Emergency Contraception Decision Guide
Select Your Situation
Answer a few questions to get personalized recommendations for emergency contraception options.
When you need emergency contraception (EC) fast, the choices on the shelf can feel overwhelming. The I-Pill is the most recognized brand of levonorgestrel, a synthetic hormone used to prevent pregnancy after unprotected sex or contraceptive failure. But it isn’t the only option. This guide breaks down how the I‑Pill stacks up against the main alternatives - ulipristal acetate, the copper IUD, the Yuzpe method and a few off‑label drugs - so you can pick the right backup plan for your body and lifestyle.
Why the I‑Pill is Often the First Choice
The I‑Pill works by delivering a high dose of levonorgestrel, which mainly stops or delays ovulation. If taken within 72hours of intercourse, it reduces the chance of pregnancy by about 85% in real‑world use. In Australia, most pharmacies sell it over‑the‑counter (OTC), so you don’t need a prescription.
Key attributes of the I‑Pill:
- Active ingredient: levonorgestrel
- Dosage: 1.5mg in a single tablet
- Window of effectiveness: up to 72hours (3days) after unprotected sex
- Typical cost in Australia: AUD30-40 per pack
- Side effects: nausea, fatigue, headache, mild spotting
Alternative #1 - Ulipristal Acetate (Ella)
Ulipristal acetate is a selective progesterone receptor modulator. It blocks the hormone’s action, preventing ovulation even later in the cycle than levonorgestrel can. In clinical trials, a single 30mg dose cut pregnancy risk by about 98% when taken within 120hours (5days).
In Australia, ulipristal acetate requires a prescription, but many pharmacists can dispense it after a brief telehealth consult. It’s marketed as Ella, though generic versions exist.
- Active ingredient: ulipristal acetate
- Dosage: 30mg single tablet
- Window of effectiveness: up to 120hours (5days)
- Typical cost: AUD80-100 per pack
- Side effects: headache, abdominal pain, menstrual changes
Alternative #2 - Copper Intrauterine Device (Paragard)
The copper IUD is the most effective form of EC known. Inserted by a trained clinician within 5days of intercourse, it releases copper ions that are toxic to sperm and prevent implantation. Its pregnancy‑prevention rate exceeds 99%.
Beyond emergency use, the copper IUD offers up to 10years of regular contraception, making it a dual‑purpose device for many.
Key details:
- Device name: Copper IUD (often sold as Paragard)
- Insertion window: within 120hours (5days)
- Cost of insertion (public sector): often covered by Medicare; private cost AUD200-300
- Side effects: cramping, heavier periods, occasional expulsion
Alternative #3 - Yuzpe Method (Combined Oral Contraceptives)
The Yuzpe method uses high doses of estrogen and progestin found in regular birth‑control pills. Two doses are taken 12hours apart, ideally within 72hours of intercourse. Effectiveness is roughly 75%-85%, lower than dedicated EC pills.
Because the Yuzpe method relies on prescription‑only combined oral contraceptives (COCs), you need a doctor’s script or a pharmacist’s assessment.
- Active ingredients: estrogen (ethinylestradiol) + progestin (levonorgestrel or similar)
- Dosage: 2 tablets now, 2 tablets 12hours later
- Window of effectiveness: up to 72hours
- Side effects: nausea, vomiting, breast tenderness, menstrual spotting
Alternative #4 - Off‑Label Options (Mifepristone)
Mifepristone is a progesterone antagonist commonly used for medical abortion. Some clinicians prescribe a low dose (10mg) as EC up to 120hours after sex, citing studies that show comparable efficacy to ulipristal. It’s not listed on the PBS for EC, so access is limited to specialist clinics.
