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Emergency hormonal contraception knowledge update
How pharmacy can empower women’s reproductive choices with contraceptive guidance
Emergency hormonal contraception (EHC) has been available to purchase in pharmacy without a prescription since 2001.1 Although this brought a new element of reproductive choice to some, nearly half of UK women (49%) still face barriers when trying to access their preferred method of contraception.1,2 It is crucial that women are well supported by pharmacists and their teams when it comes to their reproductive choices.
After reading this module you will be able to:
Understand the importance of positive conversations that empower women’s reproductive choices
Understand why ulipristal acetate (ellaOne) is more effective in preventing unplanned pregnancy than levonorgestrel
Recognise fact from fiction when advising on EHC
Be aware of other forms of contraception
Women in the UK can obtain EHC through a number of routes: via a prescription from their GP, from a sexual health clinic, by purchasing it privately from a pharmacy, or through an NHS scheme in selected pharmacies, where it can be obtained free of charge. Wherever your customer chooses to obtain their EHC, you should be prepared to advise them about their options and dispel any misconceptions they may have.
Before we continue the module, test your knowledge by separating facts from fiction regarding oral EHC available in the pharmacy.
For each statement below, select the answer ‘FACT’ or ‘FICTION’.
There is no difference in efficacy between levonorgestrel and ulipristal acetate (ellaOne®) in the first 24 hours after unprotected sexual intercourse (UPSI), and after this period neither are effective.
FICTION! In the first 24 hours after UPSI, ulipristal acetate (ellaOne®) is 2.5x more effective than levonorgestrel.3 Levonorgestrel can be used up to 3 days (72 hours) after UPSI, whereas ellaOne can be used up to 5 days (120 hours) after UPSI.3
EHC works by stopping implantation of a fertilised egg onto the uterine wall and different EHC ingredients are equally effective during the most fertile period in a women’s cycle.
FICTION! Both ulipristal acetate (ellaOne®) and levonorgestrel work by preventing and delaying ovulation (egg release).3 ellaOne® is also able to do this during the most fertile period (the LH rise), whereas levonorgestrel is no more effective than a placebo at this time.4
Using ellaOne® can have long-term effects on fertility and could potentially harm an existing pregnancy.
FICTION! ellaOne® does not have any long-term impact on a person's ability to conceive in the future. There is also no evidence to suggest that EHC will interrupt or harm an existing pregnancy.5
A woman’s BMI (body mass index) could influence the effectiveness of EHC.
FACT! There is a possibility that a higher bodyweight or BMI could reduce the effectiveness of oral EHC, particularly levonorgestrel. If the customer’s BMI is greater than 26 kg/m2 or their bodyweight is greater than 70 kg, it is recommended that either a single tablet of ulipristal acetate or a double dose of levonorgestrel is given.6 ellaOne® can be recommended for all women regardless of their weight or BMI.5
A woman can use EHC twice in the same menstrual cycle if needed.
FACT! Although EHC is intended for occasional use and other contraceptive measures should be discussed, ulipristal acetate and levonorgestrel can be used as oral EHC more than once in the same cycle. However, repeated administration of levonorgestrel as emergency contraception could result in an increased risk of side effects (such as menstrual irregularities).6
Content developed by Perrigo in association with CIG Healthcare Partnership.
© 2025 CIG Healthcare Partnership
MAT-9276 March 2025