But the morning-after pill has.

Now authorised in the European Union for
access in pharmacy without prescription.
Check availability for your country.
But the morning-after pill has.
when it matters most
ellaOne® (30mg ulipristal acetate) is an oral emergency contraceptive intended to prevent pregnancy after unprotected sex or if your contraceptive method
has failed. You should take ellaOne® as soon as possible after sex, and within a maximum of 5 days (120 hours). ellaOne® is a medicinal product. Always read the
package leaflet carefully before taking ellaOne®. Health information within this booklet is provided for educational purposes only and is not intended to replace
discussions with healthcare professionals. All decisions regarding patient care must be made with a healthcare professional considering the unique characteristics
of the patient. For internal use only. It is the responsibility of each partner to ensure that final educational material is in compliance with local regulations.
ELA-WEBGP-0813-EU
Introduction
Jargon
buster
Babies are great. But you probably want to choose if and when to
have a baby. Even if you have taken care with your contraception,
accidents can happen to anyone. Emergency contraception is a
back-up – a second chance to avoid unplanned pregnancy after
unprotected sex or contraceptive failure.
If you think you need emergency contraception – you need
to act fast. This is because emergency contraception works
in the days just after unprotected sex to prevent a pregnancy
from starting. Emergency contraceptive pills stop an egg being
released (ovulation). If you wait, it might be too late to take the
morning-after pill because you have already ovulated.
ellaOne® is an advanced morning-after pill. It is effective
when it matters most and is now authorised in the European
Union for access in pharmacy without prescription. Check
availability for your country.
Emergency
contraception
is also called:
n
The morning-after pill
n
The day-after pill
n
M
orning-after
contraception
Unprotected sex
can be when:
n
Y
our contraceptive
didn’t work properly
(contraceptive
failure). See page 13
for more on this
n
Y
ou didn’t use any
contraception
This booklet will help you understand more about your body
and emergency contraception, so you can make the choices
that are right for you.
READ ON TO FIND OUT MORE ABOUT
Me and my reproductive system
Me and emergency contraception
2
4
13
Me and ellaOne®
20
Me and my pharmacist talking about ellaOne®
24
Me and my contraception in the future
25
Check you’ve understood the facts
28
When it matters most
Top ten
things you should know about oral
emergency contraception and ellaOne®
1.If you’ve had unprotected sex, and it is not the right time in
your life to have a baby, you are right to consider emergency
contraception.PIL Unprotected sex, or contraceptive accidents
can happen to anyone.
2.Act quickly. Emergency contraception is most effective
when used as soon as possible and within 24 hours after
unprotected sex.NHS EC, PIL
3.ellaOne® works by delaying egg release.PIL So, by the time an egg
is released (ovulation) the sperm inside you are no longer capable
Pallone
of making you pregnant.FSRH,
a
4.ellaOne® is the only morning-after pill that can prevent
FSRH, SPC
pregnancy even when you are about to ovulate
– which is when your risk of getting pregnant is greatest.
Brache,
5.ellaOne® is now authorised in the European Union for access in
pharmacy without prescription. Check availability for your country.
6.ellaOne® is suitable for women of reproductive age and it
is well tolerated.PIL, Glasier
7.ellaOne® is taken as one single tablet. It is for occasional
PIL
use and should not replace a regular contraceptive method.
8.If you want to have sex after using ellaOne®, use a barrier method
of contraception until your next period.
PIL
It works by
t it is too late
pregnan
are
delaying or inhibiting egg release. If you
for emergency contraception because it works to prevent the start
®
of a pregnancy. So, you should not take ellaOne if you are
9.The morning-after pill does not cause abortion.NHS
EC
PIL
already pregnant.
10. Always read the package leaflet before taking ellaOne
.
® PIL
3
When it matters most
Chapter 1:
Me and my reproductive system
The reproductive system, sometimes called the sexual organs, is the
set of organs needed to make a baby, or reproduce.RCOG
What does my reproductive system look like?
Your reproductive system is made up of a vulva, vagina, cervix,
womb, fallopian tubes, ovaries and breasts. Unlike men, most
of your reproductive system is located inside the body.
Ovary
You have two ovaries.
The ovaries produce
an egg (ovum) each
Fallopian tube
An egg, released by
your ovary, goes into
your fallopian tube.
The egg travels to your
womb (uterus). If you
have had unprotected
sex, sperm can fuse
with the egg. This is
called fertilisation and
usually happens in the
month during the
menstrual cycle. This is
RCOG
called ovulation.
Cervix
The entrance to your
womb.RCOG
fallopian tubes.
RCOG
Vagina
The penis goes into
the vagina during sex.
In childbirth the baby
comes out through the
Womb
This is where the
fertilised egg implants
and where the baby
RCOG
subsequently grows.
Jargon
vagina.RCOG
buster
Your
repro
ducti
is the
ve sys
parts
tem
of yo
enabl
ur bo
e you
dy th
to ha
at
ve a b
aby
4
When it matters most
Understanding the menstrual cycle
The menstrual cycle is the process where an egg develops each month
and the lining of your womb is prepared for possible pregnancy.RCOG
The menstrual cycle is driven by body chemicals called hormones.
