Emergency contraception

What is emergency contraception? — Emergency contraception,also called “the morning after pill,” or “plan B.” It is a way you can keep from getting pregnant if you recently had sex. A woman might use emergency contraception if:

●She forgot to take her birth control pills

●A condom broke or slipped off during sex

●She had sex without using birth control

●She was raped


Are there different types of emergency contraception? — Yes. There are 2 types of emergency contraception. One type is pills. The other is a device that goes inside your body. It is called a copper intrauterine device. You might have heard it called an “IUD.” If you want an IUD, a nurse or doctor needs to put it in within 5 days of when you had sex. The IUD works as both emergency contraception and as ongoing birth control. It prevents pregnancy as long as it is in place.


If you weigh 165 pounds (75 kilograms) or more, you might want to consider a copper IUD instead of emergency contraception pills. That’s because the pills do not work as well in women who are overweight. If you decide you want an IUD, your doctor or nurse can tell you more about it. And if you are overweight but prefer pills over an IUD, ulipristal (described below) might be more effective than the other pill options.


Do I need to see a doctor or nurse to get emergency contraception pills? — That depends on the kind of pill you would like.  There are 3 types of emergency contraception pills. Two types contain hormones and a third option does not:

●One type, which contains the hormone levonorgestrel, is sold both with and without a prescription, depending on the brand. In the United States, one brand of levonorgestrel, called Plan B One-Step, is sold without a prescription to anyone, regardless of age. Other brand and generic versions of the medicine are also available, but the rules about prescription and age requirements are changing. Some of these are sold only with a prescription. Others don’t need a prescription but do have an age requirement. Plus, some versions of levonorgestrel have labels that say the drug is for use in women age 17 and older. No matter what it says on the label, women younger than 17 can safely and effectively use levonorgestrel for emergency contraception. Levonorgestrel is sold at many drug stores or at Planned Parenthood. If you want to buy it, call ahead to the drug store to make sure they have it.


●The other hormone pills that work for emergency contraception are really birth control pills, but you have to take more than one at a time to keep from getting pregnant. This approach works, but it is less effective and more likely to cause nausea than levonorgestrel. You will need to consult a physician for information about how many pills to take and how often. Birth control pills require a prescription.


●A third kind of emergency contraception pill is called ulipristal (brand names: ella, ellaOne). It is not a hormone and is available only by prescription.


When do I take emergency contraception? — Take the pills as soon as possible after you have sex. The pills can work up to 5 days after you have sex.


Hormonal emergency contraception works best if you take it within 3 days of having unprotected sex. It is less effective if you take it 3 to 5 days after unprotected sex. If it has been 3 or more days since you had unprotected sex, ulipristal might be a better option for you. It is more effective than hormonal emergency contraception from 3 to 5 days after unprotected sex. If you took ulipristal, and you normally use birth control pills, wait at least 5 days before starting your regular pills again. That’s because ulipristal can cause problems with the way birth control pills work. Even after you start taking your pills again, you should still use a condom every time you have sex until your next period.


If you have sex again after you take the pills, you can still get pregnant. Make sure you use a condom or another type of birth control if you have sex again after you took emergency contraception.


How well do emergency contraception pills work? — There are a lot of factors that affect how well the pills work, including not just how soon you take them, but also where you are in your cycle, and how much you weigh. If you weigh 165 pounds (75 kilograms) or more, the pills might not work well and you might want to get a copper IUD instead.


What if I throw up? — Emergency contraception pills make some women throw up. If you throw up less than an hour after you take the pills, you have to take them again. Before you take them again, take a medicine that helps keep you from throwing up called meclizine. You can get meclizine without a prescription. It is sold in drug stores under the brand names Antivert, Bonine, Dramamine, and Medi-Meclizine. If you find you throw up with birth control pills, try levonorgestrel instead. Levonorgestrel is less likely to make you throw up.


If you throw up within 3 hours of taking ulipristal, call your doctor or nurse. He or she can tell you if you should take another pill.


What happens after I take emergency contraception? — You should get your period within a week of when you expect it. If you took ulipristal, don’t be surprised if your period is a few days late. That’s normal. But if you do not get your period within 3 or 4 weeks, no matter which form of emergency contraception you took, get a pregnancy test. The pills might not have worked. If you keep bleeding or have pain in your belly, see your doctor or nurse.

Content adapted from UpToDate Patient Information.

© 2016 by Greenwood Ob-Gyn

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