Adverse effects, risk of sterility, delays in use ... Many rumors circulate about the morning after pill. We take stock of the true from the false.

Condom that cracks, unprotected or forced sex, forgotten pill ... Each year in France, about one in ten women under the age of 30 uses emergency contraception to avoid the risk of unwanted pregnancy. Many rumors circulate about the badly named “morning after pill”, as recently shown a study of Public Health France. Thus, one in two women questioned considers that she is dangerous or that she can make sterile. A phenomenon illustrated in a survey published on July 31 by the daily Liberation . Among these received ideas, we also find an exaggeration of side effects and poor knowledge of the time limits for use ... Le Figaro takes stock.

1. It's not an abortion

Unlike abortion drugs , which aim to terminate an ongoing pregnancy, emergency contraception aims to prevent fertilization of the egg by a sperm. In France, there are two types of morning-after pills: Norlévo and EllaOne. Over-the-counter in pharmacies, they are only reimbursed for adults if they have been prescribed by a health professional but are free for minors.

Each contains a hormone: the first is levonorgestrel; the second, EllaOne, has ulipristal acetate as the active substance. By blocking the growth of the ovarian follicle (an egg forming in the ovary), both are able to delay the time of ovulation. Thus, the sperm waiting in the tubes do not meet any egg to fertilize.

These pills are ineffective once the fertilized egg has implanted in the uterus and implantation has started: they can only work before pregnancy. As such, they are not therefore abortion drugs. On the other hand, EllaOne could decrease the chances of implantation of the egg in the uterus.

2. You can take the morning after pill up to three or five days after unprotected sex.

Contrary to what the name suggests, the “morning after pill” can be taken beyond 24 hours after unprotected sex. Depending on the type of pills, the timeframe is different: up to three days for Norlévo and five days for EllaOne. However, it is best to take it as soon as possible because it is all the more effective.

3. The morning after pill does not make you sterile

Like the “classic” pill, emergency contraception has no negative impact on fertility, nor does it increase the risk of spontaneous miscarriage or ectopic pregnancy in the future.

4. Taking it too often is not bad for your health.

Emergency contraception can be used as many times as needed to avoid an unwanted pregnancy without causing a problem. Side effects can happen, but they are rare, moderate and usually go away within 24 hours. It can be period disorders (early or late periods, small repeated bleeding, heavy periods), nausea (between 25% and 50% of women suffer from it), headaches (one in six), lower abdominal pain, fatigue or tension in the breasts.

In addition, emergency contraception does not increase the risk of venous thrombosis ( phlebitis , pulmonary embolism ), as is the case with estrogen-progestogen pills , in particular those of the third and fourth generations. This is because morning-after pills do not contain estrogen, a hormone that can alter certain parameters of blood clotting.

According to criteria established by the World Health Organization (WHO), "there is no situation in which the risks of using emergency contraception outweigh the benefits". Thus, women with a history of ectopic pregnancy, cardiovascular disease, migraines, liver disease or who are breastfeeding can take the morning after pill.

5. Morning-after pills are not 100% effective

Emergency contraception is never 100% effective, even if it is taken very soon after unprotected sex. Norvélo is 98% effective when taken within 12 hours of sex. For EllaOne, this rate is 85% when it is taken within 3 days. For both, efficiency decreases over time. Thus, it goes to 58% for Norvélo when the intake takes place between the second and the third day following the report, and to 61% for EllaOne between 2 and 5 days after.

Note that until the next period, it is important to use a condom because emergency contraception does not protect against the risk of pregnancy until the end of the cycle. If emergency contraception follows a missed pill, the pill should be continued until the end of the pack, but it may have reduced effectiveness. Again, it is therefore better to use condoms.

In view of the relative reliability of emergency contraception, it is recommended that a pregnancy test be taken three weeks after the date of unprotected intercourse. It should also be remembered that emergency contraception helps but does not replace regular contraception. And above all, it does not protect against sexually transmitted infections.

Another method of emergency contraception is copper intrauterine devices (IUDs) , which are 99% effective when inserted within 5 days of intercourse. Their installation requires a consultation with a gynecologist, a general practitioner or a midwife.