Emergency Contraception (EC)
What is EC?
EC is emergency contraception. Also known as the “morning-after pill,” it is a pill you can take to prevent pregnancy after you’ve had sex.
There are several different types of EC pills available, including:
- Plan B One-Step®: 1 pill containing 1.5 mg of a progesterone-type drug called levonorgestrel
- Next Choice®: 2 pills containing 0.75 mg of levonorgestrel each
- ella®: one pill containing 30 mg of a progesterone receptor modulator called ulipristal acetate
A copper IUD (ParaGard®) is another form of emergency contraception.
When should I use EC?
- You had sex without using any type of birth control (this applies to cases of rape)
- You used a condom, but you think it broke or fell off during sex
- You used a diaphragm, and you noticed a hole in it
- You used a diaphragm, but not correctly
- You forgot to take your birth control pills for more than 1 day and had sex without other protection, like a condom and spermicide
- You had sex when you think your birth control method was not used 100 percent correctly
How effective is EC?
If EC is taken within 120 hours or 5 days of unprotected sex, you will reduce your risk of pregnancy by 80 to 95 percent if you use progesterone-only pills (Plan B One-Step® or Next Choice®) or ulipristal acetate (ella®). If you have a ParaGard® IUD placed within 5 days of unprotected sex, you will reduce your risk of pregnancy by more than 99 percent.
ECP is not 100 percent effective, but it is more effective the sooner it is used. When taken more than 72 hours after unprotected sex, ella® is more effective than Plan B One-Step® or Next Choice®. If you are overweight or obese, ella® is likely more effective than Plan B One-Step® or Next Choice®. The most effective form of EC is the ParaGard® IUD. Additionally, this form of EC prevents pregnancy for at least 10 years.
If you do become pregnant, EC pills will not affect the pregnancy. EC pills do not hurt the pregnancy or increase the chance of the pregnancy being abnormal. If you become pregnant after a ParaGard® IUD is placed for EC, call your doctor immediately to have the IUD removed.
How does EC work?
Emergency contraception pills work in different ways to help prevent pregnancy. They can delay ovulation, so that an egg is not released from the ovary for fertilization. They can thicken cervical mucus, making it more difficult for sperm to reach an egg. They also can change the lining of the uterus, so that it is harder for the pregnancy to take hold. The ParaGard® IUD also makes it more difficult for sperm to reach an egg, and may also change the lining of the uterus, making it harder for a pregnancy to take hold. Emergency contraception pills work to prevent pregnancy from occurring. EC pills will not harm an established pregnancy.
Who should not take EC?
You should not take EC if:
- you have had abnormal vaginal bleeding that has not been checked by a doctor
- you are allergic to the contents in the pills
You should not use a ParaGard® IUD for emergency contraception if:
- You have Wilson's Disease, or are allergic to copper
- You currently have an pelvic infection
Talk with your doctor if you have concerns.
How do I get EC?
If you don’t already have ECP at home, you will need to visit a drug store and buy them.
You can buy Plan B One-Step® or Next Choice® without a prescription if you are 17 years old or older. If you are younger than 17 years old, you will need a prescription from your doctor. Be sure to bring identification with you. Not all drug stores have EC pills. It may be stored behind the counter so you will need to ask for it at the pharmacy. If you wish to use the brand name, ella®, you will need a prescription from your doctor.
To get the ParaGard® IUD, you will need to see your doctor to have the IUD placed in the office.
If you vomit within 3 hours after taking EC, call your doctor. You may need to repeat the dose.
Are there side effects?
You may have some minor side effects that usually go away within a day or 2. If any of these minor side effects do not go away after 2 days, call your doctor.
Side effects can include:
- breast tenderness
- slight headache
Serious side effects are rare. Call your doctor right away if you:
- have severe lower belly (abdominal) pain
- have severe chest pain or shortness of breath
- cough up blood
- have a severe headache
- have severe leg pain (in the calf or thigh)
- have eye problems like blurred vision, flashing lights, or blindness
- Talk to your doctor about a follow-up appointment.
- Your period may start earlier or later than usual.
- If you do not get your period within the next 3 weeks, take a pregnancy test.
- If you are sexually active, use another type of birth control, like condoms and spermicide. EC will help prevent pregnancy only for sex that has already taken place within the past 120 hours (5 full days of 24 hours each). The ParaGard® IUD will prevent pregnancy with future intercourse.
- You may start a new pack of oral contraceptive pills beginning the next day after completing EC.
- If there’s even a small chance that you may have been exposed to STDs (sexually transmitted diseases), tell your doctor you want to be tested.
Use condoms the right way
To protect against STDs (sexually transmitted diseases), use condoms the right way.
Except for not having sex (abstinence), latex condoms give the best protection from many STDs including HIV, the virus that causes AIDS. Condoms are helpful only if used the right way. Use a latex condom every time you have sex. Always put the condom on before the penis touches or enters the vagina. If you or your partner has an allergy to latex, you should use a plastic (polyurethane) condom.
Important steps for using condoms the right way:
- Check the expiration date.
- Check the condition of the package.
- Open the package carefully.
- Hold the condom by the last 1/2 inch at the tip, and squeeze out the air.
- If the penis is uncircumcised, pull back the foreskin.
- Place the condom on the tip of the penis.
- Unroll the condom to the base of the penis. Smooth out any extra air.
- If you want or need to use lubricant on the condom, only use water-based lubricants like K-Y Jelly or Surgilube. Do not use oil-based lubricants. They can weaken condoms and cause them to break. Do not use petroleum jelly, cooking or vegetable oil, mineral or baby oil, massage oil, butter, margarine, oil-based creams, or lotions.
- Immediately after ejaculation, hold the condom firmly by the rim at the base of the penis, and pull the penis and condom out of the vagina together, while the penis is still erect.
- Look carefully at the condom to see if there is a hole in it. If you are not sure, fill the condom with water to see if it leaks.
- Discard the condom. Wrap it in tissue, and throw it away. Do not flush it down the toilet.
- Never re-use a condom.
For UPMC Mercy patients: UPMC Mercy, a Catholic hospital, abides by the Ethical and Religious Directives for Catholic Health Care Services, as determined by the United States Conference of Catholic Bishops. As such, UPMC Mercy neither endorses nor provides medical practices or procedures that contradict the moral teachings of the Roman Catholic Church.