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Emergency Contraception Laid Bare: The 10 Biggest Myths Revealed

Medically reviewed on May 09, 2017 by L. Anderson, PharmD

Myth #1: Our Birth Control Failed! There's Nothing I Can Do Now

Was there condom failure? Forgot to take your pill? Didn't use the best judgement? The emergency contraceptive pill (ECP) is a safe and effective way to prevent pregnancy after unprotected sex, contraceptive failure, or after a sexual assault.

Millions of women have safely used what's known as the 'morning-after pill'. It can be purchased without a prescription or ID card right at the cashier. But think about it - birth control is a lot more efficient (and cheaper) over the long-run. If you find yourself regularly using the ECP to prevent pregnancy, you need to see your doctor and discuss the best method of long-term birth control.

Myth #2: Emergency Contraception is Only for the Morning After

You don't have to wait until the morning after unprotected sex to use the emergency contraceptive pill (ECP). In fact, it's more effective the sooner you take it – as soon as possible after unprotected sex. That's why if pregnancy is definitely not in your plans right now, it’s a good idea to have ECP within easy reach, just in case.

However, although ECP is a safe and effective way to avoid pregnancy for the occasional sexual mishap, it should never be used as a regular method of birth control. This may expose you to higher total levels of hormones, and can lead to irregular periods. Plus, you'll have higher (and unnecessary) prescription drug bills.

Myth #3: Emergency Contraception Can Be Harmful

According to the manufacturers, there is no medical evidence that the emergency contraceptive pill (ECP) would harm a developing baby or an existing pregnancy. The emergency contraceptive pill is only effective if used before a pregnancy is established.

ECPs work mainly by stopping the release of an egg from the ovary, but they may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing implantation to the uterus. It should not be used as a regular form of birth control. If you have any questions about the ECP, please be sure to talk to your healthcare provider.

Myth #4: The Only Option is the Morning-After Pill

You have several choices for emergency contraception. The most well-known is Plan B One-Step (levonorgestrel) and it's generic equivalents, often called 'the morning-after pill'. These are available over-the-counter without a prescription as a single tablet of 1.5 mg of levonorgestrel.

Another emergency contraceptive pill, Ella, which contains a different progestin (ulipristal) is also available, but it requires a prescription.

Finally, Paragard, a copper intrauterine device (IUD) can be inserted by a doctor up to 5 days after unprotected sex or a contraceptive failure. According to the American College of Obstetrics and Gynecology (ACOG), the copper IUD is the most effective method of emergency contraception.

Myth #5: After 72 Hours, There's No Options

The sooner, the better, as no emergency contraceptive in 100% protective. The manufacturer states in product labeling that Plan B One-Step, or its generics (Next Choice One Dose, My Way, others), be taken within 72 hours (3 days) of unprotected sex. However, studies have shown it can still be moderately effective up to 120 hours (5 days) after unprotected sex. Planned Parenthood states that the morning after pill works best up to 3 days (72 hours) after unprotected sex. However, they also state that the emergency contraceptive pill can be taken up to 5 days (120 hours) after sex but may not work as well by day five.

The manufacturer of Ella recommends it be used within a 120 hour (5 day) window after unprotected sex or birth control failure.

Myth #6: Using Emergency Contraceptive Pills More Than Once is Dangerous

Definitely a myth! If unprotected sex should occur again, even within the same menstrual cycle, it is safe to use the levonorgestrel emergency contraceptive pill again. However, your doctor should be contacted quickly so that a regular form of birth control can be started. Emergency contraceptive use shouldn't become a habit because:

  • It's costly and inconvenient which may increase the risk for a pregnancy
  • You are exposed to higher hormone levels
  • Side effects, such as irregular periods, breast tenderness, nausea or vomiting, stomach pain, tiredness, or headache can occur
  • Worrying about an unintended pregnancy can be stressful.

Myth #7: Emergency Contraceptives Are Not Affordable

Prices will vary, but in general the cost of one package of emergency contraceptive pill runs between $30 and $60. But this can add up!

Regular use of birth control pills may be a good option to prevent pregnancy, is more affordable in the long-run, and are usually covered by insurance.

The copper IUD is expensive initially, between $500 and $1,000, but if continued as a long-term form of birth control, it can be very cost-effective. It is also convenient, as there is no need to remember to take a pill each day. The copper IUD can be left in place for up to 10 years. Most insurance plans pay for the IUD, too.

Myth #8: Emergency Contraceptives Are Only Available When I Have an Emergency

Most brands of levonorgestrel emergency contraceptives, like Plan B One-Step, are available over-the-counter at any time. Most pharmacies will stock these products on the shelves and pharmacists are glad to answer any questions.

The other brand of oral emergency contraceptive pill, named Ella, does require a prescription. Ask your doctor to write a prescription ahead of time, or call your doctor. Remember, emergency contraception does not protect against the AIDS virus or other sexually transmitted diseases; only a condom can do this.

Myth #9: Emergency Contraceptive Pills Have No Side Effects

Emergency contraceptive pills are very safe to use with few side effects. For over 30 years, there have been no reports of serious complications. Nausea, vomiting, irregular bleeding or spotting, headache, breast tenderness, and stomach pain may be short-lived side effects.

If you vomit within 3 hours of taking an ECP, check with your doctor, as you may need another dose. Studies have shown that emergency contraception pill use does not increase the risk to the developing fetus in women who may unknowingly be pregnant - so that is reassuring.

Myth #10: My Weight Will Not Affect Emergency Contraceptive Use

According to the American College of Obstetrics and Gynecology (ACOG), if you have a body mass index (BMI) that's higher than 25, the levonorgestrel emergency contraceptive pill like Plan B One-Step may be less effective in preventing pregnancy. Additionally, some research suggests that ulipristal acetate (Ella) has lower effectiveness among obese women (BMI over 30).

In these cases, and if it's an option for you, the copper intrauterine device (IUD) may be your most effective choice. However, oral emergency contraception should not be withheld from women who are overweight or obese because no research has proven a threshold weight at which it would be ineffective, according to ACOG.

If you not sure how to calculate your BMI, talk with your pharmacist.

Finished: Emergency Contraception Laid Bare - The 10 Biggest Myths Revealed

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Sources

  • Rodrigues I, Grou F, Joly J. Effectiveness of emergency contraceptive pills between 72 and 120 hours after unprotected sexual intercourse. Am J Obstet Gynecol 2001;184:531-7. Accessed 05/09/2017.
  • Trussell J, Raymond E. Emergency Contraception: A Last Chance to Prevent Unintended Pregnancies. Princeton University. April 2017. Accessed 05/09/2017.
  • Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit. CEU Statement. Missed Pill Recommendations. Accessed 05/09/2017
  • World Health Organization. Media Center. Emergency Contraception. Fact Sheet No. 244. Accessed 05/09/2017.
  • Planned Parenthood. The Morning After Pill (Emergency Contraception). Accessed 05/09/2017 at https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception.
  • American College of Obstetricians and Gynecologists. Practice Bulletin. Emergency Contraception. Number 152. Sept, 2015. Accessed 05/09/2017 at http://www.acog.org/Resources-And-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Emergency-Contraception
  • Next Choice Package Labeling. Watson Laboratories. Accessed 05/09/2017.
  • Plan B One Step Package Labeling. Teva Women's Health. Accessed 05/09/2017.
  • ella Package Labeling. Afaxys. Accessed 05/09/2017.
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