How long after starting Alesse (levonorgestrel) is it effective in preventing pregnancy?

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Last updated: November 12, 2025View editorial policy

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When Alesse (Levonorgestrel) Becomes Effective for Pregnancy Prevention

Alesse requires 7 consecutive days of consistent use before it becomes effective at preventing pregnancy if started more than 5 days after the start of menses. 1

Timing Based on When You Start

Starting Within 5 Days of Menses

  • No backup contraception needed if Alesse is initiated within the first 5 days after menstrual bleeding begins 1
  • The pill is immediately effective in this scenario 1

Starting More Than 5 Days After Menses

  • Backup contraception is required for 7 consecutive days if starting beyond day 5 of the menstrual cycle 1
  • Use barrier methods (condoms) or abstain from intercourse during this 7-day period 1
  • After 7 days of consistent pill use, full contraceptive protection is established 1

Critical Implementation Points

The 7-day rule applies to continuous, correct use - missing pills during this initial period resets the timeline and requires restarting the 7-day backup period 1

Common Pitfall to Avoid

  • Do not assume immediate protection when starting Alesse at any random point in your cycle 1
  • The most common error is having unprotected intercourse during the first week when starting mid-cycle, which carries significant pregnancy risk 1

If Unprotected Intercourse Occurs During the First 7 Days

  • Emergency contraception should be considered, especially if intercourse occurred in the previous 5 days 1
  • Levonorgestrel emergency contraception (Plan B) can be taken up to 120 hours after unprotected intercourse, though effectiveness decreases over time 1, 2, 3

Switching From Another Method

When switching to Alesse from another contraceptive method, 7 days of backup contraception is needed only if more than 5 days have passed since starting menses 1

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Emergency Contraception with Plan B

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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