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Whoops! Birth control you can use after sex

There are lots of reasons the best laid plans for using birth control don't work out...

by Sara Kennedy, MD, MPH

There are lots of reasons the best laid plans for using birth control don’t work out:

I completely forgot to take my pill (!)...

I just didn’t have enough money to pay for the ring this month...

The condom broke...

We’d had some drinks and got carried away...

Something like this happens to most of us at some point. If you’ve had unprotected sex for any reason, you can still prevent pregnancy by using emergency contraception (EC). Some types of EC are also called “the morning after pill,” and all EC prevents pregnancy after sex.

How does it work, and how well?

There are two forms of EC: pills and the copper intrauterine device (IUD). All methods of EC available on the U.S. market are safe and most have been used by women for more than 30 years. EC methods differ in terms of effectiveness and side effects.

Levonorgestrel EC pills

EC pills work by preventing or delaying ovulation and preventing sperm from fertilizing the egg. You can use EC right away or up to five days after sex. The sooner you use it, the better it works. There are a bunch of EC pills currently on the market in the U.S. that are made with the hormone levonorgestrel.

If you take EC pills within 24 hours after sex, they reduce your risk of pregnancy by up to 95%. Overall, they are 89% effective, meaning they prevent about 7 of 8 pregnancies that normally would have occurred.

There are several side effects that you may experience when using an EC pill. Some women get a headache, feel nauseous or throw up. Some women feel tired, have mild abdominal pain, or irregular bleeding. These side effects clear up after one or two days. Your next period may start earlier or later than normal, or be heavier or lighter than normal. Most women will have their period within a week of taking EC pills.**

The newest EC pill: ella

Another EC pill called ella contains a different type of drug called an anti-progestin (ulipristal acetate). Studies show that ella is safe and more effective than levonorgestrel EC pills at preventing pregnancy, especially when used 3 or more days after unprotected intercourse.

The copper-T IUD as EC

The copper IUD is a small, flexible intrauterine device (IUD) that can be inserted up to 5 days after unprotected sex to prevent pregnancy. When you use the IUD as EC, it works by preventing sperm from fertilizing the egg or by preventing the egg from implanting in the uterus. It is much more effective than EC pills; it reduces your risk of getting pregnant by over 99%. If you would like a hassle-free, highly effective method of birth control for the longer term, the copper IUD could be a good choice for EC.

Looking for EC now?

Levonorgestrel EC pills are available over-the-counter in the U.S. with no age restrictions. To get ella you will need a prescription, which the pharmacist may be able to write. Most pharmacies carry at least one kind of EC, but you may want to call ahead to check, or use our EC search tool. Depending on where you live and what health coverage you have, levonorgestrel EC pills range in price from free to $45 and ella ranges from free to $60.

If you’d like to use a copper-T IUD for EC, it must be inserted by a health care provider. If you have health insurance, there's a good chance it will be totally covered. Talk to someone at your local clinic or your health care provider for more information.

Next time...

EC pills aren’t recommended for repeated use because they’re not as effective as other birth control methods and they can be expensive. If you go to your local clinic or health care provider for EC pills, talk to them about other affordable, manageable birth control methods.

**Note: If you have packets of the pill, you may be able to use regular birth control pills as EC. Read "The Yuzpe method: Effective emergency contraception dating back to the ‘70s" to learn more.

Sara Kennedy, MD, MPH, is an Obstetrician/Gynecologist in Oakland, California. Originally from Pennsylvania, Sara has studied and lived around the world, including a residency at Northwestern University in Chicago and a master’s degree in Australia, where she met her husband! Sara is passionate about women's health, particularly helping women in vulnerable situations obtain the knowledge and resources they need in order to control their reproductive health.

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