Lovingly refreshed 08/02/2023

Do you ever think of your Morning After pill timing? Or – when is the best time of your cycle to take the Morning After Pill?

In this post, we’ll answer the most common questions about the best time in your cycle to take the emergency pill, so it definitely works for you.

For example – can you take it before sex? What about after your periods? And will it work if you take it on the day you ovulate?

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We will look at four time-related questions when using the MAP in this video, but first, let’s take a quick look at how the MAP works.

How Does The Morning After Pill Work?

People reach for an EC pill when trying to prevent pregnancy after having unprotected sex. This means either you’re not on regular contraception or didn’t use a condom or used one, and it split.

The EC pill contains either the synthetic progesterone hormone LNG or an antiprogesterone called Ulipristal acetate. Both of them primarily work by delaying the release of a mature egg from the ovary, although Ulipristal does the job more effectively.

If you want to know more about Ulipristal or Ella, then check out this video.

Examples of LNG-containing pills are Post pill, Plan B, Levonelle, Take Action Postinor, etc.

Key Events During your Cycle

Pregnancy happens when a mature egg is fertilised by sperm. There is a limited time during which this can occur in any month of a woman’s cycle.

A cycle is the time between one menstrual period and the following one. Usually, we can estimate when you are most likely to fall pregnant if you have a regular cycle.

Having a regular cycle means that you get a period roughly at about the same time each month.

That tells us that you are ovulating and, likely, doing so at about a specific time from when you have a period. Women commonly have regular cycles with periods every 28 days though you could have a shorter or longer cycle length.

However, many women have irregular cycles, so they do not see their periods at about the same time each month. This means that estimating when they ovulate simply by the dates can be difficult.

For a lady with a regular 28-day cycle, the first 4-5 days of the menstrual period.

After shedding the womb lining as menstrual blood, your body starts to prepare for the release of a new egg.

Ovulation occurs in the middle of the cycle (around day 14).

In the second part of the cycle, your body may have a fertilised egg and starts changing for pregnancy.

But if the egg is not fertilised, it will be shed as menstrual blood, beginning a new cycle. The menstrual period and ovulation are events that depend on hormones.

Hormone Effects around Ovulation

From the time the menstrual period ends, your hormone levels increase. One of the hormones, FSH, helps to develop and mature the egg.

When the egg has reached the right size, there is a rise in another chemical, Luteinising Hormone (LH).

Within 36-40 hours of this rise (or surge) in the level of LH, it peaks (gets to maximum); at this point, a mature egg is released from the ovary.

The time you take the emergency pill is important because LNG prevents egg release before the LH surge.

On the other hand, Ella will work nearer the point where LH peaks and delay the release of the egg from that time.

In both cases, the drugs work before ovulation has happened, but because Ella can still delay ovulation even after the LH has started to rise, it is a better pill.

It is also effective 48 hours after LNG pills are no longer reliable.

The other minor ways the pills may work are:

• slowing sperm movement by making the cervical mucus thicker and thus preventing fertilisation or
• preventing implantation if the egg has become fertilised.

However, studies do not show this method happens reliably or consistently. So now we know how the pills work. Let’s apply this knowledge to some questions about the morning after pill timing.

Does The Pill Work On Ovulation Day?

Once the Lutenising Hormone (LH) levels start to rise, there are 36-40 hours till ovulation.

The Levonorgestrel (LNG) pills can only work before the surge has begun. This means if you know your ovulation day, the LNG pill is likely effective 1-2 days before that day and will not work on ovulation day since the surge has already started.

Ella is more reliable because it works even if taken just before the LH peak, which happens before the egg release.

So, what are your options if you monitor your ovulation and realise you’ve had unprotected sex on ovulation day?

• 1. Get the copper coil if possible. It is the most effective emergency method and will work if it is fitted within five days of having sex or five days of ovulation. But it may not be possible or convenient to do so.
• 2. Get the Ella contraception pill. It works just before ovulation, giving you time if you have sex very near ovulation. This helps if you take Ella before the LH peak triggers ovulation. But at which moment do you ovulate on the day? We can’t say with any certainty yet.
• 3. The third option is taking an LNG pill. Again this works before ovulation – but as we’ve seen, it works 36-40 hours before ovulation. 

Does the Pill Work at the End of Your Cycle?

What happens if you take the pill when your cycle is ending? What is happening at the end of your cycle?

