I-Pill vs Alternatives: What Works Best for Emergency Contraception?

When you need emergency contraception, time matters. The I-Pill is one of the most talked-about options in Australia, but it’s not the only one. Many people assume it’s the best or only choice, but that’s not true. Other methods exist - some are more effective, some last longer, and some don’t require a prescription at all. Knowing the differences can help you make a faster, smarter decision when every hour counts.

What is I-Pill (Levonorgestrel)?

I-Pill is a brand name for levonorgestrel, a synthetic hormone that prevents pregnancy after unprotected sex or contraceptive failure. It’s an emergency contraceptive pill (ECP), not an abortion pill. It works by delaying or stopping ovulation - the release of an egg from the ovary. If no egg is released, sperm can’t fertilize anything.

Levonorgestrel-based pills like I-Pill are most effective when taken within 24 hours of unprotected sex. Their effectiveness drops gradually after that. By 72 hours (3 days), they’re only about 58% effective. After 72 hours, they’re not recommended. The pill contains 1.5 mg of levonorgestrel, usually taken as a single dose.

It’s available over-the-counter in Australia at pharmacies without a prescription. You don’t need to prove your age or show ID. But it won’t work if you’re already pregnant, and it doesn’t protect against STIs.

How Effective Is I-Pill Compared to Other Options?

Effectiveness is the biggest factor when choosing emergency contraception. Here’s how levonorgestrel stacks up against other methods:

• I-Pill (levonorgestrel): 85-95% effective if taken within 24 hours. Drops to 58% by 72 hours.
• ellaOne (ulipristal acetate): 98% effective up to 120 hours (5 days) after sex. Works better than levonorgestrel even after 72 hours.
• Copper IUD: Over 99% effective if inserted within 5 days. Also works as long-term birth control.

That copper IUD is the most effective option available. It’s over 20 times more effective than I-Pill if taken after 72 hours. And unlike pills, it doesn’t lose effectiveness over time. Once inserted, it can prevent pregnancy for up to 10 years.

ellaOne: The 5-Day Alternative

ellaOne is the other main emergency contraceptive pill available in Australia. Its active ingredient is ulipristal acetate, which works differently than levonorgestrel. Instead of just delaying ovulation, it temporarily blocks the effects of progesterone - a hormone needed for pregnancy to develop.

This means ellaOne stays effective for up to 5 days after unprotected sex. If you had sex on Friday night and didn’t realize you needed emergency contraception until Tuesday morning, ellaOne is still a valid option. I-Pill wouldn’t be.

Studies show ellaOne reduces the risk of pregnancy by 85% even when taken between 72 and 120 hours after sex. Levonorgestrel drops to under 10% effectiveness in that window.

ellaOne requires a prescription in Australia, so you’ll need to see a doctor or visit a sexual health clinic. It’s more expensive than I-Pill - around $40-$60 with a script - but it’s worth it if you’re outside the 72-hour window.

Copper IUD: The Long-Term Solution

If you’re looking for the most reliable emergency contraception, the copper IUD is the gold standard. It’s inserted by a doctor or nurse into the uterus within 5 days of unprotected sex. Once in place, it releases copper ions that make the environment toxic to sperm and eggs.

Its effectiveness is over 99%. That means fewer than 1 in 100 people who use it as emergency contraception end up pregnant. It’s also the only method that works equally well on day 1 or day 5.

And here’s the bonus: once inserted, the copper IUD becomes your regular birth control for up to 10 years. If you’re not planning to get pregnant soon, it’s a one-time procedure that saves you from needing emergency pills again.

The downside? You need to book an appointment. Not all clinics offer same-day insertions. If you’re in a rural area, travel time might delay insertion past the 5-day window. But if you can get it done in time, it’s the safest, most effective choice.

Other Options: Are They Worth It?

Some people ask about natural remedies - like high-dose vitamin C, parsley tea, or douching. None of these work. There’s zero scientific evidence that any herbal remedy prevents pregnancy after sex. Relying on them can be dangerous.

There’s also the “double-dose” myth: taking two I-Pills instead of one. That doesn’t increase effectiveness. It only raises your chance of nausea, vomiting, and irregular bleeding. Stick to the recommended dose.

Another option sometimes mentioned is the Yuzpe method - using regular birth control pills as emergency contraception. It’s outdated, less effective, and causes more side effects than modern options. It’s no longer recommended by health authorities in Australia.

Side Effects: What to Expect

All emergency contraception can cause side effects, but they’re usually mild and short-lived.

I-Pill (levonorgestrel): Nausea (in about 20% of users), headache, dizziness, breast tenderness, and irregular bleeding. About 1 in 5 people get their period earlier or later than expected.

ellaOne: Similar side effects, but slightly higher rates of nausea (around 25%). Some people report fatigue or abdominal pain.

Copper IUD: Cramping during insertion, heavier or more painful periods for the first few months, and a small risk of infection or expulsion. But most people adjust within 3-6 months.

If you vomit within 2 hours of taking a pill, you may need to take another dose. Call your pharmacist or doctor right away if this happens.

Which One Should You Choose?

Your best option depends on timing, access, and future needs.

• If it’s been less than 24 hours: I-Pill is fast, cheap, and easy to get. It works.
• If it’s between 24 and 72 hours: Still use I-Pill, but consider ellaOne if you can get a prescription quickly.
• If it’s been 72-120 hours: ellaOne is your only pill option. But the copper IUD is still the best choice.
• If you want long-term birth control: Go straight for the copper IUD. It’s more expensive upfront, but saves money and stress over time.

Don’t wait until the last minute. If you’re sexually active and not using regular contraception, keep an emergency option on hand. Many clinics in Perth and other cities offer free or low-cost emergency contraception. Some pharmacies now keep ellaOne in stock with a pharmacist consultation.

What Happens After Taking It?

Your next period should come within 3 weeks. If it’s more than a week late, take a pregnancy test. Emergency contraception can delay ovulation, so your cycle might shift. But if you’re pregnant despite using it, the pill didn’t work - and that’s rare.

Don’t use emergency contraception as regular birth control. It’s not designed for frequent use. Repeated use can mess with your cycle and doesn’t offer the same protection as daily pills, patches, or IUDs.

If you find yourself needing emergency contraception often, talk to a doctor about long-term options. There are better, more reliable methods available.

If you’re unsure which option is right for you, don’t guess. Call a sexual health clinic or your local pharmacy. They can help you choose based on your timeline, health, and needs. Emergency contraception is a tool - not a last resort. Use it wisely, and plan ahead when you can.