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Emergency Contraception Laid Bare: The 10 Biggest Myths Revealed

Medically reviewed on May 26, 2018 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.

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 (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.

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 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, possibly for a lower cost. Ask your pharmacist.

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 equivalents (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. After day 3, your more effective emergency contraceptive option is ella or insertion of the copper IUD.

The manufacturer of ella recommends it be used within a 120 hour (5 day) window after unprotected sex or birth control failure. Your doctor will write you a prescription for ella.

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, according to the manufacturer of ella (ulipristal), repeated use of ella within the same menstrual cycle is not recommended, as safety and efficacy of repeat use within the same cycle has 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 $60. Whether you get a more affordable generic, and if you have an online discount coupon, can alter the prices tremendously. But either way, this can add up!

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 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, is affordable, and are usually covered by insurance.

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 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. Ask your doctor to write a prescription ahead of time or call your doctor. ella is effective up to 5 days after unprotected sex.

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
  • stomach pain

may be short-lived side effects.

If you vomit within 2 to 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).

If you not sure how to calculate your BMI, talk with your pharmacist and use this formula to calculate your BMI.

In these cases, and if it's an option for you, the copper intrauterine device (IUD) may be your most effective choice; it is not affected by body weight.

However, in 2016 the U.S. Food and Drug Administration (FDA) determined that a change in the labeling for emergency contraceptive products was not warranted in women who weigh more than 165 lbs (75 kg) or have a body mass index (BMI) of more than 25 kg/m2. The FDA stated the data are conflicting and too limited to reach a definitive conclusion. The FDA continues to believe all women, regardless of how much they weigh, can use the levonorgestrel emergency contraceptive to prevent unintended pregnancy following unprotected sexual intercourse or contraceptive failure.

Therefore, 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.

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

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Sources

  • Plan B: Consumer Questions and Answers. U.S. Food and Drug Administration (FDA). Accessed May 27, 2018 at https://www.fda.gov/drugs/drugsafety/postmarketdrugsafetyinformationforpatientsandproviders/ucm491173.htm
  • 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 27, 2018.
  • Trussell J, Raymond E. Emergency Contraception: A Last Chance to Prevent Unintended Pregnancies. Princeton University. April 2017. Accessed May 27, 2018.
  • Faculty of Sexual and Reproductive Healthcare Clinical Effectiveness Unit. CEU Statement. Missed Pill Recommendations. Accessed May 27, 2018.
  • World Health Organization. Media Center. Emergency Contraception. Fact Sheet No. 244. Accessed May 27, 2018.
  • Planned Parenthood. The Morning After Pill (Emergency Contraception). Accessed May 27, 2018 at https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception.
  • American College of Obstetricians and Gynecologists. Practice Bulletin. Emergency Contraception. Number 152. Updated 2018. Accessed May 27, 2018 at http://www.acog.org/Resources-And-Publications/Practice-Bulletins/Committee-on-Practice-Bulletins-Gynecology/Emergency-Contraception
  • Next Choice Package Labeling. Watson Laboratories. Accessed May 27, 2018.
  • Plan B One Step Package Labeling. Teva Women's Health. Accessed May 27, 2018.
  • ella Package Labeling. Afaxys. Accessed May 27, 2018.
  • Paragard Prescribing Information. Revised: 12/2017. CooperSurgical, Inc. Accessed May 27, 2018 at https://www.drugs.com/pro/paragard.html

Further information

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

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