The Guide for Emergency Contraception in Singapore

At Reallysick.sg, we have compiled a guide for some of the Frequently Asked Questions (FAQs) that our patients have consulted us with to provide you an ease of mind on the selection of emergency contraception to consider within 24 – 72 hours after unprotected sex to prevent pregnancy :

  1. What is the difference between Postinor® or Ella®?
  2. How does Emergency Pill or After Sex Pill work?
  3. Where can I get the Emergency Pill or After Sex Pill?
  4. How should you consume Emergency pill / After Sex pill?
  5. How effective is Emergency pill / After Sex pill?
  6. When does Emergency pill / After Sex pill not work?
  7. What if I am already pregnant and I took the emergency contraceptive pill?
  8. When will my menses come after taking emergency pill?
  9. Can I take after sex pill more than once in a cycle?
  10. What are the side effects of Emergency pills / After Sex pills?
  11. Why choose ReallySick.sg for your emergency pill?

What is the difference between Postinor® or Ella®?

Postinor® is the ‘old’ and relatively cheaper medication compared to Ella®. Data is in favor of Ella®, making it the ‘premier’ after sex pill. Not only it has a higher efficacy in preventing pregnancy, it is also a single dose medication that can be taken up to 5 days after intercourse. For your easy reference, we have compiled it into a table table below for your reference.

DrugDoseTimeframeEfficacyPrice
Ella®SingleWithin 5 days98 %
(Taken on day 1)
85%
(Taken on day 5)
$$$
Postinor®2 doses once or 12 hourly doseWithin 72 hours (3 days)95%
(Taken on day 1)
58%
(Taken on Day 3)
$$
OCPDailyDailyAbout 97% consistently$

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How does Emergency Pill or After Sex Pill work?

All forms of after sex pill contain hormones. The hormones delay the release of the egg from the ovary. The deposited sperm will not meet the egg and hence fertilization cannot occur. In this way, pregnancy is prevented despite sexual intercourse without protection.

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Where can I get the Emergency Pill or After Sex Pill?

Emergency pills or After sex pills may be available over the counter in some countries.

However in Singapore, a doctor’s prescription is required. Through an online doctor consultation, you can get the after sex pill delivered to you discretely in the comfort of your house. All you need to do is to raise a consult on the telemedicine service. Together with consultation charges, 1 dose of emergency pill typically costs between $35-$80.

If you find that you are requiring after sex pill too often, you should consider daily oral contraceptive pill (OCP). OCP offers better consistent efficacy compared to after sex pill. For example, after sex pill effect decreases the later you take the medicine after sex. Yet for OCP, the effect is consistent so long as it is taken regularly.

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How should you consume Emergency pill / After Sex pill?

All emergency contraceptive pill should be taken as soon as possible after unprotected sex. Emergency pill work by interfering with ovulation. The sooner you take the after sex pill, the higher the chance of preventing ovulation, preventing pregnancy. For example, emergency pill have close to 98% success to prevent pregnancy when taken within 24 hours. This reduces to 85% success when taken at the 5 days mark.

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How effective is Emergency pill / After Sex pill?

When taken at its recommended dose within a time frame of 72 hours (for postinor) or 5 days (for Ella), emergency pill can prevent pregnancy up to 95% – 98% of the time. However, there are medications and other factors that can decrease the efficacy of emergency pills, resulting in pregnancy.

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When does Emergency pill / After Sex pill not work?

Somewhere between 0.6% to 5.8% of women who take after sex pills within the time frame will still become pregnant. The efficacy of after sex pills may be reduced in women of higher body weight with suggested rates of 5.8% (using Postinor®) vs 2.6% in (Ella®).

If your BMI is on the high side >26kg/m2, it is recommended that you take Ella® instead of Postinor®.

Do note that It is not well studied how emergency contraceptive pill are affected by medications. However, certain medications are known to reduce the efficacy of contraceptive pill, also containing the same components as emergency pill.

These medications include rifampin, griseofulvin, certain anticonvulsant drugs, Saint John’s wort, certain antiretroviral drugs and antibiotics. If you are on these medications, you should consider inserting copper IUD as the failure risk is higher.

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What if I am already pregnant and I took the emergency contraceptive pill?

If you are already pregnant, taking emergency pill will not pose harm to the baby. It will not affect the pregnancy or increase the chance of a miscarriage. However, you should still do a pregnancy test to ensure that you are not pregnant before you take emergency pill. Otherwise you would have taken the emergency pill for nothing.

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When will my menses come after taking emergency pill?

Most women, 87% of the time, will have their period at their expected time, while others can expect a delay of up to 7-10 days. If it has been more than 10 days of your expected menses, you should do a pregnancy test to exclude the possibility of pregnancy.

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Can I take after sex pill more than once in a cycle?

Emergency pill are meant for ‘accidents’ and not for deliberate repeated use. For such situations, OCP taken daily proves to be more effective and cost efficient.

The efficacy of repeated use has not been well studied. Frequent use of Postinor®/Ella® within the same cycle has not caused any serious side effects and is safe for the user. The use of emergency pill preventing pregnancy again in the same cycle will still be useful. However, its efficacy has not been well studied and could be reduced.

If you have recently used emergency pill and would require emergency contraception again, it is generally more advisable to go for copper IUD insertion instead. However, if this is not possible, taking emergency pill would still be more useful than not doing so.

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What are the side effects of Emergency pills / After Sex pills?

Emergency pills / After Sex pills are generally very safe and the side effects are typically mild and self- resolving.

The most common side effect of after sex pill is having a heavier or delayed period the next time when your menustration cycle comes, occasionally accompanied with stomach cramps and nausea.

Bleeding or spotting in between your menses may be possible. If you are more sensitive to hormonal changes, you may experience more pronounced PMS symptoms which may include sore breasts, tiredness and headache.

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Why choose ReallySick.sg for your emergency pill?

Our doctors at reallysick.sg are approachable and non-judgemental. We are sure to be discreet in the packaging of your medications. You will be able to track your delivery man so you can receive your medications before anybody else gets to it.

Since its efficacy is affected by time, we understand the urgency to deliver it right away. We aim to get it delivered within 2 hours from the point of consultation!

Yes – you shouldn’t be really waiting for the ‘morning-after’.

If you still have any question(s), drop us a message on whatsapp.

Reference: Emergency contraception review: evidence-based recommendations for clinicians – PMC (nih.gov)

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