Morning-after pill and emergency contraception: time limits and effectiveness
In brief
The morning-after pill (emergency hormonal contraception) is taken after unprotected or poorly protected sex: no later than 3 days (72 hours) after sex for levonorgestrel, or 5 days (120 hours) for ulipristal. The copper coil (IUD), fitted within 5 days, is the most effective emergency method. In France, since 1 January 2023, the pills have been available free of charge, without a prescription and with nothing to pay upfront at pharmacies, to anyone, under or over 18. The sooner you take it, the better it works.
What is emergency contraception?
Emergency contraception helps prevent pregnancy after unprotected or poorly protected sex: a condom that slipped off or split, a missed pill, a patch that came off, sex without contraception, or forced sex. It is a back-up option, not a regular method of contraception.
It does not end a pregnancy that has already started and is not an abortion. The pills work mainly by delaying or blocking ovulation: this is why they are most effective when taken early, before ovulation. The copper coil prevents fertilisation and implantation.
What are the three emergency contraception methods and how long do I have?
The time limits below come from the summary sheet of the French National Authority for Health (HAS):
| Method | Time limit after sex | Access in France | Good to know |
|---|---|---|---|
| Levonorgestrel (e.g. Norlevo and generics) | Up to 72 hours, ideally within 12 hours | Pharmacy, no prescription, free | A single tablet. A few precautions for use, checked by the pharmacist. |
| Ulipristal acetate (e.g. EllaOne) | Up to 120 hours (5 days) | Pharmacy, no prescription, free | A single tablet. Slightly more effective than levonorgestrel. |
| Copper coil (IUD) | Up to 120 hours (5 days) | Fitted by a doctor or midwife | The most effective method. Can then stay in place for several years. |
The older method combining oestrogen and progestogen (the Yuzpe method, once sold as Tetragynon) is no longer used: according to the Cochrane review, it is less effective and causes more nausea and vomiting than levonorgestrel.
How effective is the morning-after pill?
No emergency contraception is 100% effective. In the 2019 Cochrane review (115 trials, more than 60,000 women), ulipristal was linked to fewer pregnancies than levonorgestrel (risk ratio 0.59).
The copper coil, fitted within 5 days of sex, is the most effective method of emergency contraception.
Several factors can make the pills less effective:
- taking the pill late, especially if ovulation has already happened;
- a higher weight or body mass index (data are limited, but mention it to the pharmacist: the copper coil is then a good option);
- some medicines known as enzyme inducers (some epilepsy drugs, rifampicin, St John’s wort, some HIV medicines);
- vomiting within 3 hours of taking the pill: you need to take another tablet.
Levonorgestrel and ulipristal must not be taken together.
How do I get the morning-after pill in France?
In France, since 1 January 2023, emergency contraceptive pills have been available free of charge, without a prescription and with nothing to pay upfront at pharmacies to anyone, under or over 18, whatever their age. Under-18s can ask for the supply to remain confidential. They are also available free of charge from school nurses, university health services, sexual health centres and CeGIDD (free STI information, testing and diagnosis centres).
For a copper coil, contact your gynaecologist, a midwife or a sexual health centre quickly and explain that it is for emergency contraception. At the practice, where coils are fitted, mention this reason when booking, via Doctolib or on 01 43 79 59 79.
You can also call the free, anonymous helpline in France for abortion, contraception and sexuality: 0 800 08 11 11.
When should I consider emergency contraception?
Emergency contraception should be considered whenever you have had sex without reliable protection, whatever the point in your cycle: ovulation is hard to predict and sperm can survive for several days.
- Missed pill: if you are more than 12 hours late with a combined pill or a desogestrel progestogen-only pill (3 hours for other progestogen-only pills), emergency contraception is recommended if you had sex in the previous 5 days. Restart your pill and use condoms for 7 days.
- Patch came off or ring removed for too long: ask the pharmacist, as what to do depends on how long.
- Condom split, slipped off or was put on too late.
- Withdrawal or a fertility awareness method that did not go to plan.
