Emergency Contraception

 

 

What is emergency contraception?

Emergency contraception (EC) is a backup method of birth control for preventing pregnancy after unprotected sex. Even though it is commonly called the "morning-after pill' it can actually be used within 5 days (120 hours) of unprotected intercourse. Most EC works better the sooner you take it.

• Some types of EC (Plan B One-Step™and Next Choice®) are available over-the-counter (without a prescription), for young women age 17 and over.
• Girls who are 16 and under can get emergency contraception with a prescription from their health care provider.
• A new brand of EC called, Ella™ (Ulipristal acetate) requires a prescription from a health care provider.

When should a women use emergency contraception?

Emergency contraception (EC) should be used if:

• You had unprotected sex, which means your partner did not use a condom and you are not using a hormonal method of birth control.
• You forget to take your birth control pills (and you've been having sex).
• Your partner's condom broke or slipped off while you were having sex.
• You were forced to have unprotected intercourse (rape).

How does emergency contraception work?

The medications work by giving a strong short burst of hormones that changes the cycle and prevents ovulation.

 

It is important to remember that EC doesn't continue to protect against pregnancy during the rest of the menstrual cycle. You should use a barrier method, such as a condom until your next period.

 

Does emergency contraception (EC) cause an abortion?

Emergency contraception (EC) does not work if a woman is already pregnant. EC will NOT cause an abortion.

 

How is emergency contraception taken?

There are three types of emergency contraception that use hormone pills:

1. The first "morning-after" type pill made specifically for emergency contraception that was approved in the United States is called Plan B One-Step™ or Next Choice®. It contains only one kind of hormone, a progestin, and it comes as 1 or 2 pills. A woman can take the total dose of 1.5 mg levonorgestrel in Plan B One-Step™ as one pill, or use Next Choice® and take both pills (.75 mg in each tablet) at the same time or take one tablet followed by the second pill twelve hours later. The medication is taken within 120 hours (5 days) of unprotected sex, but the sooner it is taken the more effective it is. No prescription is needed for girls 17 and older.
2. Ella™ (urlipristal acetate or UPA) is a new emergency contraceptive that works by stopping or delaying ovulation. It is one pill (one dose) that can be taken up to 5 days or 120 hours after unprotected intercourse. A prescription is needed.
3. Another type of emergency contraception uses regular birth control pills, which contain two hormones, estrogen and progestin. There are 2 doses. The first dose may be 2, 4, or 5 pills depending on the brand of birth control pills used, and is taken within 120 hours (5 days) of unprotected sex. The second dose is taken 12 hours after the first dose. A health care provider must prescribe how many pills should be taken for this kind of emergency contraception. This method is more likely to cause nausea.

How effective is emergency contraception?

It is important to remember that emergency contraception does not always work. It does not guarantee that pregnancy will be prevented. Emergency contraception lowers your risk of pregnancy by 75-88%. The risk of getting pregnant depends on when in your menstrual cycle you had sex and what kind of birth control you use. You are more likely to get pregnant around the time when the ovary releases an egg (ovulation).

 

On August 13, 2010, the U.S. Food and Drug Administration (FDA) approved a new emergency contraception pill, Ulipristal Acetate (Ella™). It became available to women in the United States on Dec. 1, 2010; however it has been used in parts of Europe since 2009. Because this is a new medication, it requires a prescription from a health care provider.

 

The biggest differences between Ella™ also called UPA (short for Ulipristal Acetate) and other emergency contraception methods are:

• Ella™ is equally effective for 5 full days after unprotected intercourse unlike the other EC methods that are less effective after the first 48-72 hours following unprotected intercourse.
• EllaT is likely to be covered by your insurance plan because to get it requires a prescription.

The best way to prevent pregnancy is to use a regular birth control method such as condoms or birth control pills, or to not have sexual intercourse.

Is emergency contraception (EC) safe?

Yes. Millions of women have used emergency contraception (EC) without any problems.

