Emergency Contraception Pills

In the United States, up to 95 percent of teenage pregnancies are unintended. At the same time, at least 40 percent of all pregnancies in the United States are unintended. This can occur when a woman’s regular method of contraception fails or she uses it incorrectly. For example, she might forget to take her birth control pills for two or three days in a row. She might be unable to get her contraceptive injection on time. Her diaphragm might slip, or she and her partner might accidentally tear a condom. Unintended pregnancy can also occur after a couple has had unprotected sex. Finally, unintended pregnancy can occur as a result of rape or sexual assault. In fact, experts estimate that at least 25,000 pregnancies occur each year in the United States as a result of forced sex. There is a contraceptive method that works after unprotected sexual intercourse to prevent pregnancy. This method is known as emergency contraception pills, commonly called the morning-after pill. There are two types of pills:

• Levonorgestrel pills, including the brands Next Choice One Dose and Plan B One-Step. This is a female hormone that prevents ovulation (the release of an egg from an ovary). This medication also causes changes in your cervical mucus and uterine lining, making it harder for sperm to reach the uterus and harder for a fertilized egg to attach to the uterus.
• Ulipristal acetate, known by the brand name ella. It’s a non-hormonal pill. It contains ulipristal, a non-hormonal drug that blocks the effects of key hormones necessary for conception.

Anyone — no matter how old you are — can get Plan B One-Step, one brand of emergency contraception, over the counter without a prescription at a drugstore, Planned Parenthood health center, or family planning clinic. Plan B One-Step usually costs about $40-$50, and the generics cost about $35-$45. All other brands of emergency contraception require you get a prescription from a doctor, nurse, or other health care provider if you're 16 or younger. All women need a prescription for ella, regardless of age. Ella can also be ordered through an online prescription service for $59, including shipping. Since emergency contraception works better the sooner you take it, it’s a good idea to get emergency contraception before you need it just in case. That way you’ll have it on hand if an accident happens, and you won’t have to worry about running out to a drugstore or waiting to get an appointment for a prescription.

Both kinds of emergency contraception pills can be used up to five days (120 hours) after unprotected intercourse. You may want to use it if:

• you weren't using any birth control when you had sex
• you forgot to take your birth control pills, patch, ring, or other birth control method
• your partner's condom broke or slipped off
• your partner didn't pull out in time or
• you were forced to have unprotected vaginal sex

In 1997, the U.S. Food and Drug Administration (FDA) recognized the use of oral contraceptives as being safe and effective as emergency contraception. Emergency contraceptive pills are effective in preventing pregnancy after unprotected sex. They are especially effective when begun within 12 to 24 hours after sex. Levonogestrel pills, including the brands Plan B One-Step and Next Choice One Dose, are up to 89 percent effective when taken within 72 hours (three days) after unprotected sex. They prevent pregnancy by temporarily blocking eggs from being produced, by stopping fertilization, or by keeping a fertilized egg from becoming implanted in the uterus. They continue to reduce the risk of pregnancy up to 120 hours (five days) after unprotected sex, but they are less effective as time passes.  Ella is 85 percent effective if taken within 120 hours (five days) after unprotected sex. It stays just as effective as time passes after sex. The morning-after pill will not prevent pregnancy for any unprotected sex you may have after taking the pills. Levonogestrel pills may not work as well for women who have a body mass index (BMI) of more than 25. The IUD or ella are better options for overweight women who need emergency contraception. Plan B One-Step will not affect an existing pregnancy or cause harm to a fetus. Lastly, ella should not be used by women who are already pregnant or suspected to be pregnant.

Side effects are uncommon, and usually stop within a day or two. Possible side effects include:

• an earlier or later, heavier or lighter period than usual
• breast tenderness, dizziness, or headaches, and 
• nausea or vomiting. If you vomit within two hours of taking the pill(s), it won't be effective and you need to take it again.

Frequent use may cause periods to become irregular and unpredictable. Your period also may be heavier, lighter, or more spotty than normal. If you do not get your period in 3 weeks or if you think you might be pregnant after taking ECPs, get a pregnancy test to find out for sure. Emergency contraception should not be used as a form of ongoing birth control because there are other forms of birth control that are a lot more effective and less expensive. Emergency contraception does not protect against sexually transmitted infections! You may want to consider getting tested if there is a possibility that unprotected sex put you at risk. If you’re worried about side effects or have a history of side effects when taking ECP, talk with your health care provider about your concerns. He or she may prescribe additional medicine that can help you prevent or treat side effects, such as nausea, if they occur.

Emergency contraceptive pills are sometimes confused with medical abortion. Whereas mifepristone (RU-486) terminates an existing pregnancy, emergency contraception is effective only before the pregnancy is established (that is, before implantation). If a woman is already pregnant, emergency contraception will not cause an abortion. By contrast, mifepristone is an entirely different medication, unrelated to hormonal contraception. Emergency contraceptive pills do not cause birth defects. Over 40 years experience with oral contraceptives has shown no risk of birth defects if a woman is already pregnant when she takes them. Emergency contraceptive pills are contraindicated for pregnant women only because the medication will not end a pregnancy. Studies of older, higher-dose oral contraceptives have shown that emergency contraception confers no increased risk to an established pregnancy or harm to a developing embryo.

In conclusion, emergency contraception pills are used to help keep a woman from getting pregnant after she has had sex without using birth control or if the birth control method failed. If you are already pregnant, emergency contraception will not work. The sooner you use emergency contraception after unprotected sex, the more likely it will prevent pregnancy. But you must use it correctly. ECPs are only good to protect against one act of unprotected sex. They work by blocking ovulation, but only for a few days, so if you take them and have unprotected sex again afterwards, you’re significantly increasing your risk of a pregnancy. If you have unprotected sex again within a few days of taking the pills, there will be more sperm waiting in the fallopian tubes when the egg is eventually released. It’s important to talk to your doctor if you have an issues or concerns.

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