A cycle is counted from the first day of bleeding (your period) to the
first day of your next period.Aitken The rise and fall of hormonal levels
during this time control the menstrual cycle.
WHAT’S HAPPENING IN YOUR WOMB
4. If there is no
pregnancy you
have a period
and the cycle
Aitken
starts again.
1. This diagram
shows the lining
of the womb. At
the beginning of
your menstrual
cycle it breaks
down and you
Aitken
have a period.
0 days
Luteal
phase
Follicular
phase
2. The follicular phase
describes the
maturation of eggs
Aitken The
in the ovary.
eggs grow in follicles.
Aitken By the end of
the follicular phase
one egg is ready to
pop out of its follicle;
ovulation.Aitken
28 days
Ovulation
You cannot
tell when
you will
ovulate
3. The luteal phase is
Aitken
after ovulation.
The popped follicle
(now called a corpus
luteum) produces
progesterone and
oestrogen to thicken
the womb lining
getting it ready for
Most women’s
cycles are between
15 and 45 days,
although the average
Chiazze
is 28 days.
pregnancy.
Aitken
What’s happening to your hormones?
The menstrual cycle is controlled by a complex interaction
of hormones.RCOG In each cycle, rising levels of hormones
cause the ovary to develop an egg and release it (ovulation).Aitken
The womb lining also starts to thicken.
5
When it matters most
ovulation?
What is
Ovulation is the release of an egg from the ovaries.RCOG
A woman is born with all her eggs. Once you start your periods,
one egg (occasionally two) develops and is released during
each menstrual cycle.Aitken
After ovulation, the egg lives for approximately 24 hours.Pallone
Once the egg is released from the ovary it travels down the
fallopian tube towards the womb. Fertilisation happens if a
man’s sperm meets and fuses with the egg.RCOG Sperm can
survive in the fallopian tubes for up to five days after sex.Pallone
ONS
P
TAM
2U0NT
If the egg is not fertilised, the egg is reabsorbed into the body.
Hormone levels fall, and the womb lining comes away and
leaves the body as a period.RCOG, Aitken
CO
PREGNANT
NOT PREG
NANT
A woman cannot get pregnant
if ovulation does not occur.
Oral em
ergency
contrac
eption
works
b
ovula y delaying
tion. ella SP
or sto
C, WH
ppi
O
LNG
6
ng
When it matters most
There is a risk of conception throughout your cycle
In theory, during the average woman’s menstrual cycle there
are six days when sex can result in pregnancy. This conception
risk period, also called ‘fertile window’ is the five days before
egg release (ovulation), plus the day of egg release.Wilcox 00
You are at risk of conception during:
The 5 days before egg release...
...and the
day of egg
release
1 2 3 4 5 6
You are at risk of conception if you have unprotected sex in
the 5 days before ovulation because sperm can live for about 5
days, and can be waiting in the fallopian tubes, ready to fertilise
your egg.Pallone An egg only lives for 24 hours.Pallone
The highest risk of pregnancy is when ovulation happens
shortly after unprotected sex.
Sperm viability declines in the days after sex. This means that
the risk of conception is highest when ovulation happens during
the first three days following unprotected sex.Wilcox 95
7
Wordy Birdy
Womens Health Illustrations
3131
14 Oct 2013
When it matters most
Fig 3
S/S
When is this conception risk period?
You have no way of knowing when your fertile window is - and it
can be at a different time every month.Wilcox 00
Don’t ta
a chanc ke
e
This means that you are at risk of pregnancy almost throughout
the whole of your menstrual cycle.Wilcox 00
n
Y
ou might not ovulate on the same day of your cycle from
one month to the otherWilcox 00
n
W
omen with a regular cycle can be in their fertile window any
time from day 6 to day 21Wilcox 00
n
W
omen with an irregular cycle can be in their fertile window
from day 8-28Wilcox 00
Sperm live for about 5 days
after unprotected sex
Ther
e is n
o saf
cycle
e tim
when
e in
unpr
otect you can h your
a
ed se
certa
x and ve
in no
be
t to g
et pr
egna
nt
Day
6
The egg lives for 24 hours
after release. Fertilisation
can happen up until day 6
after unprotected sex.
8
When it matters most
How and when does a pregnancy start?
When a single sperm fuses with an egg it is called fertilisation.RCOG
Pregnancy starts several days after fertilisation
Pregnancy does not begin until the fertilised egg has implanted
in the womb, after having travelled through the fallopian tube.Gold
When women have unprotected intercourse, they are not immediately
pregnant. Pregnancy can only occur when the fertilised egg implants in
the womb.Gold This occurs 6 to 12 days after ovulation.Wilcox 99
So if you’ve just had unprotected sex or contraceptive failure,
no pregnancy will start until at least the 6th day.
