Knowledge Sharing
When should you take the morning-after pill? Where can you get it? What are the side effects?
Many people choose to take oral emergency contraceptive pills as the last line of defense in an emergency. But did you know that morning-after pills on the market are divided into first-generation and second-generation types? Which one did you take?
The two types of morning-after pills have different ingredients, so the timing of when to take them and their side effects also vary slightly. By understanding the differences between the two generations, you can make a safer and more suitable choice for yourself.
This article starts with the principle of how emergency contraception works, and will explain in detail the timing, side effects, and related issues of first- and second-generation morning-after pills. Our goal is to help you take the medication correctly, reduce potential risks, and ensure effective contraception.
About the morning-after pill
How does the morning-after pill work? Is it harmful to the body?
Dr. Luo Weizhe explains that as an emergency contraceptive method, oral morning-after pills generally have little impact on overall health, as long as they’re taken at the right time and not used too frequently or for long periods.
The way oral emergency contraceptive pills work is by adding extra hormones that create a feedback effect to “trick” the brain, delaying or stopping ovulation, and thickening cervical mucus to make it harder for sperm to reach the egg.
This helps prevent sperm and egg from combining into a fertilized egg, and also reduces the chance of implantation, achieving the purpose of contraception.
| Types | Levenorgestrol | Ulipristal acetate | |
| Main ingredient | High-dose progestin | High-dose progestin | |
| Number of pills | 1 tablet | 2 tablet, taken in two doses | 1 tablet |
| Recommended time to take after intercourse | Within 72 hours (best within 24 hours) |
|
Within 120 hours (best within 24 hours) |
| Success rate | When taken within three days, the effectiveness ranges from 95% to 58%, decreasing over time. | When taken within three days after intercourse, the effectiveness is about 98%. It can still provide some contraceptive protection if taken within five days. |
|
| Common brands |
|
Ella | |
When is the best time to take the morning-after pill?
First-generation emergency contraceptive pill
- Single-pill type: Should be taken within 72 hours after intercourse. The sooner you take it, the better the effect, ideally within 24 hours.
- Two-pill type: Should be taken in two doses. The first pill must be taken within 72 hours after intercourse, preferably within 24 hours to further reduce the risk of contraceptive failure. The second pill should be taken 12 hours after the first dose.
Second-generation emergency contraceptive pill
This type only requires one dose, unlike some first-generation pills that need to be taken in two stages. If possible, take it within 24 hours, and no later than 120 hours after intercourse, as its effectiveness decreases over time.
Dr. Luo Weizhe emphasizes that whether it’s a first- or second-generation morning-after pill, the sooner you take it, the higher the success rate.
Since the morning-after pill is a prescription medication, you should see a doctor as soon as possible after unprotected sex and take it according to medical advice to make the most of its effectiveness.
What are the side effects of the morning-after pill? How long do they last?
Side effects are one of the main reasons many people feel uncertain about taking the morning-after pill. Below are some of the most common side effects:
- Nausea or vomiting
- Dizziness or fatigue
- Breast tenderness
- Mild lower abdominal pain
- Changes in menstrual cycle
How long do the side effects of the morning-after pill last?
Because the morning-after pill works by using a high dose of hormones to trigger changes in the body, side effects are usually more noticeable within the first one to two days after taking it.
Usually, the side effects will gradually ease after this period.
Dr. Luo Weizhe reminds that if the side effects last for more than a week, or if you experience severe abdominal pain or heavy bleeding, you should see a doctor immediately to check for any abnormalities.
Another important thing to note is that if you vomit within 3 hours after taking the morning-after pill, it’s recommended to take another dose, in case the medication was expelled before it could take effect.
Will taking the morning-after pill delay your period?
Your period may come later, or even earlier, after taking the morning-after pill. As mentioned earlier, one of the side effects of the pill is its impact on your menstrual cycle.
Because the high dose of hormones causes sudden hormonal fluctuations in the body, your period may come about 5 to 7 days earlier or later than usual. A difference within about a week is considered normal, so there's usually no need to worry.
