with the active ingredient levonorgestrel currently cost around 18 euros in pharmacies, the preparation with the active ingredient ulipristal acetate currently costs around 35 euros.

Even after the “morning-after pill” has been released from the prescription requirement, the costs for women with statutory health insurance up to their 22nd birthday will be covered by the health insurance. The prerequisite is that you have the morning-after pill prescribed by a doctor. However, from the 18th birthday a statutory additional payment is due. At night, on weekends or on public holidays, it is best to contact the medical on-call service, who can be reached anywhere on the telephone number 116117. The number works without an area code, is valid throughout Germany and is free of charge - both for calls with the fixed network and with the mobile phone. Another possibility is the medical or (if available) gynecological outpatient clinic at the nearest hospital.

Women under the age of 22 can also buy the morning-after pill in the pharmacy without a prescription, but will not be reimbursed by the health insurance company. Girls under the age of 14 need the consent of their parents if they want to buy or have a prescription for the morning-after pill.

If you are between 14 and 18 years old, the pharmacist will decide on this. In the conversation you will try to find out whether a girl is able to make the decisions and consequences associated with self-medication on her own.