- Active ingredient: mifepristone
- Dosage: 10mg single tablet (off‑label)
- Window of effectiveness: up to 120hours
- Typical cost: AUD150-200 (private)
- Side effects: abdominal cramping, nausea, possible bleeding
Side‑by‑Side Comparison
| Attribute | I‑Pill (Levonorgestrel) | Ulipristal Acetate (Ella) | Copper IUD (Paragard) |
|---|---|---|---|
| Mechanism | Prevents/delays ovulation | Blocks progesterone receptors, stops ovulation later in cycle | Copper ions impair sperm, prevent implantation |
| Effective window | Up to 72hours | Up to 120hours | Up to 120hours |
| Typical efficacy | ~85% (real‑world) | ~98% (clinical) | >99% |
| Prescription needed? | No (OTC) | Yes (prescribed) | Yes (inserted by clinician) |
| Cost (AUD) | 30‑40 | 80‑100 | 200‑300 (private) or PBS‑covered |
| Common side effects | Nausea, headache, spotting | Headache, abdominal pain, menstrual shift | Cramping, heavier periods, rare expulsion |
How to Choose the Right Option for You
Deciding isn’t just about numbers; it’s about what fits your schedule, health profile, and budget. Here’s a quick decision matrix you can run in your head:
- Need it now and want no prescription? The I‑Pill is the simplest pick.
- Can wait a day or two, want the highest efficacy? Ulipristal or copper IUD are better.
- Prefer long‑term contraception after the emergency dose? The copper IUD gives up to a decade of protection.
- Have a history of hormonal sensitivity? The copper IUD avoids hormones entirely.
- Weighing cost? I‑Pill is cheapest OTC; copper IUD may be free under Medicare for eligible patients.
Practical Tips for Using Emergency Contraception Effectively
- Take it ASAP. Effectiveness drops sharply each hour after intercourse.
- Don’t double‑dose. One tablet of levonorgestrel or ulipristal is enough; extra pills won’t boost protection.
- Watch for vomiting. If you vomit within two hours of swallowing, repeat the dose with a new tablet.
- Follow up with a regular method. EC isn’t a replacement for ongoing birth control.
- Check interactions. Certain anti‑seizure meds, herbal supplements (e.g., St.John’s wort) can lower EC efficacy.
Potential Pitfalls and How to Avoid Them
Even the best‑studied drugs can backfire if used incorrectly. Common mistakes include:
- Waiting past the recommended window (especially risky with levonorgestrel).
- Assuming EC will terminate an existing pregnancy - it only works before implantation.
- Skipping a medical check after repeated EC use; frequent reliance may signal the need for a more reliable method.
- Overlooking weight considerations. Some data suggest levonorgestrel may be slightly less effective at body mass indexes over 30kg/m², making ulipristal a better fit.
Bottom Line: Tailor EC to Your Life
All four options have a place in Australia’s contraceptive toolkit. The I‑Pill’s convenience and low cost make it a solid default, but if you have a few extra hours, the higher efficacy of ulipristal or the near‑perfect protection of a copper IUD could be worth the extra step.
Remember, the most important thing is to act quickly and follow up with a regular birth‑control method that matches your routine. Emergency contraception is a safety net, not a long‑term solution.
Frequently Asked Questions
How soon after sex should I take the I‑Pill?
The sooner the better. Take it within the first 24hours for optimal protection; it still works up to 72hours but efficacy drops about 10% each day.
Can I use both levonorgestrel and ulipristal together?
No. Taking both can cause hormonal overload and side‑effects without improving efficacy. Choose one method based on timing and prescription availability.
Is the copper IUD safe for women who have never had a pelvic exam?
Insertion requires a brief pelvic exam to ensure the uterus is the right size and there are no infections. Most clinicians can perform it safely, even for first‑time users.
Do side effects from emergency contraception affect my next period?
Yes. Levonorgestrel may cause your next period to arrive a few days early or late, while ulipristal can shift the cycle by up to a week. The copper IUD may make bleeding heavier for the first few months.
Can I take emergency contraception if I’m breast‑feeding?
Levonorgestrel is generally considered safe for breastfeeding mothers, but ulipristal’s safety data are limited. Talk to your GP or pharmacist before choosing a method.
Aminat OT
October 13, 2025 AT 16:57I’m freaking out, I wish someone would just hand me an I‑Pill right now!