3. As the fertilised egg
moves along the fallopian
tube it divides
2. Fertilisation when the
egg and
sperm fuse
Day 1
4. Pregnancy begins
when the fertilised egg
implants in the womb
Day 4
Day 2
Day 3
Day 0
Day
6-12
1. An egg is released
during ovulation
Embryo
Signs of pregnancyNHS pregnancy
n
L
ate period
n
T
iredness
n
F
eeling sick (nausea)
n
B
reast tenderness or soreness
n
B
eing sick (vomiting)
n
N
eeding to pee (urinate) more often
If you think you might be pregnant, take a pregnancy test and/or
visit your doctor. If you are pregnant it is too late for emergency
contraception because it works to prevent the start of a pregnancy.
9
When it matters most
CONTRACEPTION AND MENSTRUAL CYCLE MYTHS
There are a number of birth control methods that are highly effective
in preventing pregnancy. There is also a lot of misinformation about
how the reproductive system works, how to use birth control, as well
as some methods that simply do not work.
Below are some common myths regarding menstrual cycle, sex and contraception
COMMON
BELIEF
10
TRUE OR
FALSE
EXPLANATION
Ovulation happens
in the middle of the
cycle around day 14
False
The timing of ovulation is very unpredictable.Wilcox
Only 10% of women ovulate on day 14 of their cycle.
Wilcox
Ovulation can happen any time from day 1121 if your cycle is regular, and up to day 28 if your
cycle is irregular.Wilcox The timing of ovulation can
also vary from cycle-to-cycle, making it impossible
to know when it will happen.Wilcox This means risk of
conception exists on almost every day of your cycle.
If my cycle is regular
then ovulation will
always happen in
the middle of it
False
The timing of ovulation is unpredictable and varies
from cycle-to-cycle, even if the length of your
menstrual cycle is regular.Wilcox
Regular cycles
exist (unless on a
contraceptive pill)
False
Most women are not as regular as we would think.
They can be regular for a number of cycles in a row,
but then have a cycle that is much shorter or longer.
A woman never knows in advance if her current
cycle will be longer or shorter than normal. When
you use a hormonal contraceptive pill your cycles
are regular (provided you take them correctly).
I cannot get
pregnant in the
beginning or at the
end of my cycle
False
Because the timing of ovulation is unpredictable
and sperm can stay viable for up to 5 days in your
fallopian tubes,Wilcox, Pallone the risk of conception from
unprotected intercourse exists on almost every day
of your cycle.Wilcox
When it matters most
COMMON
BELIEF
11
TRUE OR
FALSE
EXPLANATION
Pregnancy starts
directly after
unprotected sex
False
Pregnancy does not begin immediately after
unprotected sex. Pregnancy starts when the
fertilised egg implants in the womb,Gold which
normally happens 6-12 days after fertilisation.Wilcox 99
This means you are not pregnant until at least the
6th day after unprotected sex.
Unprotected sex
happens very rarely
False
If you have had unprotected sex and you do not
want to become pregnant, you might be angry with
yourself, for not taking more care. But don’t be too
hard on yourself - you are not alone. Many women
(about 30%) had unprotected sex at least once over
the last year.BVA,2012 This is not to say that you should
not take good contraceptive care, but accidents
happen, so don’t think you are the only one.
I cannot get
pregnant as long
as sex takes place
outside my fertile
window
True
This is obviously true, but you cannot calculate
with certainty when your fertile window will be.
This is because the timing of ovulation is variable
and unpredictable.Wilcox If you think that your fertile
window will always be around day 14 of your cycle,
you are incorrect – your fertile time could be earlier
or later. If you want to prevent pregnancy you
should not have unprotected sex at any time during
your cycle.
I’m breastfeeding so
I can’t get pregnant
False
While breastfeeding tends to postpone ovulation,
this is not a guarantee. Ovulation can occur
even when a woman is breastfeeding. If you are
breastfeeding you should preferably use condoms
if you wish to avoid pregnancy.
You can’t get
pregnant if the
woman doesn’t have
an orgasm
False
Fertilisation occurs when a sperm from the man
fuses with an egg from the woman.RCOG While
the man must ejaculate to release sperm, it is
not necessary for the woman to have an orgasm
to release an egg. A woman of childbearing age
releases an egg each month as part of her regular
menstrual cycle. This occurs whether or not the
woman has an orgasm.
When it matters most
COMMON
BELIEF
12
TRUE OR
FALSE
EXPLANATION
I don’t need
contraception
because we only
have sex during
the ‘safe’ time.
You’re only fertile
one day a month
False
During the average woman’s menstrual cycle there
are six days when sex can result in pregnancy: the
five days before egg release (ovulation), plus the day
of egg release.Wilcox 00 The timing of ovulation can also
differ from cycle to cycle.Wilcox Therefore, pinpointing
the time of ovulation is almost impossible. This
means the risk of conception from unprotected sex
exists on almost every day of your cycle.
I won’t get pregnant
if we have sex
standing up or if the
woman is on top
False
Some people believe that having sex in certain
positions, such as standing up, will force the
sperm out of the woman’s vagina. However
sexual positions have no effect on whether or
not fertilisation occurs. When a man ejaculates,
the sperm are deposited well into the vagina. The
sperm will begin to move up through the cervix
immediately after ejaculation.
