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Sexual and Reproductive Health

Emergency Contraception

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What is emergency contraception (EC)?

EC helps prevent pregnancy if you’ve had unprotected sex or you’re not sure if you’re protected from pregnancy. EC should be used as soon as possible after unprotected sex.


Forms of EC
Emergency Contraceptive Pills (ECPs) Copper Intrauterine Device (IUD)
  • 2 types: levonorgestrel and ulipristal acetate
  • can be used up to 5 days (120 hours) after unprotected sex
  • a small, soft, T-shaped device with a copper wire wrapped around it
  • can be put into the uterus up to 7 days after unprotected sex

EC doesn’t protect you from sexually transmitted infections (STIs) and HIV.

When is EC used?

There’s about an 85% chance of getting pregnant after 1 year of having unprotected sex. You can use EC to help prevent pregnancy if:

  • no birth control was used
  • you’ve been sexually assaulted
  • withdrawal (pulling out) was used
  • a condom broke, leaked, slipped, or fell off
  • your method of birth control wasn’t used the right way

If you use hormonal birth control (e.g., birth control pills, birth control patch, vaginal ring, birth control injection) and need help deciding if you need EC, go to Sex & U and search for “stay on schedule”.

Talk to a pharmacist or health care provider if you have any health concerns, are breastfeeding, or taking medicine.

Do a pregnancy test if you don’t get your period within 3 weeks of using EC or if your period is much lighter than normal.

How do I choose which type of EC to use?

Copper IUD Levonorgestrel ECP (e.g., Plan B®, NorLevo®, Next Choice®, Option 2®) Ulipristal Acetate ECP (e.g., Ella®)
What it is
  • may prevent an egg and sperm from joining and may prevent a fertilized egg from attaching to the uterus
  • works as birth control for up to 10 years after it’s put in
  • sometimes called the “morning after pill”
  • delays an egg from being released
  • doesn’t provide ongoing protection from pregnancy
  • can be used more than 1 time in a cycle
  • delays an egg from being released
  • doesn’t provide ongoing protection from pregnancy
  • can be used more than 1 time in a cycle
How to get it
  • need a prescription
  • put in by a health care provider (call your clinic to see if this is offered)
  • don’t need a prescription
  • you can get it at most drugstores and sexual health clinics
  • need a prescription
How well it works
  • most effective form of EC
  • decreases pregnancy risk by 99% if put in within 5 days of unprotected sex
  • may not be recommended if you’ve had unprotected sex earlier in the same cycle as you may already be pregnant
  • can be used in case of missed hormonal contraception
  • is more effective the earlier it’s taken after unprotected sex
  • how well it works decreases significantly after 72 hours
  • decreases pregnancy risk by 50 to 90%, depending when it’s taken
  • don’t take with ulipristal acetate ECP because it won’t work as well
  • can’t be used in case of missed hormonal contraception
  • more effective than levonorgestrel
  • has same effectiveness if taken within 5 days of unprotected sex
  • decreases pregnancy risk by about 85% for each single act of unprotected sex
  • don’t take with levonorgestrel ECP because it won’t work as well
Weight Concerns

Effective regardless of weight

May not work as well for people who weigh more than 165 lbs. (75 kg) or with a BMI* that’s more than 25

May not work as well for people with a BMI* that’s more than 35

Safe while Breastfeeding

Yes

Yes

Not recommended and it can still be in breastmilk 1 week after taken

*BMI = body mass index. BMI is a measure of a person’s body fat based on their height and weight. You can calculate your BMI here.

What do I need to know about ECPs?

  • Different types of ECPs should not be taken together—this means don’t take them at the same time or in the same cycle. They will not work as well when taken together.
  • There’s a greater chance of getting pregnant if you use ECPs and then keep having unprotected sex in the same cycle.
  • If you’ve had unprotected sex more than 1 time in 24 hours, you only need 1 dose of ECPs.
  • Think about keeping an extra pack of ECPs at home.
  • No matter how much you weigh, ECPs may still protect you from pregnancy and should be taken if you can’t have a copper IUD put in.
  • Do not take ECPs if you have a confirmed pregnancy because they won’t work.

Levonorgestrel ECP

Take 1.5 mg (the full dose of levonorgestrel) as soon as possible after unprotected sex. This might mean you take 2 pills at the same time.

Levonorgestrel ECP does not provide ongoing protection from pregnancy. After you take it:

  • keep using your regular form of birth control at the usual time
  • you can start a new cycle of hormonal birth control (e.g., birth control pill, patch, ring, injection) or have a hormonal IUD put in on the same day or the next day
  • it will take 7 days for your hormonal birth control to start working. It’s best not to have sex during this time. However, if you do, use a condom every time.

Ulipristal Acetate ECP

Take 30 mg (the full dose of ulipristal acetate) as soon as possible after unprotected sex. Ulipristal acetate ECP does not provide ongoing protection from pregnancy.

Do not start hormonal birth control right away—it may prevent ulipristal acetate from working.

  • you can start using your new or regular form of hormonal birth control (e.g., birth control pill, patch, ring, injection or POP) or have a hormonal IUD put in 5 days after taking ulipristal acetate.
  • after you start the birth control pill, patch, ring, or injection it will take 7 days to start working. This means you are not protected from pregnancy and must use a condom or abstinence for 12 days after taking ulipristal acetate. After you start the progestin-only pill (POP) it will take 2 days to start working. This means you are not protected from pregnancy and must use a condom or abstinence for 7 days after taking ulipristal acetate.

What are the side effects of ECPs?

You may have light bleeding or spotting for a few days. This is not your period. You might have a change in the timing of your next period and it might be early, on time, or late.

Other side effects may include:

  • upset stomach (nausea)
  • throwing up
  • pain in the abdomen
  • dizziness
  • headache
  • sore breasts
  • feeling more tired than normal

For More Information

  • Health Link – Health Advice 24/7: 811

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