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Morning After Review

Morning After is an emergency birth control pill (contraceptive pill) that is used to prevent pregnancy for women who’ve had unprotected sex or whose birth control methods have failed. This pill is intended for back-up contraception only, not as an everyday birth control.


Indications for use

This emergency contraceptive pill is used to prevent pregnancy in cases of unprotected or insufficiently protected sexual intecourse. Do not take it to stop an existing pregnancy!

You can take this contraceptive:

  • if you had sexual intercourse in which neither you nor your partner used contraception;
  • if your partner’s condom was damaged in any way;
  • if you suspect that the hormonal spiral was out of place;
  • if you improperly applied a cream that reduces the effectiveness of sperm;
  • if your vaginal pessary or contraceptive cap has been twisted or removed too early;
  • if you are protected by the calendar method (calculating ovulation) or by measuring the temperature and sexual intercourse occurred during ovulation;
  • if you are afraid that the interruption of sexual intercourse has occurred inaccurately;
  • if you were raped.

Mechanism of action

A high dose of levonorgestel works by delaying the release of an egg or ovulation. After this, the egg becomes “incompetent” and there are no negative side effects for subsequent pregnancies.

After taking the pill, the next menstrual cycle comes at about the same time as usual. The cycle rarely undergoes changes and failures (+/- three days). If menstruation is unusual or is delayed for more than five days, you should do a pregnancy test.

An emergency menstruation pill only works specifically to prevent pregnancy after an unprotect-ed intercourse, so other methods of contraception must be used on the remaining days of the cycle.

It is important to know that levonorgestrel is not an abortive drug – it only prevents pregnancy, while at the same time reducing the risk of abortion. If pregnancy has already occurred, the levonorgestrel pill will not stop it.

Dosage and mode of application

This is a modern emergency contraception. The Morning After package contains only one tablet with the full dose of levonorgestrel.

This pill must be taken orally after unprotected sexual intercourse as early as possible, best of all – within the next twelve hours after intercourse and in no case later than 72 hours (three days) after it.

If vomiting occurs within 3 hours after taking the pill, then another 1 pill should be taken. This type of contraception can be used at any time during the menstrual cycle. In the case of an irregular menstrual cycle, pregnancy must be excluded.


The use of levonorgestrel for emergency contraception does not carry a risk of overdose. However, you can-not take more than one Morning After contraceptive pill during one menstrual cycle – this can just lead to an increase in side effects due to an overdose.

Treatment of an overdose should be symptomatic. There is no specific antidote.

Side effects

In general, the drug is tolerated well. However, in some cases in can give side effects. The common adverse reactions include changes in menstruation (late periods, more profuse or light menstrual bleeding), vomiting, diarrhea, dizziness, headache, breast swelling, nausea, fatigue, pain in the lower abdomen, acyclic spotting (bleeding).

If menstruation is delayed for more than 7 days, pregnancy must be excluded.


Absolute contraindications for Morning After contraceptive pill are only hypersensitivity to the components of the drug, severe liver failure or pregnancy.

Use the drug with caution if you have adrenal insufficiency, acute and chronic renal and hepatic insufficiency, severe extragenital pathology, or if you are undergo prolonged treatment with corticosteroids.


Avoid taking Morning After pill with any of the following drugs:

  • barbiturates (including primidone);
  • bosentan;
  • phenytoin;
  • rifampin;
  • carbamazepine;
  • felbamate;
  • griseofulvin;
  • oxcarbazepine;
  • St. John’s wort;
  • topiramate.

Pregnancy and breastfeeding

Levonorgestrel 1.5 mg should not be used during pregnancy. However, if pregnancy has occurred after using the emergency method of contraception, the drug will not have any adverse effect on the fetus (based on the available data).

Levonorgestrel passes into breast milk. If you took this pill, breastfeeding should be stopped for 24 hours.

What if I miss a pill?

This contraceptive pill is effective only if taken within 72 hours after unprotected intercourse as early as possible, best of all, within the next twelve hours after intercourse.

The effectiveness of emergency contraception depends on how soon the pill was taken after unprotected sexual intercourse:

  • effectiveness 95% if taken within h0-24 hours;
  • effectiveness 85% if taken within 24-48 hours;
  • effectiveness 58% if taken within 48-72 hours.

If you miss a dose of Morning After pill and more than 72 hours have passed after unprotected sexual intercourse, do not take this contraceptive pill and consult your doctor as quickly as possible.


This emergency contraception cannot be used as a regular contraceptive method – it is dangeous and not as effective as drugs designed specifically for the long-term prevention of pregnancy.

This medicine does not protect you or your partner from sexually transmitted infections – if you were raped or if you had sex with a new partner, measures must be taken to prevent them. If a risky situation arises from time to time with a regular partner, then you should think about bar-rier contraception.

The pill does not have any negative side effects on an already existing pregnancy and therefore it cannot be used as an abortion pill. Medical abortion is performed only under the supervision of a doctor in special medical institutions.

Adolescents under 16 years of age in exceptional cases (including rape) need to consult a gyne-cologist to confirm pregnancy. After using emergency contraception, adolescents should consult a gynecologist to select the most appropriate method for continuous contraception.

The effect of levonorgestrel 1.5 mg on the ability to drive a car and mechanisms has not been investigated.

The research results indicate a lack of connection between the use of levonorgestrel at high doses and an increased risk of cancer.

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