I won’t get pregnant
if my partner pulls
out before he
ejaculates
False
Pulling out before the man ejaculates, known
as withdrawal, is not a foolproof method of
contraception.Trussell The fluid a man releases prior to
ejaculation can already contain sperm. Also, a man
may simply not withdraw in time.
I won’t get pregnant
because this is my
first time having sex
False
A woman can get pregnant any time ovulation
occurs, even if she’s never had sex before.
I won’t get pregnant
if I take a shower or
bath right after sex,
or if I urinate right
after sex
False
Washing or urinating after sex will not stop
sperm that have already entered the uterus through
the cervix.
When it matters most
Chapter 2:
Me and emergency contraception
Is emergency contraception right for me?
Emergency contraception prevents pregnancy after
unprotected sex or contraceptive failure.FPA EC It has to be used
as soon as possible.FPA EC
If you’ve had unprotected sex within the last 5 days, and it is
not the right time in your life to have a baby, you are right to
consider emergency contraception.PIL
n
n
Have you had
unprotected sex?
D
id you forget to:
n
T
ake your contraceptive pill?
n
Insert your contraceptive ring?
n
A
pply your contraceptive
patch?
n
n
D
id you forget to use
any contraception?
D
id the condom slip
off or break?
n
D
id he fail to pull
out in time?
D
id your diaphragm
or cap slip or did you
forget to use it?
n
W
ere you forced to
have sex without
contraception?
My emergency contraception options
In Europe, there are two different emergency contraceptive options:
n
T
ablet ‘the morning-after pill’ for oral use
n
Intrauterine device to be fitted in the womb
13
When it matters most
The intrauterine device (IUD) which is suitable
for emergency contraception is a Copper-T IUD
Copper-T IUD is considered the most effective emergency
contraceptive method and it provides an ongoing
contraceptive solution.Cheng However in a situation where you
need to act very quickly, IUD fitting takes time and involves an
invasive and uncomfortable procedure.Glasier10
Copper-IUD can be fitted up to 120 hours (5 days) after
unprotected sex.RPS advice However its use is restricted
by its availability and the need to be inserted by a
healthcare professional.Glasier10
If you ne
ed the IU
D for
emergen
cy contr
a
ception
contact
a doctor
or family
planning
service u
rgently.
Oral emergency contraception (emergency contraception pills, ECPs)
Emergency contraceptive pills are also called morning-after
pills, because it is best to take them as soon as possible after
unprotected sex.NHS EC
There are two oral emergency contraceptives available
n
O
ne containing levonorgestrel, which was first made
available in 1999
n
O
ne containing ulipristal acetate (ellaOne®), which became
available in 2009
The mechanism of action of oral emergency contraception is
to postpone or inhibit ovulation, so that no egg is released.WHO LNG, ella SPC
Depending on the country, oral emergency contraception may be
available directly from your pharmacist, without a prescription.
The dose is one single tablet to be taken as soon as possible after
unprotected sex.NHS EC, ella SPC
1976
Copper IUDs first
used for emergency
contraceptionCleland 2012
14
1999
Levonorgestrel first
available as emergency
contraceptionHRA DOF
ellaOne® offers an advanced
emergency contraception
and was specifically
developed for emergency
contraceptionDOF
2009
ellaOne®
first available
in the EUHRA DOF
When it matters most
SUMMARY OF THE TYPES OF EMERGENCY
CONTRACEPTION AVAILABLE IN EUROPE
FORMAT
ellaOne (30mg
ulipristal acetate)
®
Tabletella SPC
Levonorgestrel
(1.5mg)
TabletFSRH
Copper
intrauterine
device (IUD)
A small
T-shaped
device that
is fitted
inside your
womb by a
doctorRCOG
HOW EFFECTIVE
IS IT?
HOW CAN
I GET IT?
As soon as possible, and
within 5 days (120 hours)
after unprotected sex or
ella SPC
contraceptive failure
Effective even when
taken just before egg
releaseella SPC when
risk of pregnancy is
Pharmacy
or doctor’s
prescription
As soon as possible,
and within 3 days
(72 hours) after
unprotected sex or
FSRH
contraceptive failure
Effective but doesn’t
work when taken just
FSRH
before egg release
Pharmacy
or doctor’s
prescription
As soon as possible,
and within 5 days
(120 hours) after
unprotected sex or
FSRH
contraceptive failure
Effective and
has in addition
the advantage of
providing regular
contraception as soon
Cheng
as it is in place
Doctor’s
prescription
HOW QUICKLY
MUST I ACT?
highest
If you are not sure which is right for you, ask
a pharmacist or other healthcare professional.
15
When it matters most
How do emergency contraception pills prevent pregnancy?
Emergency contraceptive pills work by inhibiting or delaying
ovulation (egg release).ella SPC, WHO LNG They work to prevent
pregnancy after unprotected sex by quickly postponing
ovulation, if it has not already happened. This means that the
sperm waiting in the fallopian tubes will be unable to meet an
egg and fertilise it. This is similar to regular contraceptive pills,
which also work by preventing egg release.
