Until you need it, you might not give emergency contraception — frequently called the “morning-after pill” — a second thought. Having unprotected sex or having your contraception fail, though, could make you worry about getting pregnant. Your mind might race, wondering where you could get access to the pills and how they might affect your body.
You can put your mind at ease. Emergency contraception itself actually isn’t anything scary. The oldest form — Plan B — is just a higher dose of levonorgestrel, the hormone used in regular birth control pills. A newer form — ella — contains ulipristal, a nonhormonal drug that blocks the hormones needed for pregnancy. Like birth control pills, emergency contraception pills are not typically difficult to get. You can obtain them either with a prescription or over the counter.
If you’ve never used emergency contraception before — or even if you have — you might have questions. Here are 10 things you should know about how it works and what you can expect.
1. Both Types Work in Similar Ways
Both hormonal and nonhormonal emergency contraception stops your ovaries from releasing eggs, preventing fertilization. The nonhormonal pill goes a step further. It also makes it harder for a fertilized egg to implant in your uterus and grow. Let’s be clear — these pills do not harm an existing pregnancy or cause an abortion. Those are common misconceptions.
2. Timing Matters
No emergency contraception is 100% effective. How well it works depends on when you take it and at what point in your cycle you had sex. A hormone-based pill taken within 24 hours can be 95% effective. Research shows its effectiveness drops to 61% if you take it between 48 hours and 72 hours after unprotected sex.
Nonhormonal pills are more effective over a longer time period. They lower your chance of getting pregnant by 85% if you take one within five days. Basically, though, the sooner you can take either medication, the better.
3. Weight Can Impact Efficacy
Emergency contraception generally works well, but your weight can affect how well it functions in some cases. According to the CDC, emergency contraception is less effective in women who are considered obese (those who have a body mass index of 30 or greater).
Clinical evidence shows that a nonhormonal pill is effective for women who weigh more than 155 pounds, but it may not work as well for women over 195 pounds. On the other hand, there’s a general consensus that excess weight hinders the effectiveness of hormone-based pills. So if you fall into that group, talk with your doctor.
4. Side Effects Are Uncommon, but Possible
You may have heard horror stories that emergency contraception will make you very sick. Fortunately, that’s a myth. Most women can take it without having any problems. Any issues you do have should pass within 24 hours. If they last for more than 48 hours, contact a healthcare provider.
Headache and nausea are the most common side effects. If you throw up within two to three hours after taking it, call your doctor, as you may need another dose. Other side effects, including a heavier period, lower abdominal pain, dizziness, cramping, and fatigue, are also possible.
5. Taking a Dose Can Impact Your Period
You can expect your next period to be a little different after taking emergency contraception. Your cycle could start earlier or later. Your flow could be heavier, lighter, or spotty. These are all normal outcomes, so don’t worry. If your cycle is late by more than a week, though, consider taking a pregnancy test and talking with your doctor.
6. Additional Birth Control Steps Will Be Necessary
Taking emergency contraception while using other forms of birth control is safe. You will simply need to take additional steps for a while to protect yourself from pregnancy. With hormone-based pills, restart your birth control immediately and use barrier protection, such as condoms, for seven days.
It’s a bit more complicated with a pill that does not contain hormones. If you only missed one dose of your birth control prescription, restart it immediately. If you’ve gone more than a week without it, wait six days before picking back up with your normal routine. Do the same thing if you just started using birth control. Restarting too soon can weaken the emergency contraception. And be sure to use condoms for at least a week.
7. Breastfeeding Is Safe
If you’re currently breastfeeding, you can breathe easy. Research shows emergency contraception doesn’t have any long-term effects on feeding your baby.
With a hormone-based pill, you don’t need to change your breastfeeding schedule at all. It’s best to “pump and dump” for at least 24 hours after taking nonhormonal pills, though, because the medication can pass into your breast milk. The highest concentrations appear within one to three hours, but trace amounts can linger for five days.
8. The Safety of Multiple Doses per Cycle Depends on Pill Type
Both hormone-based and nonhormonal pills should only be used in emergency situations. You can safely use hormone-based pills more than once per menstrual cycle, though. Just be cautious because multiple uses can increase your chances of getting pregnant and have a bigger impact on your period.
In contrast, a nonhormonal pill should only be used once per cycle. If you take one, don’t use a hormone-based pill during the same cycle.
9. Using Emergency Contraception as Regular Birth Control Isn’t a Good Option
Even though an emergency contraceptive can help prevent pregnancy, you shouldn’t use it as your normal form of birth control. A daily regimen of standard birth control pills gives you consistent protection. It offers you peace of mind, and it can also be better for your bank account. Relying on emergency contraception can get expensive — each dose ranges between $20 and $50.
10. A Copper IUD Is the Most Effective Emergency Contraceptive
Emergency contraception pills are effective, but you may not know that the most effective emergency contraception option is actually something different. It’s a copper intrauterine device (IUD).
This device works in two ways. Not only does the copper kill sperm, but it also causes inflammation in your uterus. That makes it nearly impossible for a pregnancy to take hold. IUDs are 99% effective, and your doctor can implant one up to five days after you’ve had unprotected sex.
Needing to use emergency contraception can be a scary thought. Actually taking it doesn’t have to be. When used correctly, either hormone-based or nonhormonal pills lower the chances you’ll get pregnant if you have unprotected sex. Just keep everything above in mind, and choose the option that’s right for you.
