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Preventing unplanned pregnancy with ellaOne

All about ellaOne®
Putting customers at ease
Assessment questions

module menu icon Putting customers at ease

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module menu icon Putting customers at ease

Putting customers at ease

Women may feel embarrassed when asking for advice about EHC due to perceived stigma and shame associated with it. However, we know that they trust and value the pharmacy team’s advice and this is one of the most important considerations when choosing their EHC.7 It’s important to speak to your customer without judgement or prejudice and ensure they feel comfortable talking to you, so they receive the most appropriate treatment.

IN YOUR CONSULTATION YOU SHOULD ALWAYS:

  • Offer a private space to speak, such as a consultation room

  • Offer for a chaperone to be present in your consultation

  • Remember your safeguarding training and be conscious of anything that may concern you.

In each of the following customer scenarios, consider what advice you could offer each individual.

CLICK ON THE FLASHCARDS to reveal the advice.

You are speaking to 30-year-old Emma in the consultation room. She says:

I had UPSI last night but the period tracking app I have on my phone tells me that I have already ovulated at day 14, so I really don’t think I need this!

You could advise Emma:

  • Although EHC does work by delaying ovulation, only a small percentage of women ovulate exactly 14 days before the onset of their period12,13

  • To avoid the risk of an unplanned pregnancy it would be better to take ulipristal acetate, which is most effective within the first 24 hours after UPSI and can still work in your most fertile time before ovulation (during an LH rise).3,5

40-year-old Isabella has a BMI of 28kg/m2 and tells you:

I had UPSI around 4 days ago, but I have been so busy with the new baby that I have not had a chance to come in. Will EHC still work for me? I know last time, because of my weight, I was given 2 tablets.

You could advise Isabella:

  • EHC is most effective within the first 24 hours after UPSI, however ellaOne® can be taken up to 5 days (120 hours) after UPSI5

  • ellaOne® is recommended for all women regardless of their weight or BMI and, unlike levonorgestrel, only one tablet needs to be taken5,6

  • If you are currently breastfeeding, you should avoid this for 7 days after taking ellaOne®.5 If Isabella is breastfeeding, advise her to continue expressing and discarding breastmilk to help stimulate breastmilk production so that she can resume after a week.

18-year-old Eleanor looks very anxious and tells you:

I had UPSI this morning and this is my first time taking EHC. I’ve heard it can give you a really painful ‘emergency period’ and that it could affect my fertility later in life. What if I am already pregnant, could this harm my baby!?

You could reassure Eleanor by telling her:

  • As you have had UPSI this morning (less than 24 hours) it is highly unlikely that you are already pregnant from this incident. EHC, such as ulipristal acetate, is most effective within the first 24 hours, especially if taken ASAP after UPSI.5

  • ellaOne® will not affect your future fertility and there is no evidence that it will affect an active pregnancy5

  • Your next period should come on time but it may be slightly earlier or later than normal and you may experience some light bleeding beforehand. Some people do experience painful periods after taking the pill but this does not affect everyone.5,11

Encouraging positive sexual health conversations

 

Alongside offering your support and advice to women asking for EHC, you should also offer information on:

  • The avoidance of sexually transmitted infections (STIs) through safer sex

  • The use of regular and long-term contraceptive methods

  • Onward signposting to services as appropriate.

Remember, good communication is integral as almost half of all women face barriers to receiving the contraception they need,1 which could be a factor in why unplanned pregnancies are so prevalent in the UK. Furthermore, the Department of Health and Social Care found that from a survey of 615 respondents, approximately 25% of women who had a birth or an abortion in 2021 did not receive information and advice about contraception around that time.14

Conversations around sexual health can be embarrassing for customers so ensure that you handle these with empathy and sensitivity, and without judgement.

Complete the care with conversations about contraception

CLICK THROUGH THE CAROUSEL to learn more about different types of contraception methods available.15

1. Barrier methods

Barrier methods include male condoms, the female condom, diaphragms and caps. They prevent sperm from entering the womb (uterus).

Condoms help to provide protection from STIs. However, they are not as reliable as other methods and can break or come off.

2. Daily methods

The combined oral contraceptive (COC) pill contains two hormones; oestrogen and progestogen. It is a very effective contraceptive, but women must remember to take it daily. It is also not suitable for everyone.