Emergency contraceptive pills are not 100% effective.ella SPC
This is because there is a chance that you may have already
ovulated when you take an emergency contraceptive pill.
Taking emergency contraceptive pills as soon as possible after
unprotected sex gives the best chance of success.NHS EC
s, the better
The sooner you take emergency contraceptive pill
n
16
SPC
are not 100% effective
Emergency contraceptive pills
n
fter pill that is still effective
ellaOne® is the only morning-a
e 2013
tSPC, FSRH, Brach
when risk of pregnancy is highes
n
chance
y contraception, the better the
he sooner you take emergenc
T
NHS EC
ncy
lation and avoiding pregna
of successfully postponing ovu
When it matters most
Sexually transmitted infections
Emergency contraceptive pills do not protect against
sexually transmitted diseases or infections.NHS EC
If you have had unprotected sex you might have caught
a sexually transmitted infection. If this might be the case,
talk to your doctor, or another healthcare professional,
about getting tested.PIL They can put your mind at rest,
provide treatment and explain how you can avoid passing
the infection on to other people whom you have sex with.
Jargon buster
infections?
What are sexually transmitted
and include:
These are passed on through sex
tal warts
n Genital herpes n Geni
HIV infection (AIDS) n Chlamydia
B n Syphilis
n Gonorrhea n Hepatitis
Bedsider
from these diseases.
Only condoms can protect you
n
Emergency contraceptive pills will not protect you from
pregnancy if you have further unprotected sex.NHS EC
If you want to have sex after using an emergency
contraceptive pill, use a barrier method of contraception
until your next period.
Myth buster
Emergency contraceptive pills do not cause abortion.
You might have heard that emergency contraceptive pills cause
abortion. This is not true. Emergency contraceptive pills prevent
pregnancy.FPA They act before pregnancy can occur.
If you are already pregnant, emergency contraception will not stop
your pregnancy. It will not cause an abortion.FPA
17
When it matters most
Common myths about emergency contraception
COMMON
BELIEF
18
TRUE OR
FALSE
EXPLANATION
Oral emergency
contraception can
only be used if you
have a ‘contraceptive
accident’ e.g. torn
condom
False
Emergency contraception is for women who want
to prevent pregnancy after unprotected sex.
Unprotected sex can be through an accident,
or not using any contraception at all. This not
uncommon. Many women (about 30%) had
unprotected sex at least once over the last year.BVA
Oral emergency
contraception is a
‘hormonal bomb’
that will ruin my
cycles
False
For the last 10 years, dedicated emergency
contraceptives have been available. The hormones
contained in oral emergency contraception can
alter your menstruation (period), during the cycle
you take it. This means after intake your next
period might be on time, or earlier, or later than
normal. After this your cycle normally returns to
its regular pattern.
Oral emergency
contraception is a
‘hormonal bomb’ that
will make me sick
False
The morning-after pill was specifically designed
and developed for emergency contraception.
Emergency contraception is well tolerated; however
like all medicines it can cause side effects, although
not everyone gets them.WHO LNG, ellaOne SPC
If you are sick (vomit) within 3 hours of taking an
emergency contraception tablet, go back to a
pharmacist and get another ellaOne® tablet to take.2,3
I cannot take
oral emergency
contraception twice
in the same cycle
True
and
False
The aim of taking an emergency contraception
pill is to delay or inhibit egg release until the
sperm that are waiting in the fallopian tube are
no longer capable of making you pregnant. It will
delay ovulation for 5-6 days. If you have further
unprotected sex during the same cycle your
chances of postponing ovulation again are lower
than when you took it the first time. It is possible
to take emergency contraception twice in the
same cycle, provided you are not already pregnant,
but it is really much safer to think about a regular
contraceptive method, because they are more
effective in preventing pregnancy. In any case, you
should get medical advice if you need emergency
contraceptive twice in the same cycle.
When it matters most
COMMON
BELIEF
19
TRUE OR
FALSE
EXPLANATION
Oral emergency
contraception is a
sort of mini abortion
False
Emergency contraception works by inhibiting or
delaying egg release.ella SPC, WHO LNG This means that
the sperm that is waiting in the fallopian tube will
no longer be capable of making you pregnant. This
all happens before pregnancy can begin, which is
6-12 days after unprotected sex.Wilcox, Gold If you are
pregnant, emergency contraception will not stop
your pregnancy.
Oral emergency
contraception will
have a negative
effect on my fertility
False
Emergency contraception has no effect on future
fertility.WHO LNG, ella SPC If you want to have sex after
using emergency contraception, use a barrier
method of contraception until your next period.NHS
EC, ella SPC
This is because your fertility can come back
very quickly.
I can use oral
emergency
contraception
as my regular
contraception
False
Emergency contraception is not a regular
contraceptive.NHS EC, ella SPC After unprotected
sex it is wise to use emergency contraception
to prevent pregnancy. But emergency
contraception is not 100% effective (because you
may have already just ovulated when you took
the emergency contraceptive pill).
When it matters most
Chapter 3:
Me and ellaOne®
What is ellaOne ?
