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Levonorgestrel vs ulipristal vs copper IUD

Timing, current contraception, medicines and preference all matter when comparing emergency options.

2026-07-20·3 min read
Levonorgestrel vs ulipristal vs copper IUD — article cover image

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The “morning-after pill” is not one universal product. In Europe, oral emergency contraception may contain levonorgestrel or ulipristal acetate, while a copper IUD offers a non-oral option. The best choice depends on more than convenience.

Levonorgestrel

Levonorgestrel is generally taken as soon as possible within 72 hours. Regular hormonal contraception can usually be started or resumed immediately after it, with additional barrier precautions as instructed. Medicines that increase liver-enzyme activity may reduce exposure, so epilepsy, tuberculosis, HIV and herbal treatments such as St John’s wort must be mentioned.

Ulipristal acetate

Ulipristal can be used up to 120 hours after unprotected sex and remains an important oral option later in that window. Because progestogen-containing contraception can interfere with its effect, restarting hormonal contraception requires specific timing and barrier advice. Vomiting soon after a dose can also change what to do.

Copper IUD

The copper IUD is the most effective emergency method and continues to provide contraception. Insertion is a clinical procedure, and suitability depends on medical and sexual-health history. Some people prefer to avoid a device or cannot access insertion quickly; others value its effectiveness and ongoing protection.

When to seek help

Emergency contraception is time-sensitive. Seek a pharmacy, sexual-health service or clinician as soon as possible rather than waiting for symptoms. Urgent in-person care is needed for severe one-sided or lower abdominal pain, collapse, very heavy bleeding or a severe allergic reaction. Emergency contraception does not treat an established pregnancy and does not protect against sexually transmitted infections.

What to prepare for a medical review

Be ready to share when each episode of unprotected sex happened, the first day of the last period, usual cycle length, the contraception that failed, current medicines and supplements, breastfeeding, and whether a period was already late. These details help a professional compare oral options with a copper IUD and explain when regular contraception can be restarted.

A calm next step

Do not choose from a comparison table alone. A pharmacist or clinician can combine timing, current contraception, medicines, cycle information and your preferences into one practical recommendation.

Clinical sources used: World Health Organization emergency-contraception fact sheet and European Medicines Agency product information for ulipristal acetate.

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