Levonorgestrel: Emergency Contraceptive Pill (Morning-After Pill)

Unplanned pregnancy can be a source of stress and worry for many women. In such cases, emergency contraception provides a safe and effective option to reduce the risk of pregnancy after unprotected sex, contraceptive failure (like condom breakage), or missed regular contraceptive pills.

One of the most widely used emergency contraceptive pills is Levonorgestrel. It is a second-generation synthetic progestogen that has been trusted worldwide for decades. Levonorgestrel works best when taken as soon as possible after unprotected intercourse, ideally within 72 hours.

In Nepal, it is easily available at community pharmacies and hospitals under brand names such as I-Pill, Econe, iFree, and Unwanted-72. Because of its accessibility and effectiveness, Levonorgestrel has become a go-to choice for women seeking quick protection against unintended pregnancy.

However, while it is highly effective for emergency use, it is not a substitute for regular contraceptive methods. Understanding how it works, its side effects, contraindications, and the risks of repeated use is essential for safe and informed decision-making.

Mechanism of Action (MOA)

Levonorgestrel is a synthetic progestogen. It prevents pregnancy mainly by:

Inhibiting or delaying ovulation – prevents the release of an egg from the ovary.
Thickening cervical mucus – makes it difficult for sperm to reach the egg.
Altering endometrial lining – reduces chances of implantation if fertilization occurs.

Note: It does not work if implantation has already occurred and is not an abortion pill.

How It Prevents Pregnancy

Most effective when taken as soon as possible within 72 hours of unprotected sex.
Effectiveness:
- Within 24 hours → ~95% effective
- 24–48 hours → ~85% effective
- 48–72 hours → ~58% effective

Side Effects

Common side effects include:

Nausea, vomiting
Headache, dizziness, fatigue
Irregular bleeding or spotting
Breast tenderness
Delay or early onset of next menstrual period

Contraindications (CI)

Levonorgestrel should be avoided or used with caution in:

Known pregnancy (not effective once pregnancy is established)
Unexplained vaginal bleeding
Severe liver disease
Allergy to levonorgestrel or pill components

Long-Term Use May Lead To

Levonorgestrel emergency pill is not recommended for regular contraception. Frequent or long-term use may cause:

Menstrual irregularities (delayed or irregular cycles)
Hormonal imbalance
Nausea, repeated vomiting
Reduced effectiveness compared to regular contraceptives
Anxiety or psychological dependence due to repeated use

For regular contraception, safer long-term methods (oral contraceptives, IUDs, injectables, implants) are recommended instead of repeated ECP use.

Brands Available in Nepal

UNWANTED
FEMINOR
CHOICE
E PILL
OKAY
ECON
I PILL

Final Note (Pharma Info Nepal)

Levonorgestrel is a safe and effective emergency contraceptive when used properly. It should only be used in emergencies, not as a routine contraceptive method. For long-term birth control, consult a healthcare provider for better options like oral contraceptives, implants, or IUDs.