®
n
e
llaOne® is a morning-after pill, that can prevent a pregnancy after
unprotected sex, or if your contraceptive method has failedPIL
n
e
llaOne® is effective when it matters most because it can prevent
a pregnancy even when you are about to ovulate – which is
when your risk of getting pregnant is greatestSPC, FSRH, Brache 2013
n
e
llaOne® works by delaying egg release.PIL So, by the time an egg
is released (ovulation) the sperm inside you are no longer capable
of making you pregnantFSRH, Pallone
n
E
ach tablet of ellaOne® contains 30 mg ulipristal acetatePIL
n
e
llaOne® is easy to take – it is one tablet to be taken as soon as possiblePIL
n
e
llaOne® should be taken as soon as possible, but no later than 5 days
(120 hours) after unprotected sex or contraceptive failurePIL
n
e
llaOne® is for women of reproductive ageSPC
n
e
llaOne® is suitable any time during your cycleSPC
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20
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When it matters most
What ellaOne is not...
®
NOT a regular contraceptive methodPIL
You should not use ellaOne® as a regular method of contraception.PIL The
emergency contraceptive pill is a backup method for preventing pregnancy
and should only be used occasionally.PIL
NOT a contraceptive for future intercoursePIL
If you have unprotected sex again after taking ellaOne®, it will not stop
you from becoming pregnant. You should use a barrier method, such as
condoms, every time you have sex until your next period. If you are currently
taking the contraceptive pill, continue to use it as usual, starting the day after
taking ellaOne®. Be sure to use condoms every time you have sex until your
next period.
NOT used to cause abortionNHS EC
ellaOne® works by delaying egg release.PIL If you are pregnant it is too late
for emergency contraception because it works to prevent the start of a
pregnancy. So, you should not take ellaOne® if you are already pregnant.
ellaOne® does not affect your fertilitySPC
If you want to have sex after using ellaOne®, use a barrier method
of contraception until your next period.ella SPC This is because
your fertility can come back very quickly.
Who is ellaOne not suitable (contraindicated) for?
®
when it
matters
most
You should not use ellaOne® if:
n
ou are allergic to ulipristal acetate or any of the other ingredients in
Y
ellaOne®. (Ingredients are listed in the pack leaflet – ask a pharmacist
if you are unsure)PIL
Can I take ellaOne if I am breastfeeding my baby?PIL
®
Do not breastfeed your baby for one week after taking ellaOne®. During this
week you should express your breast milk to stimulate and maintain milk
production. Throw away the milk you express.
21
When it matters most
What to know when taking ellaOne®
ellaOne® is easy to take – it is one single tablet. You can take ellaOne® with some
water as soon as possible and no later than 120 hours (5 days) after you have
had unprotected sex.PIL
Sometimes women decide to take ellaOne® in the pharmacy when they buy it.
It’s fine to take it either before, during or after a meal.PIL
If you are sick (vomit) within 3 hours of taking an ellaOne® tablet, go back to
a pharmacist and get another ellaOne® tablet to take as soon as possible.PIL
ellaOne® is well tolerated
Like all medicines, it can cause side effects, although not
everyone gets them.PIL
The most commonly reported side effects were headache,
nausea (feeling sick), abdominal pain and painful periods.PIL
These are also possible signs of pregnancy. If you miss your
period or your period is lighter or heavier than normal, and you
experience such symptoms after taking ellaOne®, you should
do a pregnancy test.PIL
If you get any side effects, talk to your doctor or pharmacist.PIL
How do I know if it worked?
You will know that ellaOne® has worked when your next
period starts. After taking ellaOne®, most women have a
normal period at the expected time. But some may have their
period later or earlier than normal.PIL
If your period is more than 7 days late, or is unusually light
or unusually heavy, or if you have any doubt about being
pregnant, do a pregnancy test.PIL
Sex after ellaOne
®
After using ellaOne®, if you want to have sex, always use a
reliable barrier contraceptive method such as condoms until
your next period, even if you use a regular contraceptive pill.PIL
22
If you
don’t
use b
contr
arrie
acep
r
tion a
fter t
aking
ellaOne
®
until
your
next
you c
peri
an be
come od,
preg
nant
When it matters most
The contraceptive pill and ellaOne
®
STARTING THE
CONTRACEPTIVE PILL
CONTINUING TO TAKE THE
CONTRACEPTIVE PILL
If you wish to start a regular
method of contraception after
using ellaOne®, you can do
so but you should also use
condoms until your next period
ellaOne® may make regular hormonal contraceptives,
like pills and patches, temporarily less effective. If you
are currently taking hormonal contraception, continue
to use it as usual after taking ellaOne®, but be sure to use
condoms every time you have sex until your next period
ALWAYS USE A RELIABLE BARRIER CONTRACEPTIVE, LIKE CONDOMS, UNTIL YOUR NEXT PERIOD
Pregnancy registry
If you have accidentally taken ellaOne® during pregnancy, or have
become pregnant despite having taken ellaOne®, HRA Pharma (the
licence holder of ellaOne®) is interested in receiving more information
about your pregnancy. Information is anonymous to preserve your
confidentiality. You can report information at www.hra-pregnancyregistry.com, or ask your doctor to do it for you. You are strongly advised
to contact your doctor as early as possible during your pregnancy.
