PLAN B AND BEYOND: YOUR EMERGENCY CONTRACEPTION OPTIONS
PLAN B AND BEYOND: YOUR EMERGENCY CONTRACEPTION OPTIONS
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You've probably heard of Plan B and other morning-after type pills. For most people, Plan B is the easiest form of emergency contraception to get, but many don't know that it's not the only option.
In this article, we're gonna talk you through the details, but if you're in a rush (it's called "emergency contraception" after all), check out this handy chart and our FAQs:
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FAQs for Plan B and Beyond:
Q: Do Plan B or emergency contraceptive (EC) pills cause abortion?
A: No. Abortion pills are not the same medications as EC pills, and EC pills will not end an existing pregnancy.
Q: Do I need to use EC if I have unprotected sex on my period?
A: It is unlikely for pregnancy to occur if you have unprotected sex during the first 5 days of your period, but you can choose to use EC if you wish.
Q: Is name brand Plan B more effective than other brands?
A: No. All 1.5mg Levonorgestrel pills work the same way. Using other brands like Julie, EContra, OneStep, etc are all equally effective.
Q: Should I take Plan B if I weigh over 165 lbs?
A: Plan B and other levonorgestrel pills are unlikely to work for people weighing over 165 lbs.
Q: Can I take a double dose of Plan B if I weigh over 165 lbs?
A: Current research does not recommend double dosing Plan B. Not because it is harmful, but because it looks like double dosing doesn't work better than a single dose. (NIH article)
Q: Can I get an IUD if I've never been pregnant or given birth?
A: Yes. Whether or not you've been pregnant before doesn't change your eligibility to get an IUD.
Plan B and Beyond: A Look at Emergency Contraceptives
Emergency contraception (EC) refers to medical treatment taken after unprotected sex to prevent pregnancy. Emergency contraceptives do not cause abortion. Plan B and other EC pills are NOT the same as abortion pills and will not work to end a pregnancy.
There are two different types of pills + two types of IUD (intrauterine device) that can be used as emergency contraception to prevent pregnancy.
Emergency contraception (EC) like Plan B is an option because neither fertilization nor pregnancy occur immediately after unprotected sex*.
(*By “unprotected sex”, we mean sex that could result in pregnancy, i.e., penis-in-vagina sex + you aren’t using another contraceptive, a condom breaks, you forgot to take your birth control pills, etc.)
In fact, it typically takes several days for egg and sperm to meet. Sources that say that emergency contraceptives cause abortion are spreading misinformation and disinformation.
Sperm can live in the reproductive tract, swimming around looking for an egg, for up to 5 days (or even up to 7 days according to some studies). The idea with all forms of emergency contraception is to make a change to the reproductive system so you can avoid sperm meeting the egg.
IUDs FOR EMERGENCY CONTRACEPTION
The copper IUD (brand name Paragard) and two hormonal IUDs (brand names Mirena and Liletta) can be inserted any time up to 5 days after unprotected sex to prevent pregnancy at a rate of over 99%.
IUD insertions require an appointment at a medical office. You can often quickly get an appointment at your local Planned Parenthood and other reproductive health clinics. It’s a good idea to let them know that it is for emergency contraception when you make the appointment so they understand the urgency.
WHAT'S AN IUD?
IUDs are small T-shaped devices made of flexible, medical grade plastic that contain either copper or a locally acting hormone called “progestin”. They are inserted into the uterus by a medical provider during a pelvic exam using a speculum and other tools.
IUDs are expensive without insurance, but funding may be available at some providers to help offset the cost for uninsured patients.
HOW DO I GET ONE?
The medical provider will place the IUD into the uterus through the natural opening in the cervix (the cervix is the base of the uterus). There is no surgery or cutting, and the procedure takes 5-10 minutes.
Some people find it easy and pretty painless to get an IUD. Other people find the process uncomfortable or outright painful. You can talk to your provider about pain management.
Taking ibuprofen before an IUD insertion has not been found to substantially reduce pain during the procedure, but it might be worth a try anyway. Some providers offer nitrous (aka laughing gas, like you might have at the dentist) for pain management.
HOW DOES IT WORK?
IUDs work through a combination of actions. They may: 1) immobilize sperm through chemical means (copper IUD), 2) thicken cervical mucus to prevent sperm from swimming, 3) create a low-level inflammatory response in the uterus and the resulting increase in white blood cells attack sperm, and 4) alter mechanisms in the egg that prevent fertilization.
If you want, you can continue to use the IUD you choose as birth control for many years. If you decide you no longer want your IUD, you can have it removed at any time. Your ability to get pregnant will return immediately after removal, so keep that in mind!
EMERGENCY CONTRACEPTIVE PILLS
Both types of emergency contraceptive pills (the UPA pill, aka Ella and progestin pills, aka Plan B and others) work by delaying ovulation long enough for sperm to die off before an egg is released. No egg for sperm to find = no pregnancy. Both types of pills achieve the same goal, but are different medications that work differently in the body.
Because you are delaying ovulation, it is very common for your period to come late after taking emergency contraceptive pills. You can take a pregnancy test around 3 weeks after unprotected sex and get reasonably accurate results.
ELLA (ULIPRISTAL ACETATE) PILL
Ella (UPA pill) is a prescription-only medication, so you have to have a medical appointment to get it.
Because it is prescription only, health insurance generally covers the costs. If your health insurance covers birth control, it should also cover Ella.
HOW TO GET ELLA
You can get this prescription from an online provider and pick it up at a local pharmacy. Sometimes your prescriber will even write you refills for your prescription (ask them if they can), so you can just pick it up from the pharmacy if you need it again in the future. Try Planned Parenthood, PRJKT RUBY, Nurx, or other online docs.
Ella can be taken from 0-5 days after unprotected sex and is about 85% effective for people who weigh up to 195 lbs. If you weigh over 195 lbs, it may still work, but it's not as reliable.
Talk to your medical provider if you take birth control pills as it may effect what type of emergency contraceptive will work best for you. If you're breast feeding, you may also need to pump and dump for 24 hours if you use Ella.
PROGESTIN MORNING AFTER PILL (PLAN B and others)
The progestin EC pill (Plan B, Julie, others) is an over-the-counter medication. It may range in price from $10-$60 depending on the brand and where you purchase it. Cheaper options are usually available at health departments, Planned Parenthood, Wal-Mart and Costco.
Progestin pill/Plan B is 60-90% effective. The sooner you take it after unprotected sex, the more likely it is to work. Taking it more than 3 days after unprotected sex is not likely to work.
If you weigh over 165 lbs, Plan B and other progestin pills are not likely to work for you. A majority American women weigh over 165, so that really sucks. If you weigh over 165 lbs, it is a good idea to explore other options for emergency contraception.
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If no other options are available, birth control pills can be used as emergency contraception.
Birth control pills contain progestin, the same hormone in Plan B that can delay ovulation. Different birth control pills contain different amounts of this hormone, so taking the correct number of pills is important. Use the chart below to find your pill.
If you decide to use birth control pills for EC, you will need to take two doses 12 hours apart for it to be effective.
Nausea and vomiting are common with this method because of the included estrogen. If possible, it is a good idea to take an anti-nausea medication before you take the pills. If you throw up very soon after taking the pills, it probably won't work.
Because this method works the same way as Plan B, if you weigh over 165 lbs, it is not likely to work for you.
Image from https://www.plannedparenthood.org/files/5713/9611/6188/Emergency_Contraception_History_and_Access.pdf