At this time, you are far away from ovulation and your fertile window.

For a woman who is quite regular in her cycle, this is theoretically when you are less likely to fall pregnant, i.e. your safe period.

But please be careful while relying on safe periods – because even in a woman with regular cycles, sometimes you may ovulate earlier or later than usual.

So it’s essential to use regular protection or a condom or an emergency method even if you believe you are safe.

Therefore, taking the pill at the end of your cycle (a safe period) if you’ve had unprotected sex is still an excellent idea to prevent unplanned pregnancy if there is a slight chance it happens.

The pill may bring your next period forward or delay it. However, it’s also possible its effect can wear off before your ovulation in the next cycle.

When is the Best Time of Your Cycle to take the Morning After Pill?

The EC pill should be used by a woman who has had unprotected sex ANYTIME during her cycle.

However, there are certain times when it is most effective.

Although there are some theoretical ‘safe days’, the fact that ovulation is unpredictable and the duration of sperm survival means that pregnancy could still happen when it’s least expected.

This is why you should consider emergency birth control after unprotected sex.

Given a regular 28-day cycle, when you menstruate from day 1 to 4, your fertile window can fall between days 10 and 14.

With this, we assume your ovulation day is about day 14.

Remember, these are estimates, and you may ovulate one or two days earlier or later – from days 12 to 16.

If you have sex on day 7 of your cycle (the day after your period), sperm could remain alive five days later until day 12.

If you ovulate on day 12, that’s a potential chance of falling pregnant.

So, taking the pill in the 7-8 days leading up to ovulation looks like the period when it will work best.

Recall that Levonorgestrel (LNG) taken too close to ovulation may not work because of the LH surge I described earlier. 

Does Plan B work After your Period?

Yes, it does. Plan B is a Levonorgestrel-containing pill.

If you have a regular cycle, your fertile window starts a few days after your period ends.

If you have sex around this time and are not too close to ovulation, that’s the best time to use the LNG pill.

The pill will delay your ovulation for five days, and then you will ovulate.

So please remember to get your regular birth control going straight back on after sex.

If you don’t have a regular method and have sex again – make sure you use an emergency method again!

What happens if I forget to take my Birth Control pill?

If you’re on regular birth control, it’s recommended that you take the pill at a specific time each day, but if you forget, you can still take it within 12 hours, and it should still work. After this, continue taking the pill at the same time the next day as normal.

You should only consider taking a morning-after pill if you have missed your birth control pill 2 days straight and had sex within that time. At this point, taking a birth control pill may not be enough to prevent pregnancy.

Phone alarms are a good way to keep on top of taking birth control pills. If you take lots of medication, you may want to consider looking into a medication management app to help you organise all your pills so that birth control doesn’t get forgotten. This guide offers more tips as to how medication management works. 

If I take the Emergency Contraception pill before sex, will it work?

So assuming you want to be very well protected, can you take the EC pill preemptively?

These drugs are meant for use as soon as possible after sex. If you take the pill before sex, you will not get the maximum protection.

This is because sperm can live inside you for up to 5 days after sex. As the pills can only protect you for three days (LNG) or five days (Ella) after sex, taking them before means you cut short the length of your protection.

In other words, the sperm may outlive the protection window of the pills leading to pregnancy. 

Final Word…

Many women have questions about the morning-after pill – I hope this article helps answer some of yours about the best time around your cycle to use the emergency birth control pill. 

Don’t forget that taking it as soon as possible after sex increases the chances that it works, and taking it regardless of where you are in your cycle is better than doing absolutely nothing.

More Reading

• Period Sex, Ampicillin and Two Other Birth Control Myths To Avoid
• Delayed Periods! How Late Can My Period Be After Taking Plan B?
• Dr, How Do I Know If the Morning After Pill Worked Effectively?
• Emergency Pill Wahala! Why’s My Period All Over The Place?
• Being Real! Can You Get Pregnant From Period Sex?

References

1. FSRH Emergency Contraception Guideline
2. Am I Ovulating?

Editing by AskAwayHealth Team

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of healthcare conditions to provide evidence-based guidance and to help promote quality healthcare. The advice in our material is not meant to replace a qualified healthcare practitioner’s management of your specific condition.
To discuss your condition, don’t hesitate to get in touch with a health practitioner or reach us directly through info@askawayhealth.org

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