Using the ‘Morning After’ Pill

 

Like a lot of sexually active teenagers, I have faced the embarrassment of walking into a pharmacy and asking to speak to someone about the morning after pill. Thankfully, it has been much easier to access since it became available over the counter instead of with a doctor’s prescription and supervision, but that doesn’t make it any easier to find the courage to ask for it.

Whoever you speak to should be non-judgemental but it’s still an awkward situation. The nightmare scenario is if the pharmacist is an older person, as you can see that behind their mask of neutrality they are judging you so hard.

I know how hard it can be to even pick up the courage to go into the building let alone speak to anyone. Having come from a family who were well known around my friend group for being knowledgeable about sexual health because it’s my mum’s area of expertise, I had always been the ‘go-to’ person for my friends whenever they had worries or queries about anything related to sex. This meant that I was usually the one who ended up being dragged to the local pharmacy and pushed up to the counter to ask for a morning after pill which wasn’t even for me!

In theory, this meant that I should have felt very relaxed about doing it for myself, but when the moment came, I can honestly tell you that I felt anything but relaxed. When you are asking on behalf of someone else, you are somehow protected from the reality of the predicament.

While I was talking to the pharmacist, there was a constant niggle going on at the back of my head: what if this doesn’t work?

What am I going to do then?

PillsThe morning after pill, also known as Levonelle or ellaOne, works more effectively the quicker you take it after having unprotected sex. You can take Levonelle, which became available in 2001, for up to 72 hours after sex and ellaOne, which arrived in 2009, for up to 120 hours afterwards.

I wanted the pill more out of panic than anything else, I had used a condom but given the horror stories I had heard about how unreliable they could be and since I had no other form of contraception at the time, I decided that the best plan of action was to brush off my awkwardness and get the pill.

However, as I sat with the pharmacist listening to the stats about the likelihood of the pill not working, all I could think was, my mother is going to kill me…a thought that everyone has had at some point and definitely in this situation.

There are two kinds of morning after pill, or emergency hormonal contraception. The first contains levonorgestrel, a form of the female hormone progesterone, and the other has ulipristal acetate, which works with the hormone receptors in your body. What they have in common is that they work by stopping or delaying the release of eggs from your ovaries. The critical difference between them is that the first one can only be used up to three days (72 hours) since you had unprotected sex, and the second one can be used up to five days later (120 hours) (reference here).

Within the first 12 hours, Levonelle has an effectiveness rate of 95%, this then decreases by 10% between 12-24 hours and decreases by another 10% between 24-48 hours. The likelihood of it working between 48-72 hours is much lower at 58%. EllaOne however, has an effectiveness of 95% which stays effective until the 120-hour mark.

Unlike a lot of my friends, my mum did know when I lost my virginity and we had a relatively open dialogue about it, so she also knew that I had taken the pill. Unfortunately for me, the pill messed up my hormones so much that I ended up missing a period…perhaps not the worst thing that could have happened but it does make you think that the worst has happened.  I was surprised to find that it’s not an uncommon side effect.

The pill has various side effects, ranging in severity from the common ones which include nausea, headaches and tiredness to the not so common, breast tenderness, vomiting and skipping periods.

I spent an entire month thinking that I was pregnant and taking half a dozen negative pregnancy tests gave me even less money and still could not give me peace of mind. This anxiety was coupled with a background voice-over saying:

Well you should have waited until you had contraception sorted.

and

It’s your own fault if you’re pregnant, it wouldn’t have happened if you’d made better decisions.

or, my personal favourite,

Choices and consequences, Joanna.

The whole situation was basically just a huge mess and not entirely helping me with the worry of a possible pregnancy at 16. All I could do was continue taking tests and hoping as hard as I could that everything would turn out all right. I was lucky and thankfully it did. I have only used the morning after pill that one time and don’t plan to put myself in the situation where I need it again.

There are a few things I wish I had known before I took the pill which I will share with you and I hope that it can maybe help you at some point in the future. I think that the main thing people need to understand is that you shouldn’t avoid it because you feel embarrassed or awkward – that is the worst thing you can do since the longer you wait, the more that reduces the chances of it working.

I also wish I’d had a better understanding of how it worked. If I’d known that it was a massive dose of hormones which would mess up my system, maybe I would have been more inclined to have got proper contraception in place before I had sex – I certainly did that as soon as possible afterwards, and that was also because I’d found out that it’s far from 100% guaranteed to work, so you can’t rely on it. It also might have saved me a lot of worry if I’d known that I might miss a period because of the hormonal disruption.

One final peace of wisdom which I can offer is that you can’t rely on it as a regular form of contraception. Because despite 95% sounding like a good statistic the morning after pill isn’t as reliable as you think. And there is always the chance that you could end up on the wrong side of that 5%. It sounds obvious but you would be probably horrified by the number of my friends who would just brush off an incident with unprotected sex saying, ‘Oh it’ll be fine I’ll just take the morning after’ when they had already taken it twice that month. The chances of becoming pregnant are 1 in 20 with unprotected sex, Levonelle reduces that risk to 1 in 40, ellaOne to 1 in 50 (reference here).  While that might sound like a big improvement there is still scope for the pill not to work which I think is something that people tend to forget.

When it comes to pregnancy, a life-changing event for you, your family and the baby you may have, you can’t have the attitude that it’ll all be fine, and it won’t happen to you. The statistics are not there to scare you, they are there because of real people whose lives have been changed dramatically, and I can be pretty sure that you really don’t want to be on the wrong side of that statistic.

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