Are Emergency Contraceptives a Substitute for Regular Birth Control?

We've all missed a birth control pill. It happens. And if it's happened to you, you may have opted for an emergency contraceptive such as Plan B. But is an emergency contraceptive a substitute for your regular birth control pill?

What is emergency contraception and how does it work?

Emergency contraception is used when someone wants to protect themselves from a possible pregnancy. It works by delaying or preventing ovulation or fertilization. It will not work if fertilization has already occurred, because it is not an abortifacient (a substance or drug used to induce abortion).

There are two main types of emergency contraception:

1. Intrauterine devices (IUDs such as Paragard or Mirena)
2. Emergency contraceptive pills

The Copper Intrauterine Device (IUD)

The copper IUD causes a local inflammatory response, which can help stop implantation and fertilization. It can be used within five days (120 hours) of unprotected sex and reduces the chances of pregnancy by 99%. The IUD is the most effective method in stopping pregnancy, as less than 1% of users become pregnant after having the device placed. The copper IUD can remain in for continuous contraception use for at least 10 years.

Hormonal IUDs that contain levonorgestrel (e.g., Mirena) are as effective as the copper IUD as a form of emergency contraception. These can stay in for continuous use for up to 6 years.

Emergency contraceptive pills

There are two main types of emergency contraceptive pills:

1. Ulipristal (Ella)
2. Levonorgestrel (Plan B)

Ulipristal (ella)

Ella contains ulipristal acetate, which stops progesterone from working normally. The pill is taken as a single dose and can be used within five days (120 hours) of unprotected sex. It’s only available by prescription from a healthcare professional or a pharmacist.

Levonorgestrel (Plan B)

Plan B should be taken within three days (72 hours) to be most effective at stopping a possible pregnancy, reducing your chances by 81% to 90%. The tablet can be purchased over the counter at a pharmacy, with no need for a prescription.

When to use emergency contraception

Emergency contraception can be used when:

• Regular birth control pills weren’t taken correctly (late or missed)
• Barrier contraception, such as a condom, failed during sexual intercourse
• No birth control was used
• Sexual assault occurred

What are the disadvantages of using emergency contraception?

The doses of hormones used in emergency contraceptive treatments are often different from those in regular pills. Because of this, the side effects of emergency contraception can be much more unpleasant than the side effects you experience from your regular birth control pill.

Side effects from emergency contraception may include:

• Headache
• Vomiting or nausea (if you are sick within two hours of taking the emergency pill, you may need to retake it or try an alternative method such as an IUD)
• Stomach pain
• Breast tenderness
• Dizziness
• Tiredness
• Menstrual cycle disruption, including irregular bleeding or spotting
• An increase in menstrual bleeding (copper IUD)
• A very small chance of having a procedural complication, such as an infection, from getting an IUD placed

These side effects may last for a week or month after taking emergency contraception. The American College of Obstetricians and Gynecologists shares that, although you may experience unpleasant side effects, taking emergency contraception will not cause serious health issues or infertility.

The most common reason you would not be able to take emergency contraception is if you are already pregnant, as emergency contraception does not work after a pregnancy has already occurred.

Certain methods may be better for some people. For example, if you currently have an infection such as pelvic inflammatory disease, you should not get a copper IUD. Similarly, if you have an allergy to an ingredient in a specific type of pill, you should not take that pill.

The bottom line

While emergency contraception is an important method to prevent unwanted pregnancy, it should not be used as a regular form of birth control. It only works if taken in the right window of time and is not 100% effective.

Additionally, while it is safe to use multiple times, emergency contraception can be difficult to access when you need it, especially if you need a new prescription for Ella or are waiting for a doctor’s appointment to have an IUD placed.

Want to stop relying on emergency contraception? See how Emme can help you to take your birth control pills on time, every time.

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Sources:

• https://www.nhs.uk/conditions/contraception/emergency-contraception/
• https://www.kff.org/womens-health-policy/fact-sheet/emergency-contraception/#footnote-271499-2
• https://ec.princeton.edu/questions/ec-review.pdf
• https://www.acog.org/patient-resources/faqs/contraception/emergency-contraception
• https://www.plannedparenthood.org/learn/birth-control/iud/non-hormonal-copper-iud
• Turok DK, Gero A, Simmons RG, Kaiser JE, Stoddard GJ, Sexsmith CD, Gawron LM, Sanders JN. Levonorgestrel vs. Copper Intrauterine Devices for Emergency Contraception. N Engl J Med. 2021 Jan 28;384(4):335-344.