The progestogen-only pill (POP) contains only the progestogen hormone. This is sometimes used by women who can’t use COC; however, some women report irregular periods and increased side effects.

3. Weekly or monthly methods

The contraceptive patch contains the same hormones as the COC but in a patch format. Patches are effective and easy to use, do not require daily intake like a pill, however they can be less discrete.

The contraceptive vaginal ring also contains the same hormones as the COC pill. It is inserted into the vagina for three weeks and then removed for one week. It is as effective as the COC, however some may find it uncomfortable, particularly during sex.

4. Long lasting methods

Contraceptive injections are administered every 8-13 weeks and contain progestogen that is slowly released into the body. They are very effective and convenient; however, women may experience side effects that last longer than with other options.

A contraceptive implant is a small device placed under the skin, usually in the arm. It releases progestogen into the body slowly. Each implant lasts for three years, after which it should be removed. They are very effective and convenient, however some women may experience more irregular periods (although they are often lighter or may stop altogether).

An intrauterine contraceptive device (IUCD) is also known as a coil. This plastic and copper device is placed into the womb (uterus) and lasts for five years or more. It is very effective, however periods may become heavier or more painful and some women find inserting it uncomfortable. This can also be used as a form of emergency contraception.

An intrauterine system (IUS) is a plastic device containing progestogen that is inserted into the womb where it releases the hormone at a slow, but constant rate. This method is also very effective and side effects related to the hormone are less likely than with other hormonal methods.

References

1. Schenk KD. Emergency contraception: lessons learned from the UK. BMJ Sexual & Reproductive Health 2003; 29:35-40

2. BPAS. 49% of Women in the UK Face Barriers to Contraception Access, Reveals New BPAS Report. 2025. Available at: https://www.bpas.org/about-bpas/pressoffice/press-releases/49-of-women-in-the-uk-face-barriers-to-contraception-access-reveals-new-bpas-report/#:~:text=Nearly%20Half%20%2849%25%29%20of%20Women%20Face%20Barriers%3A%20Women,trying%20to%20access%20their%20preferred%20method%20of%20contraception

3. Glasier AF, et al. Ulipristal acetate versus levonorgestrel for emergency contraception: a randomised non-inferiority trial and meta-analysis.
Lancet. 2010. doi: 10.1016/S0140-6736(10)60101-8.

4. Brache V, et al. Ulipristal acetate prevents ovulation more effectively than levonorgestrel: analysis of pooled data from three randomized trials of emergency contraception regimens. Contraception. 2013 doi: 10.1016

5. SmPC. ellaONE. 2014. Available at: https://www.ema.europa.eu/en/documents/product-information/ellaone-epar-product-information_en.pdf

6. BNF. Treatment summaries: Emergency contraception. 2023. Available at: https://bnf.nice.org.uk/treatment-summaries/emergency-contraception/

7. HRA Data on file. Questionnaire of a representative sample of 700 sexually active UK women ages 16-45, 2013.

8. HRA data on file. Consumer Research 2016. Festival Questionnaire of 933 UK women aged 18+.

9. FSRH Emergency Contraception CEU Clinical Guidance Document December 2020.
Available at: https://www.fsrh.org/Common/Uploaded%20files/documents/fsrh-guideline-emergency-contraception03dec2020-amendedjuly2023-11jul.pdf

10. Community Pharmacy England. Supply of Emergency Hormonal Contraception (EHC) under a Patient Group Direction in Community Pharmacies. 2025.
Available at: https://cpe.org.uk/?our-services=emergency-hormonal-contraception-4

11. Oxford Health NHS. Patient information leaflet for ellaOne® emergency hormonal contraceptive (EHC) pill. 2025.
Available at: https://www.oxfordhealth.nhs.uk/wp-content/uploads/2014/08/CY-063.15-EllaOne-information-leaflet.pdf

12. Baird DD, et al. Application of a method for estimating day of ovulation using urinary estrogen and progesterone metabolites. Epidemiology. 1995 Sep;6(5):547-50.
doi: 10.1097/00001648-199509000-00015.

