Emergency contraception facts vs. fiction

Although it goes by many names—from “the morning-after pill” to Plan B—emergency contraception does one very important thing: helps prevent a pregnancy from occurring, following unprotected penis-in-vagina sex or after a birth control method fails (for example, if a condom breaks). There’s no need to wait until an “emergency” to get the facts about emergency contraception. Here’s what you need to know about this safe, effective reproductive health option. 

TRUE: There are different types of emergency contraception

There are two common types of emergency contraceptive pills, levonorgestrel, or Plan B, and ulipristal acetate, also known as Ella.

Ella vs. Plan B

Some differences between these two medications include:

• When it works: Ella can be taken up to 5 days, or 120 hours, after unprotected intercourse. Plan B should be taken a bit sooner, within 3 days, or 72 hours. For both options, it’s most effective to take the pill as soon as possible.
• Effectiveness: Ella is 95% effective when used as directed, Plan B is close behind, about 89% effective with proper intended use.
• Weight Considerations: Some studies show a higher rate of unintended pregnancy in people with a higher BMI. Plan B is most effective in people weighing 165 pounds or less and Ella works best in those weighing less than 195 pounds. That being said, emergency contraceptive pills do not have a weight restriction, may still help to prevent pregnancy, and are safe no matter your BMI.
• Prescribing: While Plan B is available over -the -counter, Ella requires a prescription. Consider asking your health care provider for a “standing order” at your pharmacy or use an online service, like Hey Jane, to get a prescription fast.
• Resuming oral contraceptives: If you intend to start or restart a daily oral birth control pill after taking an emergency contraceptive, plan to wait at least 5 days after taking Ella, because the ingredients in oral birth control may make Ella less effective. If you take Plan B, you can take birth control pills as soon as the next day. 

Using IUDs as emergency contraception

The most effective form of emergency contraception is also a long-term birth control method! When used within 5 days of unprotected intercourse, a copper-containing IUD, like the ParaGard, is 99% effective in preventing an undesired pregnancy. It also protects against future pregnancies for up to 12 years. While the copper IUD has been shown to be most effective, recent studies suggest hormonal IUDs might also be used as emergency contraception. Because inserting an IUD requires an in-office visit, we recommend that you talk to your health care provider about which option is best for you.

FALSE: The “morning-after pill” has to be taken the morning after having sex

Emergency contraception is effective 72 to 120 hours after intercourse, depending on the method used. For some brands, it’s more effective the sooner you take it; we recommend talking to your prescriber or reading through the instructions that came with your emergency contraception to get a better idea of the timeline.

TRUE: You can use multiple birth control pills as emergency contraception

Some daily oral birth control pills can be used as emergency contraception by taking 2-5 tablets at once. Because the dosage varies widely depending on your birth control, contact your prescriber about the best dosage for you.

While this option can be helpful for people in a pinch who can’t access other emergency contraception methods quickly, it does mean that you’ll be short on the number of birth control pills you have available for the rest of the month. If that’s the case for you, using a backup method like condoms might be a good idea.

FALSE: You can only use Plan B a limited number of times

Have you ever heard the rumor that you can only take Plan B 3 times in your life without long term reproductive or hormonal consequences? Totally a myth! Plan B is safe to take as many times as needed. 

Taking emergency contraceptives multiple times a month won’t cause long-term side effects or impact how effective it is, but if you find you need it regularly, a different kind of birth control, like a daily oral contraceptive pill or an IUD, might be a more effective and convenient option for you. Frequent use of Plan B can also cause mid-cycle vaginal spotting or change the regularity of your period, making it a bit more difficult to track your menstrual cycle.

IT DEPENDS: Emergency contraception is expensive

Plan B can cost anywhere between $10 to $50 over the counter and varies based on whether or not you opt for a generic or name-brand option. Your insurance may also help cover the cost of both Plan B or Ella, but a prescription from a health care provider is likely required. Hey Jane offers prescriptions for both brands to help lower the cost for you—click here to get started.

TRUE: Plan B isn’t as effective if you weigh over 165 pounds

While emergency contraceptive pills do not have a weight restriction, Plan B is most effective for people weighing 165 pounds or less. Additionally, Ella works best in those weighing less than 195 pounds. An IUD is a good option for those with a higher weight or BMI who are looking to prevent pregnancy after unprotected sex and long term. If you’re not interested in an IUD but still want to prevent pregnancy, it’s absolutely safe to take an emergency contraceptive pill, no matter your weight.

FALSE: Emergency contraception pills cause infertility

The science is clear: emergency contraception does not impact future fertility. Studies have shown that despite misconceptions, there are no long term side effects of using emergency contraception pills to prevent pregnancy. Emergency contraception does not increase the likelihood of miscarriage in the future, nor does it increase the risk for fetal abnormalities in future pregnancies. There is no evidence that emergency contraception permanently disrupts menstruation, either. 

FALSE: Plan B and Plan C are the same medication

Plan B is a specific brand of emergency contraception that’s available over-the-counter, but the name is often used to describe the entire category of medications  used to prevent pregnancy after sex. 

Plan C refers to abortion pills, used in medication abortions, that can be taken in person at a clinic or at home to safely and effectively end a pregnancy. 

FALSE: Emergency contraception is for emergencies, and you can’t buy it whenever you want to

Emergency contraception is safe, can be used any time you’ve had unprotected sex, and can be purchased in advance. There are no long-term side effects or impact on your fertility when you use emergency contraception so if you’re trying to prevent pregnancy, you can feel confident that it doesn’t have to feel like an “emergency” to take Plan B. 

What can make the experience feel like an emergency is locating the medication within the effective time frame, as not all pharmacies keep reliable stock of Plan B or Ella. To avoid the stress, you can get emergency contraception in advance and save it for a day when you need it! Plan B expires after 4 years and Ella expires after 3 years, meaning you can buy them in advance, tuck them away, and have them on hand for when you, a friend, or a loved one needs it.