Emergency Contraception: Plan B, Ella and Copper IUD, Oh My!

Nobody’s perfect. If you are sexually active, chances are you may need to use an emergency contraception method at some point. But you might be wondering — if you are already on the pill or another form of birth control, when would it be necessary to use emergency contraception?

There are several instances it may pop up. You may need to take the emergency pill if you forgot to take your regular contraceptive pill on time, if you didn’t use your contraceptive patch or vaginal ring correctly, or if you were late in having your contraceptive implant or contraceptive injection administered.[1]

If you find yourself in one of these circumstances, you may ask yourself — is emergency contraception considered abortion? From a scientific standpoint, absolutely not. Emergency contraception does its job before pregnancy begins. In order words, before a fertilized egg implants in the lining of your uterus. Implantation begins five to seven days after sperm fertilizes the egg, and the process is completed several days later. Emergency contraception will not work if a woman is already pregnant.[2] Emergency contraception prevents egg from fertilizing, whereas an abortion terminates an egg that has already been fertilized.

1. The Emergency Contraceptive Pill

Emergency contraceptive pills clean up the spills. There is Levonorgestrel, aka “Plan B.” This progestin-only pill must be taken within 3 days (72 hours) of intercourse. Plan B contains levonorgestrel, a synthetic version of the natural hormone progesterone produced by the ovaries.[3] By taking this pill you are essentially stopping the release of an egg, also known as ovulation. After you’ve take Plan B, resume your normal form of birth control within 12 hours. Make sure to use additional contraception for 7 days if you use a patch, ring, combined pill, implant, or injection.

Then there is Ulipristal acetate aka “Ella.” This pill must be taken within 5 days (120 hours) of intercourse. Keep in mind that the sooner you take emergency contraception the better, as they are less effective the longer you wait. Ella contains ulipristal acetate, which stops progesterone from working normally. Similar to Plan B, it stops the release of an egg. After taking Ella, wait at least 5 days before you resume your normal contraception method. Just like Plan B, use additional contraception for 7 days after you get back into your normal birth control routine.

Note: Obesity has been found to decrease the effectiveness of emergency contraceptive pills in women. Emergency contraceptive pills were found to be less effective for women whose body mass index exceeds 30 kg), but there are no safety concerns.[4]

Now let’s talk safety. There are no safety concerns about using progestin-only emergency contraceptive pills more than once. Ella (ulipristal acetate) should not be used more than once in the same cycle. However, a recent study showed that it is safe to take Ella repeatedly, although it may not be as effective because most women in the study eventually ovulated. It is not advisable to use emergency contraception as your primary contraception method.

2. The Copper IUD

Thought that the Copper IUD was just for ongoing contraception? Think again. Known as the most effective type of emergency contraception, ParaGard, or the copper IUD, lowers your chances of getting pregnant by more than 99.9 percent if you have it put in by a medical practitioner within 5 days of unprotected sex.[4] Once the copper IUD is in place, it prevents pregnancy by impacting sperm movement, making it difficult for sperm to swim well enough to reach an egg.

Now time for some real talk. Whether you choose the Copper IUD or the morning after pill, we applaud you for being proactive about your emergency contraception needs. It must be said, however, that these methods do not 100% guarantee the prevention of pregnancy. On the bright side, emergency contraception can prevent up to 95% of pregnancies when taken within 5 days after sex.[5]

In terms of side effects, you might experience headaches, stomach pain, or changes in your next period. Your period can arrive early, late, or be more painful than usual. You also might experience vomiting. If that is the case, consult your doctor, as if you vomit within 2 hours of taking emergency contraception you might need another dose.[2]

Now, you might ask, where is emergency contraception available? Emergency contraception pills are available over the counter in pharmacies. You can also purchase them online and have them delivered to your door. As for the IUD, schedule an appointment with your doctor to make sure that the copper IUD is a good option for you and to have it inserted.

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Sources:

1. https://www.nhs.uk/conditions/contraception/emergency-contraception/
2. https://ec.princeton.edu/questions/ecabt.html
3. https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception
4. http://www.who.int/news-room/fact-sheets/detail/emergency-contraception
5. https://www.nhs.uk/conditions/contraception/emergency-contraception/
6. https://www.hhs.gov/opa/pregnancy-prevention/birth-control-methods/emergency-contraception/index.html
7. https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/how-does-copper-iud-work-emergency-contraception
8. http://www.who.int/news-room/fact-sheets/detail/emergency-contraception
9. https://ec.princeton.edu/questions/ecabt.html