Emergency Contraception (Morning After Pill)

Considering emergency contraception, aka the morning after pill?

If you’ve unprotected sex and are considering taking the morning after pill, here are a few things to consider before using this form of contraception.

How does it work?

Emergency contraceptives (EC) work primarily by preventing ovulation, fertilization, and the implantation of a fertilized egg in the uterus. It’s important to note that depending on when ovulation occurs, when the medication is taken, and when you had sex, it’s possible that EC’s will prevent the implantation of a fertilized egg (meaning sperm and egg have already met) in the uterus. Many people view this as an abortifacient effect, which is something to consider. Additionally, the longer after unprotected sex they’re taken, the less effective they are. Emergency contraceptives will not work to terminate a pregnancy if you are already pregnant.

Types of emergency contraceptives

  • Levonogestrel (Plan B One-Step®)

    - Utilizes synthetic progestin.
    - Must be taken within 72 hours of unprotected sex.
    - It is recommended to abstain from sex or use a barrier method for up to 7 days after using Plan B.
    - Should not be used in women weighing over 155 lbs.

  • Ulipristal acetate (ella®)

    - Can be taken within 5 days of unprotected sex.
    - Requires a prescription.
    - Ella® should not be taken twice in the same cycle.
    - It is recommended to use a barrier method of protection for up to 2 weeks after taking ella® as it can decrease the effectiveness of other forms of hormonal birth control.
    - Should not be used in women weighing over 195 lbs.

  • Copper IUD (Paraguard®)

    - Should be placed within 5 days of unprotected sex.
    - Needs to be inserted by a healthcare professional.

Side effects

  • Nausea
  • Vomiting
  • Headache
  • Irregular periods

A few considerations

If you take use an emergency contraceptive, it’s possible that your periods may be irregular in the days to weeks after you take the medication. You might miss a period during your next cycle, and if your next period does not come within 3 weeks it’s advised to take a pregnancy test. If you experience sharp, one-sided pain in the abdomen, you should seek medical care immediately. Some clinical trials have reported ectopic pregnancies in up to 10% of pregnancies in which progestin was used to prevent pregnancy.

It’s recommended not to take 2 different types of EC (i.e. Ella and Plan B) within 5 days of each other, as this may cause the pills to be less effective. EC’s are not meant to be used as a birth control.

Reviewed by Lynn Boyea, RN, BSN

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