Australian women now have access to another emergency contraceptive pill.

April 27, 2016

Even though we’re well into the 21st century, emergency contraception isn’t something that’s often openly discussed. In fact, in many ways it’s still surrounded by stigma and plenty of misconceptions.

However, today marks a positive step: women in Australia now have access to one more form of emergency contraception.

It’s a pill called EllaOne, and while it’s ideally taken as soon as possible after unprotected intercourse, it’s effective for up to five days afterwards.

This is two days longer than the levonorgestrel (or “morning after”) pill, which is currently the most common emergency contraceptive in Australia.

“We don’t want to it be known as the ‘five day pill’, because we don’t want people to put things off for that time. It’s best to take it as early as possible,” says Dr Deborah Bateson, Medical Director of Family Planning NSW.

Kahla Preston

April 27, 2016

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EllaOne is now available in Australia. (Image: EllaOne)

"But it's another alternative, and we want women to know about it and speak to their doctors about it."

Like other emergency contraception, EllaOne works by delaying or preventing ovulation. However, it contains a new compound — a selective progesterone receptor modulator, to be more specific — called ulipristal acetate.

"EllaOne is able to stop ovulation from occurring even when the egg's just about to be released; in other words the luteinising hormone surge has already begun. So it's more effective at preventing ovulation," Dr Bateson explains.

In fact, comparative data has indicated EllaOne is three times more effective that the current levonorgestrel pill when taken within the first 24 hours of unprotected sex.

However, like any form of birth control, it isn't 100 per cent effective and can fail. Dr Bateson advises that if women have any concerns after taking it, like a delayed period, they should take a pregnancy test. (Post continues after gallery.)

Popular forms of birth control

Intrauterine deviceIUDs are small, T-shaped devices that are inserted into the uterus by a doctor in order to prevent pregnancy. There are two types of IUD: copper, which affects the movement and survival of sperm in the womb while changing the lining of the womb;and hormonal, which releases progestogen (a synthetic version of the naturally-occurring hormone progesterone) into the uterus. Although IUDs have a success rate of more than 99%, only around 2% of Australian women currently use one.

Contraceptive pillThe Pillis the most popular form of birth control. There are two types: the combined pill, containing two hormones, and theprogestogen-only, or mini, pill, which only contains one female hormone. The combined pill works by preventing the ovary from releasing an egg each month. The mini pill changes the mucus at the entrance of the uterus, which stops sperm from entering. Both are 99.7% effective; however, they don't offer protection from STDs.

CondomsThe male condom is a barrier contraception that prevents both pregnancy and the transmission of STDs. They work by collecting semen so it doesn't enter theman's partner's body. Condoms are 95 to 99% effective at preventing pregnancy.

The female condomThe female condom is a pre-lubricated sheath, which loosely fits inside of the vagina. The condom has a removable ring, which helps to insert the sheath and keep the condom in place. A larger ring remains on the outside to cover the opening of the vagina. They are designed to fit all women and can only to be used once. Due to misuse of the product it is only 79 per cent effective.

DiaphragmLike the male condom, the diaphragm is a barrier method of contraception. It's a shallow silicone dome that's inserted into the vagina andcovers the cervix, which is the entrance to the uterus. It's held in place by the pelvic muscles, and works by preventing sperm from entering the uterus. After sex, diaphragms need to remain in placefor another six hours, in which time the sperm inside the vagina die. This method is 88 to 94% effective at preventing pregnancy, although this rate increases with experience.

Birth control implantThis is a 4cm-longimplant that is inserted into a woman's upper arm, just under the skin, by a doctor. It releases a hormone called etonogestrel, which prevents ovulation and thickens the mucus in the cervix, which can stop sperm from entering. Contraceptive implants - usually sold as Implanon - are removed under anaesthetic every three years, and are close to 100% effective.

Vaginal ringVaginal rings are soft plastic rings that contain the same two hormones as the combined pill - oestrogen and progestogen. The ring is inserted into the vagina, where the hormones are absorbed into the body and then prevent the ovaries from releasing eggs. Once inside the ring can't be felt, and it needs replacing every three weeks (with one week's break in between). When used correctly, this method is more than 99% effective.

Depo ProveraDepo is a long lasting hormonal injection. The synthetic form of progesterone is administered every 12 to 14 weeks to woman, preventing pregnancy within this ongoing time period. The injection, which is given in the buttock or muscle of the upper arm, prevents ovulation and thickens the mucus in the cervix, helping to block sperm. The injections are 99 per cent effective but do not protect against STDs. Male contraceptive injections are currently being trialled

The morning after pillEmergency contraception (popularly referred to as the morning after pill) is used to prevent a pregnancy following unprotected sex. Other reasons include missing a contraceptive pill or a condom breaking. It is common in Australia to use the progestogen-only method. This entails a dosage of EC pills containing progestogen or the synthetic version. A doctor can prescribe the pill or they can be bought over the counter at a pharmacy without a prescription. Emergency contraceptionis 85 per cent effective in reducing the risk of pregnancy.

SterilisationSterilisation is a permanent form of contraception. For women there are two types of sterilisation: tubal ligation, in which clips are placed on the fallopian tubes, or tubal occlusion in which a device is inserted into the tubes. These methods work by preventing the sperm from reaching the egg. Tubal litigation is 99.5 per cent effective. The Vasectomy (for men) works by cutting and blocking the tubes called the vas deferens, preventing sperm from leaving the testicles. The chances of impregnation with a vasectomy are 1 in 1000.

Although EllaOne is available over the counter in some countries, including the UK, it won't be in Australia.

Women here will require a doctor's prescription in order to purchase it; according non-profit pharmaceutical company MS Health, the pill's sponsor in Australia, this is because it's a "new chemical entity."

EllaOne isn't listed on the Pharmaceutical Benefits Scheme, and while the price is currently unknown (and it will vary between pharmacies) Dr Bateson says it's likely to be more expensive than the current emergency pill.

"The cost may be an issue for some people," she adds. "But I think it's a very useful option for women who may find it difficult to get to the chemist in a short period of time. So they can then see their doctor, their doctor can prescribe it, and they can access it."

EllaOne is new to Australia, having been approved by the Therapeutic Goods Administration last year, but it's been available in around 89 other countries since 2009. It's been used by more than five million women in that time.

You won't be able to buy EllaOne over the counter, for the time being at least. (Image: The Pill)

There are few side effects associated with EllaOne, but it can sometimes cause a disturbance to a woman's bleeding pattern. It's also not suitable for everyone — for instance, women who are breastfeeding are recommended not to do so for the week after taking the tablet.

Ultimately, Dr Bateson believes EllaOne offers a "good new option" for emergency contraception, joining the levonorgestrel pill and the copper IUD (which is an effective form of emergency contraception if inserted within five days of unprotected sex).

"Obviously, it's useful for women to think about long-term methods of contraception," she says.

"But we certainly want women to know that [EllaOne] is safe, there's no effect on future fertility, it's not associated with ectopic pregnancy and there are very few side effects."

See your doctor for more information.

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Tags: birth-control , contraception , emergency-contraceptive-pill