Just the Facts: Emergency Contraception

Health & Wellness Reproductive Health

As many states heavily restrict or ban abortions, understanding family planning options and reproductive health is critical. One option is emergency contraception.

Emergency contraception is not intended to replace routine birth control, but is safe and effective when needed. There is a whole lotta misinformation out there so let’s take a step back and answer some questions about emergency contraception.

➡What is emergency contraception?

Emergency contraception is a safe and effective way to prevent pregnancy for up to 5 days after unprotected sex. No one should feel judged or shamed when needing or choosing to use emergency contraception.

➡What types of emergency contraception are available?

There are 2 main types of emergency contraception, pills and intrauterine devices (IUDs).

Let’s start with the pills. There are 2 commonly used pills for emergency contraception: levonorgestrel (Plan B) and ulipristal acetate (Ella).

Levonorgestrel is also called Plan B or the morning after pill. Other brand names are Take Action, Option 2, Preventeza, AfterPill, Aftera, and Econtra. It works best if taken within 3 days of unprotected intercourse but can be taken up to 5 days out. It is about 75-89% effective. The best part of this option: you don’t need a prescription. It may be on store shelves, but some pharmacies keep it in locked display boxes or behind the counter. If you can’t find it, you may have to ask the pharmacist for it. It usually costs between $11 and $50. Some brands are cheaper, and they all work the same, so choose whichever is available and cheapest! Helpful tip: Insurance may cover the cost if your healthcare provider writes a prescription for you.

Ulipristal acetate, or Ella, is more effective than Plan B. The downside: it requires a prescription from a medical provider. Ella reduces the risk of pregnancy by 85% if taken within 5 days of unprotected sex and works better the sooner you take it. Other hormonal contraceptives should not be started within 5 days of taking Ella. Exposure to progestins within those 5 days can decrease Ella’s ability to block ovulation and prevent pregnancy. If you were previously taking birth control and needed Ella or are planning on starting a new birth control method, talk with your healthcare professional about timing to start. Ella usually costs about $50 but may be free or lower cost depending on insurance.

IUDs are the most effective form of emergency contraception. IUDs are inserted by a medical provider within 5 days of intercourse to prevent pregnancy. Both copper and hormone containing IUDs can be used. IUDs lower the risk of pregnancy by more than 99.9% when used as emergency contraception. IUDs also provide very good long-term birth control, lasting between 3 to 12 years depending on which kind someone gets. Hormone containing IUDs have the added benefit of improving heavy menstrual bleeding and cramping and can be used to treat endometriosis-related pelvic pain.

➡Are some forms of emergency contraception better for people who weigh more?

Levonorgestrel is less effective in people who weigh over 165 pounds. Ulipristal is more effective than Plan B for people who weigh more than 165 pounds but the efficacy is reduced in people who weigh more than 195 pounds. IUDs are the most effective regardless of weight.

➡What are the side effects?

The IUDs are usually well tolerated, but there is pain and cramping with the insertion. Medication can be given prior to insertion to reduce discomfort. Very rarely, a hole can be poked in the uterus when the IUD is placed. Side effects of IUDs are usually mild and typically improve in about 6 months but can include cramping and bleeding.

Ulipristal and levonorgestrel are very well tolerated and side effects are typically mild. Ulipristal can cause headache, belly pain, nausea, cramping, fatigue, and dizziness. Levonorgestrel side effects are similar and can also include menstrual changes and breast pain.

➡How does emergency contraception work?

Emergency contraception pills delay or prevent ovulation. This prevents the egg from being released and meeting up with active sperm. IUDs prevent fertilization, so even if an egg is released, it can’t team up with sperm.

➡Is emergency contraception the same as abortion?

No. Emergency contraception prevents pregnancy from happening in the first place. Medication abortions are used to end a pregnancy that already occurred. Currently in the US, emergency contraception is legal in places that have banned abortion.

➡Does emergency contraception protect me from STDs?

Nope. Emergency contraception protects against pregnancy, but not sexually transmitted infections. For someone who is sexually active, condoms are the best bet for preventing infections.

➡Is there an age limit for emergency contraception?

No. There are no medically indicated age restrictions for pills or IUDs. Some states have laws that require parental consent before IUD placement for minors.

➡Can I get a prescription for emergency contraception pills before I need it?

Yes! Absolutely! In fact, many healthcare providers will write prescriptions as a precaution and to reduce barriers to access.

Tl;DR: Emergency contraception is safe and effective, but needs to be taken within 5 days of unprotected sex. There are several different types and your medical provider can help steer you to which may be right for you.

Stay safe. Stay well. Stay protected.

Those Nerdy Girls


Planned Parenthood “Emergency Contraception”

NPR “Emergency Contraception: How it works, how effective it is, and how to get it.”

World Health Organization “Emergency Contraception”

Office of Women’s Health “Emergency Contraception”

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