Emergency Contraceptives 101: Your Options Explained

If you’ve ever found your­self in a sit­u­a­tion where con­tra­cep­tion failed or was for­got­ten, you’re not alone. Emer­gency con­tra­cep­tion is an option that can offer peace of mind and help pre­vent preg­nan­cy after unpro­tect­ed sex­u­al intercourse.

What is Emer­gency Contraception?

Emer­gency con­tra­cep­tion is a way to pre­vent preg­nan­cy after unpro­tect­ed sex­u­al inter­course or con­tra­cep­tive fail­ure. It con­tains a high­er con­cen­tra­tion of hor­mones than rou­tine birth con­trol pills. Because of its poten­cy and spe­cif­ic pur­pose, emer­gency con­tra­cep­tion is not meant to be a rou­tine form of birth con­trol but rather a back­up option for those who find them­selves at risk of an unin­tend­ed pregnancy.

How Does Emer­gency Con­tra­cep­tion Work?

The emer­gency con­tra­cep­tive pill, also known as the Morn­ing-After Pill, works by pre­vent­ing or delay­ing ovu­la­tion, which in turn stops preg­nan­cy from occur­ring. It’s impor­tant to note that emer­gency con­tra­cep­tion can­not affect an exist­ing preg­nan­cy or harm a devel­op­ing embryo.

When Should You Use Emer­gency Contraception?

Emer­gency con­tra­cep­tion should be used when no form of con­tra­cep­tive has been used, or if there is a con­cern of pos­si­ble fail­ure from con­tra­cep­tives, such as for­get­ting to take a birth con­trol pill or a con­dom break­ing. Emer­gency con­tra­cep­tion works best if tak­en as soon as pos­si­ble after unpro­tect­ed sex, but can still work to pre­vent preg­nan­cy if tak­en up to three to five days after intercourse.

Your Emer­gency Con­tra­cep­tion Options

Morn­ing-After Pills: Lev­onorgestrel vs. Ulipristal Acetate

Lev­onorgestrel (Plan B) and ulipristal acetate (ella) are two com­mon types of emer­gency con­tra­cep­tive pills. Both pills are sim­i­lar­ly effec­tive when tak­en with­in three days after unpro­tect­ed sex. How­ev­er, ulipristal acetate can be tak­en up to five days after intercourse. 

How Effec­tive Is Emer­gency Contraception?

Effi­ca­cy Based on Tim­ing and Method

The effec­tive­ness of emer­gency con­tra­cep­tive pills is depen­dent on how quick­ly they are tak­en after unpro­tect­ed sex, and where you are in your cycle. It’s rec­om­mend­ed to take emer­gency con­tra­cep­tion as soon as pos­si­ble after inter­course, as the effec­tive­ness of the pill decreas­es with each pass­ing day. 

Lev­onorgestrel works best when tak­en with­in 24 hours, reduc­ing the risk of preg­nan­cy by 95 – 97%. Its effec­tive­ness decreas­es over time, drop­ping to around 89% if tak­en with­in three days. If ovu­la­tion has already occurred, lev­onorgestrel may not be as effective.

Ulipristal acetate main­tains a high­er effec­tive­ness rate for a longer peri­od. It can reduce the risk of preg­nan­cy by up to 98% with­in the first few days after unpro­tect­ed sex. By day five, its effec­tive­ness drops to around 85%.

Oth­er Fac­tors That Can Impact Effectiveness

Weight may impact the effec­tive­ness of emer­gency con­tra­cep­tive pills. Lev­onorgestrel can be less effec­tive for those who weigh over 165 pounds, and ulipristal acetate can be less effec­tive for those who weigh over 195 pounds.

Some med­ica­tions, such as the antibi­ot­ic Rifampin, the anti­fun­gal Grise­o­ful­vin, cer­tain HIV med­ica­tions, and cer­tain anti-seizure drugs may also reduce the effec­tive­ness of emer­gency contraception.

Also read: Which Birth Con­trol is Best for Me?

Com­mon Side Effects of Emer­gency Con­tra­cep­tive Pills

Most peo­ple expe­ri­ence only mild side effects from emer­gency con­tra­cep­tive pills, such as:

• Light bleed­ing or spotting
• Changes in the men­stru­al cycle
• Fatigue and tiredness
• Headaches
• Dizzi­ness
• Breast ten­der­ness
• Abdomen pain or cramping
• Nau­sea and vomiting

If you expe­ri­ence more severe symp­toms or have any con­cerns, con­tact a Duly obstet­rics and gyne­col­o­gy provider.

Emer­gency Con­tra­cep­tion FAQ’s

What to Do if You Vom­it After Tak­ing the Pill?

Vom­it­ing with­in two hours of tak­ing an emer­gency con­tra­cep­tive pill may pre­vent it from work­ing. If you vom­it, con­tact your health­care provider, as you may need anoth­er dose. To reduce the chance of nau­sea, it’s sug­gest­ed to take the emer­gency con­tra­cep­tion pill after eating.

Can Emer­gency Con­tra­cep­tive Pills Delay Your Period?

It’s pos­si­ble for emer­gency con­tra­cep­tive pills to cause tem­po­rary changes to the men­stru­al cycle. Those who take the pill may find that their peri­od arrives three to four days ear­li­er or lat­er than their nor­mal cycle date. 

If your peri­od is five to sev­en days late, con­sid­er tak­ing a preg­nan­cy test. If it’s delayed for three weeks or more, a preg­nan­cy test is strong­ly rec­om­mend­ed. How­ev­er, keep in mind that preg­nan­cy tests can some­times pro­vide inac­cu­rate results. If a preg­nan­cy test is tak­en too ear­ly, it can show a false neg­a­tive result. 

If you expe­ri­ence any con­cern­ing irreg­u­lar­i­ties in your men­stru­al cycle after tak­ing the emer­gency con­tra­cep­tive pill, such as heavy or abnor­mal bleed­ing, or severe abdom­i­nal pain, con­tact your health­care provider.

Can Emer­gency Con­tra­cep­tion Work Dur­ing Ovulation?

While emer­gency con­tra­cep­tion tem­porar­i­ly delays ovu­la­tion, it will not pre­vent preg­nan­cy if you are cur­rent­ly ovu­lat­ing, as an egg has already been released by the ovary. 

How Often Can You Use Emer­gency Contraception?

It’s advised to take emer­gency con­tra­cep­tive pills no more than once per men­stru­al cycle. If you find your­self using emer­gency con­tra­cep­tion more than three times a year, it’s rec­om­mend­ed to con­sid­er start­ing a reg­u­lar con­tra­cep­tive method like the IUD, implant, or birth con­trol pills. 

Where to Get Emer­gency Contraception

Many emer­gency con­tra­cep­tive pills are avail­able over the counter at phar­ma­cies and drug­stores. How­ev­er, cer­tain types, like ulipristal acetate, require a pre­scrip­tion. Over the counter emer­gency con­tra­cep­tive pills, depend­ing on brand, typ­i­cal­ly cost between $10 and $50.

No one plans for the risk of an unin­tend­ed preg­nan­cy, but know­ing your options for emer­gency con­tra­cep­tion can help you make informed deci­sions if you find your­self in that sit­u­a­tion. If you have any ques­tions or need guid­ance, sched­ule an appoint­ment with a Duly Health and Care OBGYN.