- Coil expelled or threads cannot be felt.
- Vomiting or severe diarrhoea in the hours after taking a pill.
If in doubt, do not wait: the pharmacist can advise you straight away, without an appointment.
What should I do after taking the morning-after pill?
- Use condoms until your next period: the morning-after pill does not protect you from later sex.
- If you were taking a pill, continue or restart it as advised by your pharmacist or doctor. After ulipristal, restarting hormonal contraception should be delayed for a few days, as the two can interfere with each other: ask exactly what to do.
- Breastfeeding: after ulipristal, the HAS advises not breastfeeding for one week (express and discard the milk).
- Take a pregnancy test if your period is more than 5 to 7 days late, if it is unusual (very light or different from normal) or if you have signs of pregnancy.
- Consider STI testing if you had sex with a new partner or a partner whose status is unknown.
- Review your contraception: if you often forget pills, a long-acting method (coil, implant) may suit you better. See contraception methods.
Side effects are usually mild and short-lived: nausea, headache, tiredness, tummy pain, light bleeding. Your period may come a little earlier or later than expected.
Why choose a copper coil as emergency contraception?
The copper coil has two advantages: it is the most effective emergency contraception, and it then gives you ongoing contraception for several years. Its effectiveness is not reduced by body weight. It can be fitted in women who have never had a child.
Before fitting, the practitioner checks that you are not pregnant and do not have a genital infection; testing for chlamydia and gonorrhoea may be done depending on your situation. A follow-up appointment is planned in the following weeks.
When should I see a doctor urgently after emergency contraception?
See a doctor promptly if, after emergency contraception, you have:
- a late period or a positive pregnancy test;
- pain on one side of the lower abdomen, especially with bleeding: an ectopic pregnancy must be ruled out;
- fever or pelvic pain after a coil has been fitted.
If you have severe abdominal pain, feel faint or have heavy bleeding, call 15 or 112 in France, or your local emergency number. After a sexual assault, go to an emergency department: medical care (emergency contraception, preventive HIV treatment) and forensic care can be arranged there.
Frequently asked questions
Can the morning-after pill make you infertile?
No. It has no effect on future fertility, even if used repeatedly. It is, however, less effective than regular contraception.
Can I take the morning-after pill more than once in the same cycle?
It is possible but not recommended, as it does not protect you from later sex. If you need it repeatedly, it is better to start regular contraception with a health professional.
Does the morning-after pill cause a miscarriage?
No. It works before fertilisation by delaying ovulation and does not end a pregnancy that has already implanted.
Do I need a prescription for the morning-after pill in France?
No. In France, since 1 January 2023, it has been available free of charge, without a prescription and with nothing to pay upfront at pharmacies, to anyone, under or over 18.
Does the morning-after pill affect your period?
It can bring your next period forward or delay it by a few days, and cause light bleeding. Do a pregnancy test if your period is more than 5 to 7 days late or unusual.
References
- Haute Autorité de santé (French National Authority for Health). Contraception d’urgence : dispensation en officine. Fiche mémo. HAS, 2019. has-sante.fr
- Shen J, et al. Interventions for emergency contraception. Cochrane Database Syst Rev, 2019. doi:10.1002/14651858.CD001324.pub6 — PMID 30661244
- Assurance maladie (French national health insurance). Contraception d’urgence hormonale gratuite en pharmacie (updated 16/12/2025); Quelles méthodes de contraception d’urgence ? (updated 15/12/2025). ameli.fr. ameli.fr (free supply) — ameli.fr (methods)
Dr Olivier KadochObstetrician-gynaecologist and gynaecological surgeon in Paris (16th and 5th arrondissements). Former chef de clinique-assistant (senior registrar) at the Paris public hospitals (AP-HP); individually accredited by the French National Authority for Health (HAS). RPPS 10003957809. Background and practice locations
A question about your situation?Appointments at the practice or by video consultation, usually within one week to 10 days.
Book an appointmentGeneral information article: it does not replace a medical consultation. In an emergency, call 15 or 112 in France, or your local emergency number.