13. Wilcox AJ, et al. The timing of the "fertile window" in the menstrual cycle: day specific estimates from a prospective study.
BMJ. 2000 Nov 18;321(7271):1259-62. doi: 10.1136

14. GOV.uk. Women’s Reproductive Health Survey 2021 national pilot: contraception and abortion results. 2025. Available at: https://www.gov.uk/government/publications/womens-reproductive-health-survey-2021-national-pilot-contraception-and-abortion-results/a048d786-8ea4-4a10-808b-8b0311f2f1d2

15. Willacy H. Contraception methods. 2023. Available at: https://patient.info/sexual-health/contraception-methods#barrier-methods

Online references last accessed May 2025.

Essential information

ellaOne® 30 mg film-coated tablet (ulipristal acetate). Refer to the SmPC for further information. INDICATION: Emergency contraception (EC) within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure. DOSAGE: one 30mg tablet taken orally as soon as possible, but no later than 120 hours (5 days) after unprotected intercourse or contraceptive failure. Another tablet should be taken if vomiting occurs within 3 hours of intake. Can be taken at any time during the menstrual cycle. Not recommended for women with severe hepatic impairment. CONTRAINDICATIONS: Hypersensitivity to the active substance or excipients. SPECIAL WARNINGS AND PRECAUTIONS: Occasional use only. Use reliable barrier method after use until next menstrual period. If next menstrual period is delayed >7 days or is abnormal or suggestive symptoms occur then perform pregnancy test. Consider ectopic pregnancy. If pregnancy confirmed, woman should contact their doctor. Concomitant use with EC containing levonorgestrel not recommended. Does not contraindicate the continued use of regular hormonal contraception but reliable barrier method should be used until next menstrual period. Not recommended in severe asthma treated by oral corticosteroids. Concomitant use of CYP3A4 inducers [e.g. barbiturates (including primidone and phenobarbital), phenytoin, fosphenytoin, carbamazepine, oxcarbazepine, herbal medicines containing Hypericum perforatum (St. John’s wort), rifampicin, rifabutin, griseofulvin, efavirenz, nevirapine] not recommended (may decrease efficacy of ellaOne®). Long term use of ritonavir not recommended. Not recommended for women who have used enzyme-inducing drugs in the past 4 weeks. Non-hormonal emergency contraception (i.e. a copper intrauterine device (Cu-IUD)) should be considered. Contains lactose. FERTILITY, PREGNANCY AND LACTATION: Not intended for use during existing or suspected pregnancy. Limited human data does not suggest safety concern. Does not interrupt existing pregnancy. No teratogenic potential was observed; animal data insufficient with regard to reproduction toxicity. Marketing Authorisation Holder maintains a pregnancy registry (www.hra-pregnancy-registry.com) to monitor outcomes of pregnancy in women exposed to ellaOne®. Patients and health care providers are encouraged to report any exposure. Ulipristal acetate is excreted in human breast milk; breastfeeding is not recommended for one week after intake. Breast milk should be expressed and discarded. A rapid return of fertility is likely following ellaOne® use; regular contraception should be continued or initiated as soon as possible; subsequent acts of intercourse should be protected by reliable barrier method until next menstrual period. UNDESIRABLE EFFECTS: Always consult the SmPC before prescribing. Only the most common side effects and those which are rare but may be serious are listed below. Most commonly reported adverse reactions: headache, nausea, abdominal pain and dysmenorrhea. Common (≥1/100 to <1/10): mood disorders, dizziness, abdominal pain upper, vomiting, abdominal discomfort, myalgia, back pain, dysmenorrhea, pelvic pain, breast tenderness and fatigue. Rare (≥1/10,000 to <1/1,000): ruptured ovarian cyst. Hypersensitivity reactions including rash, urticaria, angioedema RETAIL PRICE: ellaOne® 30 mg single film-coated tablet blister pack; £34.95. MARKETING AUTHORISATION HOLDER: Laboratoire HRA Pharma, 200 avenue de Paris, 92320 Châtillon, France. Marketed in the UK by: HRA Pharma a Perrigo Company, One Embassy Gardens, Viaduct Gardens, Nine Elms, London SW11 7BW, United Kingdom MARKETING AUTHORISATION NUMBER(S): PLGB 17836/0011. LEGAL CATEGORY: P Date of last revision of text: October 2024

Adverse events should be reported. Reporting forms can be found at www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. Adverse events should also be reported to HRA Pharma on +44 (0)203 598 9603 or email UKLOCustomerService@perrigo.com

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