If your period doesn’t come after taking the morning-after pill, should you take a pregnancy test?
Yes, if your period is still late after taking the morning-after pill, you should take a pregnancy test.
If your period is delayed for more than a week, you can first use a home pregnancy test, or visit an OB-GYN clinic for a blood test.This helps you accurately understand your current situation, whether the emergency contraception failed, and also check if there are any other gynecological issues that need treatment.
Are there any long-term effects from taking the morning-after pill? Will it affect the uterus?
Taking the morning-after pill occasionally will not cause lasting side effects, harm the uterus, or affect future fertility.
However, it's important to note that frequent use means your body will repeatedly experience strong hormonal fluctuations. This can increase the risk of irregular menstrual cycles and hormonal imbalance, which may indirectly affect fertility and your chances of getting pregnant.
Who should avoid taking the morning-after pill?
Dr. Luo Weizhe reminds that while the morning-after pill can be an option for emergency contraception when necessary, it’s not suitable for everyone.
If you fall into any of the following groups, you should avoid taking it or use it with extra caution, and always consult a doctor first for professional evaluation:
- Those who are already pregnant: The morning-after pill has no effect once pregnancy has occurred and may affect embryo development.
- People with severe liver dysfunction: Since the medication is metabolized through the liver, poor liver function may cause improper metabolism and increase side effects.
- Those with serious cardiovascular disease or a history of blood clots: The morning-after pill can make the blood thicker, potentially increasing health risks.
- Patients with hormone-related cancers: Such as breast cancer or endometrial cancer, since the pill contains a high dose of hormones that may affect the condition. Patients with hormone-related cancers: Such as breast cancer or endometrial cancer, since the pill contains a high dose of hormones that may affect the condition.
- People taking certain medications — such as anti-epileptic drugs, sleeping pills, or antibiotics — as these can interfere with the pill’s effectiveness.
Therefore, if you need to use emergency contraception, be sure to consult a doctor first to confirm whether it’s a suitable option for your condition.
FAQ About the Morning-After Pill
Q1: Where can I get the morning-after pill? Can I buy it at a pharmacy?
In Taiwan, the morning-after pill is still classified as a prescription medication, which means you need a doctor’s prescription to purchase it.
If you need the pill, you can visit an OB-GYN clinic or hospital. After a doctor’s consultation and evaluation, the prescription can then be used to buy the medication at a pharmacy.
Q2: Which is more harmful, the morning-after pill or regular birth control pills?
Unlike low-dose daily birth control pills, the morning-after pill works by using a single high dose of hormones to stop ovulation and alter the uterine environment, reducing the chance of implantation, that’s how it achieves emergency contraception.
Because of this, the morning-after pill tends to cause more side effects than regular contraceptive pills. It's not meant for regular use and shouldn't be taken frequently or long-term.
In some countries, emergency contraception is also called "Plan B," meaning it's a backup method for unexpected situations. It's still best to rely on regular contraception methods, such as daily birth control pills, condoms, or IUDs, for ongoing protection.
Q3: How much does the morning-after pill cost?
The price of the morning-after pill usually ranges from NT$350 to NT$500. Since it requires a doctor's prescription, the total cost may vary depending on the consultation, hospital, or pharmacy.
Lastly, if you need to use emergency contraception, be sure to consult a qualified doctor, purchase it with a prescription, and take it exactly as directed. Don't let worries about side effects cause you to miss the crucial window for effective emergency contraception.
References：
- Kahlenborn C, Peck R, Severs WB. Mechanism of action of levonorgestrel emergency contraception. The Linacre Quarterly. 2015 Feb;82(1):18-33.
- Chao YS, Frey N. Ulipristal versus Levonorgestrel for Emergency Contraception: A Review of Comparative Clinical Effectiveness and Guidelines [Internet]. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2018 Nov 29. Available from: https://www.ncbi.nlm.nih.gov/books/NBK538737/
- Reviewing Physician: DR. Wei-Che Lo
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