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Emergency Contraception Laid Bare: The 10 Biggest Myths Revealed

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Oct 21, 2020.

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

We get it. Accidents happen. Did the condom break? Forgot to take your pill? Didn't use your best judgement?

The emergency contraceptive (EC) is a safe and effective way to prevent pregnancy after unprotected sex, contraceptive failure, or after a sexual assault. EC can prevent some, but not all, pregnancies.

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.

The emergency contraceptive pill is not a long-term solution as regular birth control. Think about it - contraception is a lot more efficient (and cheaper) over the long-run.

Save yourself the anxiety. If you find yourself regularly using the emergency contraceptive pill 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. 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 the emergency contraceptive pill within easy reach, just in case.

  • However, although the emergency contraceptive pill 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 would harm a developing baby or an existing pregnancy. The emergency contraceptive pill is only effective if used before a pregnancy is established. The emergency contraceptive pill will not work if you are already pregnant.

Emergency contraceptive pills 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.

If you have any questions about the emergency contraceptive pill or how to use it most effectively, 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.

  1. The most well-known is Plan B One-Step (levonorgestrel) and it's 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. Generics, as well as other trade names are available, often for a lower cost. Ask your pharmacist.
  2. Another emergency contraceptive pill, ella, which contains a different progestin (ulipristal) is also available, but it requires a prescription.
  3. Finally, Paragard, a copper intrauterine device (IUD) can be inserted by a doctor up to 5 days after unprotected sex or a contraceptive failure.

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 equivalents (for example: Next Choice One Dose, My Way, Take Action, others), be taken within 72 hours (3 days) of 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 (EC) pill can be taken up to 5 days (120 hours) after sex but the longer you wait the less effective it is. Also, if you weigh 155 pounds or more, the levonorgestrel emergency contraceptive pill like Plan B One Step may not work as well. Talk to your doctor about this.

After day 3, your more effective emergency contraceptive option may be Ella or insertion of the copper IUD (Paragard). According to the American College of Obstetricians and Gynecologists and Planned Parenthood, the copper IUD is the most effective form of emergency contraceptive. Also, if you are overweight or obese, you may want to consider having a copper IUD inserted. Copper IUDs are effective in women of any weight.

See the next slide to learn more about ella, another option after the 72 hour (3 day) time frame.

Ella: A Prescription Emergency Contraceptive Pill

The manufacturer of ella states it can be used within a 120 hour (5 day) window after unprotected sex or birth control failure. Your doctor will need to write you a prescription for ella, or contact your local Planned Parenthood.

There's a few important things to know about taking the ella (ulipristal) emergency contraceptive pill:

  • Don’t use two different kinds of morning-after pills (like Plan B One Step and ella) at the same time or within 5 days of each other, because they may counteract each other and not work at all.
  • If you used ella and want to continue (or start) a hormonal birth control method (pill, patch, ring, implant, shot, or hormonal IUD), you need to wait to do so until 5 days after taking Ella. After using ella, you ALSO must use a barrier method like a condom (or not have sexual intercourse) until your next menstrual period. Using ella and hormonal contraceptives together can lower the effectiveness of each medicine.
  • If you do not use hormonal contraception, after using ella, you should use a reliable barrier contraceptive method (such as condom with spermicide) each time you have sex.

Learn more: ella Overview (in more detail)

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, as noted by Planned Parenthood.

ella is a bit diferent. According to the manufacturer of ella (ulipristal), repeated use of ella within the same menstrual cycle is not recommended, as studies of repeat use within the same cycle have not been evaluated.

Your doctor should be contacted quickly so that a regular form of birth control, such as the oral contraceptive pill, or IUD, can be started for long-term use.

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 Over the Long Run

Prices will vary, but in general the cost of one package of emergency contraceptive pill runs between $15 and $45, using a free, online discount card.

The copper IUD (Paragard) 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.
  • However, the copper IUD (Paragard) must be inserted by a healthcare provider. The copper IUD can be left in place for up to 10 years.
  • If inserted up to 5 days after unprotected sex as an emergency contraceptive, the copper IUD can be then be left in place for long-term birth control. Many insurance plans pay for the IUD, too.
  • Some health clinics or Planned Parenthood may offer the copper IUD at low or no cost.

Regular use of birth control pills is also a good option to prevent pregnancy over the long run, is affordable, and is usually covered by insurance.

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

Levonorgestrel emergency contraceptives, like Plan B One-Step (and generics), are available over-the-counter at any time and DO NOT require a prescription. 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 from your healthcare provider.

  • Ask your doctor to write a prescription ahead of time for Ella or call your doctor quickly if you need it.
  • Ella should be taken as soon as possible, but is effective up to 5 days after unprotected sex. If you use Ella, be sure your pharmacist checks for drug interactions each time you get a new prescription.

Remember, emergency contraception does not protect you against the AIDS virus or other sexually transmitted diseases; only a condom can do that.

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, as noted by Planned Parenthood.

Short-lived side effects may include:

  • nausea
  • vomiting
  • irregular bleeding or spotting
  • headache
  • breast tenderness
  • stomach pain

If you vomit after taking an emergency contraceptive pill -- within 2 hours (for levonorgestrel like Plan B One Step) or 3 hours (for Ella) -- check with your healthcare provider quickly, as you may need another dose.

Myth #10: I'm Too Heavy to Use Any Form of Emergency Contraception

According to the American College of Obstetrics and Gynecology (ACOG), being overweight or obese may decrease the effectiveness of emergency contraceptive pills and you may want to consider having a copper IUD (Paragard) inserted. Copper IUDs are effective in women of any weight.

Additionally, the manufacturer states that Ella (ulipristal acetate) may have lower effectiveness among women with a body mass index (BMI) > 30 kg/m2.

Planned Parenthood states that Plan B may not work if you weigh 155 pounds or more, and Ella may not work as well if you weigh 195 pounds or more.

If you are overweight or obese and need an emergency contraceptive, contact your doctor immediately and ask if a copper IUD is a better option for you. Plus, you can leave the IUD in place for long-term birth control for 10 years.

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

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Sources

  • World Health Organization. Media Center. Emergency Contraception. Fact Sheet No. 244. Accessed Oct. 16, 2020 at https://www.who.int/news-room/fact-sheets/detail/emergency-contraception
  • Planned Parenthood. The Morning After Pill (Emergency Contraception). Accessed Oct. 16, 2020 at https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception.
  • American College of Obstetricians and Gynecologists. Emergency Contraception. FAQs. Updated June 2020. Accessed Oct. 16, 2020 at https://www.acog.org/womens-health/faqs/~/link.aspx?_id=69A606AF46F34A7D8F8C894E901B6DF8&_z=z
  • Paragard Prescribing Information. CooperSurgical, Inc. Accessed May 24, 2019 at https://www.drugs.com/pro/paragard.html
  • Ella [product information]. Drugs.com. Accessed Oct. 16, 2020 at https://www.drugs.com/pro/ella.html
  • 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 May 24, 2019.
  • Trussell J, Raymond E. Emergency Contraception: A Last Chance to Prevent Unintended Pregnancies. Princeton University. Jan. 2019. Accessed Oct. 16, 2020. https://ec.princeton.edu/questions/ec-review.pdf

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.