 

Does emergency contraception (EC) cause birth defects?

Emergency contraception does not cause birth defects or affect the health of future children that a woman may have.

 

Does emergency contraception (EC) have any side effects?

EC is tolerated well and side effects are usually absent or mild. A few percent of women may have nausea, dizziness; headache and/or stomach pain with Plan B One Step™, Next Choice® or Ella™. Some women may complain of moderate side effects if regular birth control pills are used (for EC) which can include: nausea, vomiting, and breast soreness. Side effects from emergency contraception (when using regular birth control pills) most often go away after 1-2 days. There are over-the-counter medicines you can get (Dramamine II or Bonine) for nausea.

 

Where can I get emergency contraception?

In the United States women 17 and older can get (progestin-only) EC at pharmacies without a prescription. For teens under the age of 17, EC may require a prescription depending upon the state; some states have a special program that allows trained pharmacists to give out EC. You may need to check many different pharmacies because EC is not available in all pharmacies. Ella™ or Ulipristal Acetate requires a prescription.

 

Use the EC website to find a doctor or pharmacy if you have any questions about emergency contraception.

 

Be ready to answer the following questions:

• When was the first day of your last menstrual period?
• When was the exact date and time of unprotected sex?
• What types of birth control have you have used in the past?

Can I use emergency contraception as my regular form of birth control?

Emergency contraception is not meant to be a regular method of birth control. It is meant to be a one-time emergency treatment. Emergency contraception can be used when a condom breaks, when a diaphragm or cervical cap gets moved, if a woman is raped, or any time when there is unprotected sex. You should not use emergency contraception as your only protection against pregnancy, because this method doesn't work as well as other types of birth control. Also, emergency contraception does not protect against STDs.

 

When can I expect my next menstrual period after I have taken emergency contraception?

Your period should start within 7 to 9 days after taking EC. Your next period may start a little early or a few days later than when you usually get it.

 

What if I have problems after I have taken emergency contraception (EC)?

If you have any problems after you take emergency contraception, you can contact your health care provider.

 

You should definitely call your health care provider if:

• You do not get your period within 2 weeks after taking EC
• You have very bad abdominal (belly) pain
• You are spotting (small amount of blood on your underwear in between your menstrual periods)
• Your next menstrual period is very light
• You are dizzy

Do I need to do anything else to prevent pregnancy after I have taken emergency contraception?

Yes. You should talk to your health care provider about using a regular type of birth control method. Until you have your next menstrual period, it is best not to have sexual intercourse. If you decide to have intercourse, make sure to use a barrier method, such as a condom, every time you have sex even if you are taking birth control pills. Your health care provider may suggest that you start birth control pills right away after emergency contraception. Find out more about birth control methods so you can start thinking about what method will be best for you.

We hope that you have learned a lot about emergency contraception (EC) and that we have answered your questions. Below are the key points to remember about EC so you can be a resource to your family, friends, and others.

Key Points to Remember about Emergency Contraception (EC):

• Emergency contraception (EC) is a safe treatment to help prevent pregnancy in adolescent girls and adult women who have had unprotected sex.
• EC will NOT cause an abortion. It does not work even after ovulation.
• Emergency contraception does not guarantee that pregnancy is prevented. The best way to prevent pregnancy is to use a regular birth control method, such as condoms or birth control pills, or to not have sexual intercourse.
• (For young women 17 and older) Plan B One-StepT and Next Choice® (emergency contraception) is available to young women 17 and older at pharmacies in the United States without a prescription. Ella™ is available with a prescription.
• If you are 16 or younger, you will need a prescription for Plan B One-StepT or Ella™.
• No matter your age, talk with your health care provider about your options and decide if you want a prescription to fill just in case you need it.

Be sure to talk with your health care provider about how you can prevent pregnancy and stay healthy.

 

Written and reviewed by the CYWH Staff at Boston Children's Hospital

 

Updated: 3/11/2011

 

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