Emergency contraception can be effective, but it’s important to know what’s available, how it works, and how soon after sex you need to take it.
Types
Though most people know them as the “morning-after” pill, this isn’t an accurate name since you can use emergency contraceptive pills for three to five days after condomless sex, depending on what you use. One type is available over-the-counter and another is only available with a prescription.
Over-the-Counter
Over-the-counter emergency contraceptive pills include:
Plan B One-Step Next Choice One Dose Take Action My Way
Plan B is the brand name and the others are generic forms of the same medication. Each consists of one pill that contains 1.5 milligrams of levonorgestrel, a synthetic version of the hormone progesterone that has been used in many types of birth control pills for years. Levonorgestrel needs to be taken within three days of having sex.
Prescription
The only emergency contraceptive pill that you need a prescription for is called Ella. This pill contains a substance called ulipristal acetate and you can take it up to five days after having sex.
Daily Birth Control Pills
If you’re already on a combination birth control pill (and depending on the pill you’re on), you have one more option: taking a certain number of your daily pills, usually four to five, in two doses within 12 hours of each other.
This method may not be as effective as Plan B or Ella, and it may also cause worse side effects. You should talk to your healthcare provider before using this option to make sure it’ll work with your prescription, as it doesn’t work with all birth control pills.
How They Work
Though it’s unclear exactly how emergency contraceptive pills work, evidence shows that they primarily prevent, or at least delay, ovulation so that there’s no egg released to be fertilized for several days.
They may also prevent sperm, which can live for up to five days in your body, from fertilizing an egg that has already been released. Lastly, there is some question if they may change the lining of your uterus so that even if an egg does get fertilized, it won’t be able to implant in your uterus. That possibility has made these pills a source of major controversy. However, there is evidence that shows this is highly unlikely.
That said, the jury is still out regarding whether or not emergency contraceptive pills, particularly Plan B, actually prevent implantation. Much of the research so far shows that Plan B and its generic equivalents don’t have any effect on your uterine lining at all, so they wouldn’t prevent a fertilized egg from implanting. In other words, they don’t cause an abortion.
Similarly, other studies have shown that while Plan B is very effective when it’s taken before ovulation, it’s virtually ineffective when it’s taken on the day you ovulate or after. This is further evidence that it probably doesn’t affect anything that happens after an egg is fertilized.
Effectiveness
With Plan B and other products containing the same drug, timing is key—the sooner after sex you take it, the better it works.
On the other hand, Ella maintains its efficacy at a steady rate and it’s approved for use up to five days after sex. It’s about as effective as Plan B for the first 72 hours, but once you pass the three-day mark, Ella is more effective.
Whether emergency contraceptive pills work for you depends in part on two factors.
The amount of time that has gone by since you had sex: The sooner you take the pill, the more likely it is to keep you from getting pregnant. The point in your cycle when you had sex: The closer you are to ovulation, the less effective the morning-after pill will be. If you’ve already ovulated, emergency contraceptive pills won’t help.
How to Use
If you find yourself in need of emergency contraception, choosing and using over-the-counter levonorgestrel is easy. Generic versions are just as safe and effective as Plan B but do check the expiration date before buying it.
You can take the pill at any time of day. Again, the sooner after you’ve had sex, the better. In fact, it may be a good idea to have a package of the morning-after pill on hand so you can use it as quickly as possible if the need arises, rather than take time to go to the store. To make sure it will be effective, store it at room temperature and if you don’t use it before it expires, toss it and replace it with a new one.
If it’s been close to three days since you had condomless sex or birth control failure, you may want to consider talking to your healthcare provider about getting a prescription for Ella or getting a copper IUD instead.
Do read the directions and package insert first, especially so you know how you may feel after taking this emergency contraceptive. Thousands of people have taken the morning-after pill with no serious complications, though there are some common minor side effects.
Potential Side Effects
You may experience some common side effects of emergency contraceptive pills such as:
Nausea or vomiting (you may be able to avoid this by taking an over-the-counter nausea drug an hour before you take the pill)Breast tendernessHeadachePain in the lower part of your abdomenFatigueDizzinessSpotting or irregular bleeding before your next periodChange in timing of your next periodAltered flow during your next period (heavier or lighter)
Risk of Ectopic Pregnancy
Some studies have reported an increased risk of ectopic pregnancy, in which a fertilized egg implants somewhere other than your uterus, in people with vaginas taking levonorgestrel. Ectopic pregnancy is a medical emergency.
However, not all researchers agree about the risk. A 2010 review of literature on the subject concluded that the risk of ectopic pregnancy was no greater with emergency contraception than in any other circumstance. Since then, though, ectopic pregnancies have continued to be reported. A 2018 safety profile study states that while a causal relationship between levonorgestrel and ectopic pregnancy isn’t established, the number of known cases suggests that there could be an association.
Symptoms of an ectopic pregnancy include:
Vaginal bleedingShoulder painAbdominal painWeaknessDizziness
If you develop any of these three to five weeks after using the morning-after pill, see your healthcare provider right away. This is a potentially life-threatening condition that requires immediate medical treatment.
How Long They Last
If an emergency contraceptive pill prevented you from getting pregnant, it has done its job. Remember that the pill won’t continue to prevent pregnancy after that one instance. After you use it, your fertility will return, so don’t take a chance and have condomless sex. And remember that emergency contraceptive pills don’t protect you from STIs.
You can use Plan B more than once during the same month, but you should only use Ella once per menstrual cycle; otherwise, its effectiveness can be decreased.
A Word From Verywell
Don’t treat emergency contraceptive pills as a regular form of birth control. For one thing, they’re not as reliable as other options. For another, your periods could become irregular and unpredictable and you may have more unpleasant side effects since you’re exposing yourself to higher hormone levels.
These pills can also end up being a lot more expensive than regular birth control. Talk to your healthcare provider about the best birth control option for you.
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