To think women should be told this about the morning after pill?

[christmaselfie1]

The morning after pill is directly linked to ovulation, and if you have already ovulated then it is pretty much pointless!

I had sex where the condom split on Monday last week, but due to covid restrictions and living rurally I was not able to get the morning after pill until Friday (4 days after sex). I have taken Ellaone before, the brand that you can take up to 5 days after, so assumed that all would be okay. I am also tracking my cycles on the instruction of my gynaecologist because I suffer with ovarian cysts.

I got my LH surge and a positive ovulation test on Wednesday morning, which means ovulation would have occurred imminently, most likely well before I took the morning after pill on Friday evening!

Since researching, I have discovered that the morning after pill works by delaying or preventing ovulation. Therefore, if you have already ovulated, and the sperm happened to meet the egg in that time, the morning after pill has pretty much zero effect! You can read it yourself on the manufacturers website...

www.ellaone.co.uk/faqs/does-ellaone-work-if-youve-already-ovulated

I have taken the morning after pill three times and I have never been told this by any pharmacist. I have never been informed on how it works, just that is it effective up to 5 days after unprotected sex. The only emergency contraception that works in these circumstances is the IUD. I have now got the worry for the next week that I might be pregnant.

Am I the only person that had no idea how the morning after pill works?!

@Cauterize It seems a lot of people are woefully misinformed

If this issue ditectly affected men, ypu can guarantee the information would be a hell of a lot clearer

Good luck, op. I hope you get the outcome you want. Why don't you use non-emergency contraception though ?

I haven't used any non-emergency contraception as I have had lots of gynaecological issues that are being monitored by my doctors. I need to track my cycle, have regular scans etc. That's why myself and DP rely on condoms.

I've just asked a WhatsApp group of 10 highly educated women, several of whom have taken it, and not one was aware of this. One is a medical student.

To be fair, I didn't know this until I did my contraception course (nurse) and I'd taken them twice in life.
We have to ask when last period was, when sex was and work out if they will have ovulated and if so it should be copper IUD instead. I was surprised at myself really as I'm not sure how I thought it would work, I suppose I thought it was like abortion pills but really early! If you'd already ovulated then the egg would have been fertilised and any pill that stops pregnancy then would technically be an abortion.
We are told to explain this to patients, but I guess if they've checked your timings and conclusion is you won't have ovulated, you may not get told? Although they should still explain.

The outcome of the MAP is currently nagging me for a drink and getting excited about Christmas

It's always verbally explained and the booklet that comes in the pack also explains this 🤷‍♀️

IUD can be fitted up to 10 days after

Yes I agree it absolutely should be explained. I queried this with the pharmacist when I took it who advised me that this was definitely not the case and reassured me that it’s highly effective. I’d already ovulated after and the morning after pill failed. Like you our condom split. It’s vital information that must be made clear.

Exactly @ImEatingVeryHealthilyOhYes !

@jessstan1

I think most women are aware of what the morning after pill can and cannot achieve.

They really aren't. Lots of HCPs on the course I was on and it was news to many of us! We all have degrees in health fields... A random sample of the population would know even less. We had a load of complicated scenarios to work through with dates of UPSI (unprotected sexual intercourse, oops-y, made us lol) and dates of last period and average cycle length. Then had to decide if they could have the MAP. Also, it's a lot less effective than we expected (probably due to people using it at the wrong time!).

I think partly the issue here is most women aren’t aware of ovulation or tracking it unless you’re trying for a baby really. So saying to you well if you’ve ovulated this won’t work, when most women I would argue wouldn’t know when they had ovulated and it can vary person to person, it’s worth taking on the off chance it may work? If you wish to prevent a pregnancy, it’s worth a go? Getting a coil fitted can’t always be done within the timeframe and may not be suitable for most people.

Just checked the guidelines and it clearly says the woman should be told that it will not be effective after ovulation so YANBU.

This wasn't explained to me either, in fact the only thing the clinic doctor explained to me was "how it's actually very rare that a condom splits" after I told her that was why I needed the MAP, she was very patronising for sure!

I think it’s worth telling the woman on the off chance that it’s clear whether she’s ovulated or not (she may know) so that she’s got the option of having an iud instead

I took it 10 years ago and was never told any of this.

Luckily I didnt fall pregnant.

Good point that an iud might not be possible though

I think partly the issue here is most women aren’t aware of ovulation or tracking it

I really dont think thats true! Most women know its roughly 2 weeks after their period starts, many women get egg white/increased discharge & it's common to experience mittelschmerz (ovulation pain) too.

Just thought - any benefit to the woman doing an ovulation test, those ones you use to discover your fertile window, or some other urine test that shows if ovulation has already happened? Do they exist?

@NoIDontWatchLoveIsland

I think partly the issue here is most women aren’t aware of ovulation or tracking it

I really dont think thats true! Most women know its roughly 2 weeks after their period starts, many women get egg white/increased discharge & it's common to experience mittelschmerz (ovulation pain) too.

Indeed roughly, but I don’t think that’s an exact science to base an entire decision on whether to take it or not. I took it as a teenager and my cycle was very irregular I wouldn’t have had a clue! It should be explained I don’t disagree but I don’t think lots of women know all of the things you listed. Having worked as a midwife the little women knew about their own bodies would surprise you!

YY Orange. I have to track my BBT to check whether and when I've ovulated. I wouldn't have a clue otherwise. I don't get any physical symptoms and I get lots of cervical mucous before and after so it's not clear unless I do that temping, which tbh is a bit of a faff. My last two pregnancies I've had to rely on scans for dating as I just don't know when in my cycle I ovulated.

No, there's no test to check whether ovulation has happened, at least none you can do at home.

You can test for a surge of a hormone that predicts (but doesn't guarantee) ovulation should occur in the next 48 hours. And if you've been checking resting heart rate or basal body temperature, you can see a difference but only compared to what it was before. A single reading won't tell you anything, you need several over a few days at the very least.

Haven’t RTFT but given you have taken it several times you should have also been aware that the sooner you take it the better, the fact that it can work up to five days after sex doesn’t mean the rate if success is the same on day one as on day 5, the sooner always the better.

I had a pharmacist explain this to me years ago.

@jessstan1

I think most women are aware of what the morning after pill can and cannot achieve.

No idea whatsoever, and I had mine prescribed by the FPC. Admittedly it was the 1990s and I was very lucky as none of those men were father material at the time.

I've taken Levonelle twice, the first time when I was 18 and I actually think I still got pregnant. I did not know this. Although I was so frightened at the prospect of being pregnant I never took a test but I've always been convinced I was, I did not have my period afterwards for six weeks. I was a student and when it arrived I was so happy I threw a party in relief but did not tell anyone. Actually I'm pretty sure this was really a miscarriage but it was a traumatic time in my life and I'd had sex with three people that week so I tried to push it out of my mind.