What medicines or health conditions should I
tell my pharmacist about before taking ellaOne ?PIL
®
23
n
L
iver disease. ellaOne® is not recommended for women with severe liver disease
n
S
evere asthma
n
C
ertain medicines used to treat epilepsy
(phenytoin, fosphenytoine, phenobarbital, primidone, carbamazepine, oxcarbazepine)
n
C
ertain medicines used to treat HIV infection
(ritonavir, efavirenz, nevirapine)
n
C
ertain medicines used to treat bacterial infections
(for example rifampicin, rifabutine)
n
H
erbal remedies containing St John’s wort (Hypericum perforatum)
used for depression or anxiety
n
e
llaOne® should not be used together with emergency contraceptives
containing levonorgestrel
When it matters most
Chapter 4:
Me and my pharmacist talking about ellaOne®
Getting ellaOne® should be simple and fuss-free. The pharmacist
may ask you a few questions, just to check ellaOne® is suitable for
you. There’s no need to feel embarrassed. Remember pharmacy
staff deal with all kinds of sensitive situations everyday – it’s their
job to make this experience as stress-free as they can for you.
Rosa’s ellaOne® story
when it mattered most
I had just started college. I had been
Plan what you are going to say
with Paulo for a while. When his condom
came off I was really worried that I’d get
pregnant. I knew I wasn’t ready to have
Here are some ideas:
a baby. I had read about emergency
contraception on the internet.
I thought it would be easier to go to a
pharmacist than get an appointment
“ I’d like the
emergency contraceptive
pill please.
”
with the doctor. When I went in I was
nervous, but the pharmacist was really
nice. There were a few questions, but
the whole experience was friendly and
“ I’ve had a
contraceptive mishap and
I’d like the morning-after
pill please.
fuss-free. I went to a café and read the
leaflet in the pack. Then I took ellaOne®
and went to my next lecture. It felt like a
weight was off my mind.
”
Bella’s ellaOne® story
“
Can I talk to
someone about emergency
contraception?
when it mattered most
”
After my second baby our family was
complete. On my 40th birthday my
“
husband organised a surprise party. It
I’d like the
day-after pill please.
”
was a great night. Next day I realised I’d
forgotten to take a couple of my usual
contraceptive pills that week and we’d
had sex after the party.
I asked my sister what to do. She
told me to get the morning-after
pill from a pharmacist. After a short
discussion I bought ellaOne®. While
Take somebody with you if it makes you feel more comfortable.
I was there I bought some condoms
just in case. Getting ellaOne® was very
The main thing to remember is to act fast. Go to a pharmacy
as soon as you can.
24
straightforward.
When it matters most
Chapter 5:
Me and my contraception in the future
The emergency contraceptive pill is not a regular method
of contraception.
After using the emergency contraceptive pill it makes good
sense to think about what regular contraceptive you are
going to use.
If you have had a problem with your usual contraceptive
method, this might be a good time to consider a change of
contraception, so you get a method that suits you better.
Jargon
buster
Contr
ac
also c eption is
alled
birth
contr
ol
You have lots of contraceptive choices: barrier methods,
hormonal contraceptive methods, IUD and sterilisation.
Some methods are shown below.Bedsider
METHOD
WHAT IS IT?
EFFORT
BARRIER METHODS
Male condom
Female condom
Cap and
diaphragm
Sponge
25
Forms a barrier that
stops sperm (and sexually
transmitted diseases)
getting into your body
Use every time you
have sex
Forms a barrier that
stops sperm (and sexually
transmitted diseases)
getting into your body
Use every time you
have sex
Round latex or silicon domes
that block the cervix. Need
to be used with spermicide
A round piece of white plastic
foam that blocks the cervix
and releases spermicide
Put in every time you have
sex (but can be done hours
ahead of time)
Put in every time you have
sex (but can be done hours
ahead of time)
When it matters most
METHOD
WHAT IS IT?
EFFORT
‘The Pill’
Hormone tablets. If you wish
to start or continue using
hormonal contraception,
you can do so after using
ellaOne®, however, you should
be advised to use a reliable
barrier method until the next
menstrual period, see page 23
Once a day, everyday
Ring
Small bendable hormonal
ring that goes in the vagina
Ring in. Wait 3 weeks.
Ring out. Wait 1 week.
Repeat
Patch
A thin hormonal ‘sticker’
Patch changed once
a week
Contraceptive
implant
A small rod inserted in the
upper arm which releases
hormones
Quick insertion and lasts
for up to 3 years
Contraceptive
injection
An injection of a
contraceptive hormone
One injection every
three months
Intrauterine device
A T-shaped device that is
inserted in the womb. Two
types: hormonal or copper
It’s inserted once and
lasts between 3 and 10
years depending on the type
HORMONAL METHODS
METHOD
WHAT IS IT?
