Sex Ed

Whoops! Happens – Let’s Talk Through Your Emergency Contraception Options

By Gabi Powell Apsaline Douglas Jillian LoPiano, MD

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We’re not shy about championing safe sex. Condoms, birth control pills, IUDs –Betties, choose your fighter! And while having a preventative method in place before sexual experiences is ideal, sometimes things, well, er, don’t go as planned.

Maybe the condom broke.

Maybe you missed a pill.

Maybe you got swept up in a moment.

Maybe you never gave your consent to begin with.

Whatever your “maybe” may be, Betties, emergency contraception is an option and we’re here to talk you through the different methods available so, in the case of the unplanned, you can feel informed.


What is emergency contraception?
Emergency contraception, or EC, is a type of intervention to prevent an unplanned pregnancy after unprotected or under-protected sexual intercourse.

A brief history: EC’s been around a loooong time! In the 1960s, a particular combination and dosage of birth control pills prescribed by your gynecologist was used for emergency contraception. In 1998, the FDA approved the first emergency contraception-specific medication. Fast forward and present-day Betties now have several options of emergency contraception available.


What are the different types of EC?

Emergency contraception comes in two different forms:

• pills

combined birth control Pills – estrogen and progestin pills

levonorgestrel-based pills – such as Plan B

ulipristal pills – such as Ella


• copper iud


So, how do emergency contraceptive pills work?

combined birth control Pills: Taken in higher-than-usual amounts this can still be used for emergency contraception but will require a prescription if not on hand and a provider’s recommended dosage based on the brand of each pill. This regimen typically has the most side effects, including nausea and gastrointestinal-related pain.

levonorgestrel-based pills: Sounds like a Harry Potter spell, but the levonorgestrel  found in Plan B (and some combination birth control pills) is a type of a progestin.

ulipristal pills: Ella is comprised of this medication, ulipristal, which regulates the progesterone receptors in the body.



Emergency contraceptives end a pregnancy.


Emergency contraceptives prevent a pregnancy.


It’s important to note, Betties, hormonal ECs do not end a pregnancy. These methods have different makeups but work the same to delay or prevent the release of an egg to the ovary, aka, ovulation. And without ovulation, pregnancy can’t occur.

Say you take Plan B and ovulation has already occurred, now what? Great question! This EC method will go to work by thickening cervical mucus to prevent sperm from getting to the uterus. Taking EC will not affect an already existing pregnancy.


Okay, so how well do these methods work?

Plan B and other levonorgestrel-based emergency contraception pills are 87% effective if taken within 72 hours of unprotected sex. The sooner taken, the more effective it will be for preventing pregnancy. Ella works about the same for all five days after unprotected sex and is about 98% effective.


Anything else I should know about EC pills?

While hormonal ECs are highly effective when taken correctly, every Betty’s body and lifestyle is unique and each should consider these factors before taking it:



Their effectiveness is affected by a Betty’s weight

Hormonal EC pills may be less effective in women with overweight or obese BMIs. It’s not exactly clear why this is, but current research shows Plan B may be less effective after 155lbs and Ella after 195 lbs. However, these methods of EC should not be withheld for any Betty, but keep this information in mind, especially with other options available (we’re looking at you, copper IUD!).



They miiiiiight come with side effects

Hormonal EC’s side effects aren’t super common, but possible. Some Betties may experience nausea, light vaginal bleeding, dizziness, light-headedness or tender breasts. EC might also interfere with your menstrual cycle, so no need to panic if yours is delayed or shows up earlier than expected. If your period is more than 7 days late after taking an EC, take a pregnancy test and consult your doctor to talk about next steps.



These methods are safe, but are not a long-term solution

Hormonal ECs are an emergency form of contraception. And while there’s no “limit” to the number of times you can take it, if you find yourself taking it frequently, it may be time to loop in your provider and talk long-term methods of contraception to minimize cost and/or side effects.


Where can I get EC pills?

Plan B doesn’t require identification or a doctor’s prescription and is easily accessible at your local pharmacy over-the-counter. Brand-name Plan B is priced at $40-$50 while other generic brands such as Aftera, EContra, and My Choice usually cost between $11-$45. Ella does require a prescription, but most online pharmacies carry and ship this method. If you cannot afford one of these EC options, rest assured! Some providers and clinics offer emergency contraception free of charge or at a lower price.


What about that non-pill EC option? How does it work?

Ah yes. Let us introduce: the copper IUD. Copper IUDs can be inserted up to 5 days after unprotected sex to prevent pregnancy.

how it works:

This non-hormonal, flexible T-shaped device is wrapped in copper that works to prevent pregnancy by changing how sperm move! (How cool is that?!) Think of the copper as a sort of bug repellent, swatting those sperm swimmers away from the egg for fertilization.

You’ll need to pay your healthcare provider a visit if you take this route since it’s placed into the inside of your uterus. The copper IUD doesn’t affect the ovulation process, but generally disrupts sperm motility and can affect a post-ovulation egg and the endometrium. Cramping (after insertion) is the most common side effect.

why we’re fans:

Copper IUDs are highly effective – we’re talking 99% effective (yes please) – and get this: a single insertion can last you up to 12 years (YES, PLEASE!). Copper IUDs are not influenced by weight or BMI and because they’re non-hormonal, make for great alternatives for Betties with medical contraindications and/or who prefer a convenient, long-term form of birth control.



Is having a preventative plan in place before sexual encounters ideal and preferred? Sure. But knowing your options for situations unplanned is equally important when making a decision that is right for you.

Betties, if you have questions about emergency contraceptives or are looking for a more long-term method of contraception, book a Care Anywhere or Care Close-By appointment.

Our providers are ready to listen, answer your questions and help talk through options that make sense for you.



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