EFFORT
Spermicides
Creams, films, foams, gels and
suppositories that are inserted
into the vagina. Work best
with other barrier methods
Have to apply it every
time you have sex
Sterilisation
Men or women can have the
tubes that carry sperm or
eggs closed or blocked
Only required once
SPERMICIDES AND STERILISATION
Some of these methods may have medical contraindications.
For comprehensive information on contraceptive methods, talk to a healthcare professional.
Remember that only condoms protect you from sexually transmitted infections, including HIV.Bedsider
Other methods of contraception do not offer any protection. If you are worried about sexually
transmitted infections, talk to a healthcare professional.
There are also several other “natural methods” such as withdrawal and fertility awareness methods
(Ogino method, Billings and temperature method). These methods have been shown to be unreliable.Trussell
26
When it matters most
Tips to avoid
contraceptive accidents
Contraceptive accidents can happen to anyone.
Here are some tips to help you:
n
e prepared. Carry condoms or keep your sponge, diaphragm
B
or cap with you
n
n
e careful when taking condoms out of the packet, especially around
B
nails and jewellery
n
Store condoms correctly so they don’t get too hot or damaged
n
Ensure that condoms are not past their use by date
n
n
n
27
on’t use oil based lubricants with latex condoms, as they can
D
weaken them so they split
se pill manufacturers’ apps, or use the reminder or calendar
U
function on your mobile telephone, to set up daily alerts to remind
you to take your contraceptive pill
nsure you follow the correct guidance if you miss a contraceptive
E
pill. See your pill pack leaflet
ign up to telephone or SMS alerts provided free by some
S
contraceptive manufacturers
n
Set up a mobile reminder to take out and reinsert your vaginal ring
n
Set up a weekly mobile reminder to change your contraceptive patch
n
Set up a mobile reminder to have your next contraceptive injection
n
Don’t assume you will remember. Don’t take a chance
When it matters most
Chapter 6:
Check you’ve understood the facts...
…about ellaOne
®
1.ellaOne® is an effective morning-after pill, when it matters most because:
It can prevent a pregnancy even when you are about to ovulate (release an egg)
It puts you off sex
It can replace your regular contraceptive
2.ellaOne® works by delaying egg release (ovulation).
How does this prevent you getting pregnant?
The sperm travel slower
The sperm that are already waiting in your reproductive tract
are no longer capable of making you pregnant
The sperm live longer
3.You can get ellaOne® from
A pharmacy with a doctor’s prescription only
Specialist clinics
Directly from a pharmacy
4.At what time in a woman’s life does it ‘matter most’
that she doesn’t get pregnant by accident?
When she is young and not ready to be a mum
When she already has children and doesn’t want any more
It can matter most at any stage in her fertile life – there are no ‘rules’.
Everyone is different
28
When it matters most
Check you’ve understood the facts...
…about avoiding pregnancy
5.Your best friend tells you she’s had sex without using any contraception
the night before. She doesn’t want to become pregnant. What would you advise her?
She’ll be OK – she probably won’t get pregnant
She should do a pregnancy test
She could get pregnant and needs to act fast and get the morning-after pill from a pharmacist
6.Three friends are talking about what ‘unprotected sex’ is. Who is right?
Frieda says it is when you have sex without any contraception
Julietta says it is when you have a contraceptive mishap (contraceptive failure) – for example
a condom came off
Anna says it is either of the above - sex without contraception, or contraceptive failure
7.Which of the following is true about ovulation (egg release)?
It always happens on day 14 of the menstrual cycle
It always happens in the middle of the menstrual cycle
It can happen at any time in the menstrual cycle
8.Women sometimes get confused about the morning-after pill and abortion.
Which of the following is a myth?
The morning-after pill is totally different to abortion
The morning-after pill causes abortion
If you are pregnant it is too late for the morning-after pill because
it works to prevent the start of a pregnancy
29
When it matters most
Answers
1.ellaOne® is an effective morning-after pill, when it matters most,
because it can prevent a pregnancy even when you are about to
ovulate (release an egg).
2.ellaOne® delays ovulation so the sperm that are already waiting
in your reproductive tract die before the egg is released.
3.You can get ellaOne® both with a doctor’s prescription and
directly from a pharmacy without prescription.
4.It can matter most at any stage in her life – there are no ‘rules’.
Everyone is different.
5.She could get pregnant and needs to act fast to get emergency
contraception from the pharmacist.
6.Anna is right. Unprotected sex, is sex without contraception,
or contraceptive failure.
7.Egg release (ovulation) can happen at any time in the
menstrual cycle.
8.It is a myth that the morning-after pill causes abortion –
it acts to prevent pregnancy.
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30
When it matters most
ellaOne® emergency contraception
is now available directly in a
pharmacy without a prescription.
But the morning-after pill has.
31
n
e
llaOne® has previously only been available with a doctor’s prescription, but now it is
available for you to self-select directly in pharmacy
n
e
llaOne® is a morning-after pill that can even prevent a pregnancy when you are about
to ovulate – when it matters mostSPC, FSRH
n
A
sk your pharmacist or other healthcare professional for more information or advice
When it matters most