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Here's What Happens If You Take The Morning-After Pill All The Time

Let's get to the bottom of this, once and for all.

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The morning-after pill is a form of emergency contraception that can prevent pregnancy when taken after having unprotected sex.

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It comes in a few different forms, but the morning-after pill most often refers to Plan B One-Step (and generics like Next Choice One Dose), which can be purchased over the counter. It's a single pill with a high dose of levonorgestrel, the same progestin hormone found in many birth control pills, and it can be used up to 72 hours (three days) after unprotected sex.

Another pill option is Ella, or ulipristal acetate, which can be used up to 120 hours (five days) after unprotected sex, but it requires a prescription. Both Plan B and Ella primarily work by delaying ovulation, and they may in some cases also work by preventing a fertilized egg from implanting in the uterus.

Although we'll focus on the pills in this article, it's worth mentioning that the copper IUD can also be used as an emergency contraceptive. It's extremely effective if inserted within five days of unprotected sex and offers pregnancy protection for up to 10 years.

FYI: The morning-after pill is not the same as the abortion pill.

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Emergency contraception pills like Plan B and Ella will not terminate an existing pregnancy. It's not the same as the abortion pill, otherwise known as a medical abortion, where a person takes a combination of mifepristone and misoprostol to terminate an early pregnancy.

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Since the morning-after pill is really meant for emergencies, you might be wondering if it's harmful to take it too often.

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BuzzFeed Health reached out to two experts to find out: Dr. Alyssa Dweck, board-certified OB-GYN, author of The Complete A to Z for Your V; and Dr. Lauren Streicher, associate clinical professor of obstetrics and gynecology at Northwestern University’s medical school, and author of Sex Rx.

First let's start with Ella, the prescription-only morning-after pill. This one should not be taken more than once per menstrual cycle.

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Ella has a different active ingredient than Plan B, and according to its website, it shouldn't be taken more than once per menstrual cycle. "I would say repeated use of Ella has not been well-studied and is not recommended," says Streicher.

Additionally, using Ella with hormonal birth control pills can reduce the effectiveness of both preventing pregnancy, so you should wait at least five days after taking Ella to resume your birth control.

But because Ella requires a doctor's visit and prescription, you'd probably have to jump through a lot of hoops to take it frequently. So aside from it not being recommended, repeated use of Ella would also take up a lot of your time and money. So...just don't do it.

On the other hand, taking Plan B is basically like taking a ton of birth control at once. And it isn't going to hurt you if you take it multiple times.

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Actually, the morning-after pill is even safer and more tolerable than taking a ton of birth control because it only contains levonorgestrel, whereas most birth control pills also have estrogen. "In the past, women who needed emergency contraception would just take a super-high dose of birth control, but the estrogen just caused a lot of nausea and vomiting," Dweck tells BuzzFeed Health.

So they made one pill with fewer side effects but enough hormones to still prevent pregnancy. "It's very safe and well-tolerated, even in women who aren't able to take some birth control pills because of clotting disorders," says Dweck.

Even if you take it while you're already on hormonal birth control — for example, after missing more than three pills and having unprotected sex — it's still safe. "It’s not going to harm you — it's really just a little extra progesterone on top of the birth control," Dweck says.

Obviously, though, taking such a high dose of hormones could cause irregular bleeding and mess with your menstrual cycle — which isn't ideal.

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"About 16% of women report side effects like nausea, vomiting, or irregular bleeding," says Dweck. But the main downside is that it can cause a lot of menstrual irregularity. Depending on how often you take the morning-after pill, it can throw off your cycle for weeks or even months, says Streicher. And a messed-up cycle can make it harder to prevent pregnancy if you aren't using another method like condoms.

"You never know for sure when you are ovulating, even less so if you have taken a big dose of hormones that may interfere with your normal cycle," Streicher says. So you should always remember to use a backup barrier method when you're having sex after taking emergency contraception.

Plus, it's a lot of unnecessary hormones when you just could be on a more reliable, low-dose method. For instance, if you have unprotected sex 20 times in one month (and take Plan B 20 times in one month), that's a lot of progestin to take as opposed to taking a small, regular dose every day — not to mention a lot of spotting or bleeding.

But there's no evidence that repeated use of Plan B will cause permanent damage to your reproductive organs or cause infertility.

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"It's a very safe drug, and taking it multiple times won't kill you or cause any permanent damage, infertility, or even blood clots," Dweck says. So no, there are really no long-term implications of regularly using the morning-after pill.

"We know that hormones in emergency contraceptives, which are just a different dosage of the same ones found in birth control pills, have no impact on fertility whatsoever," says Streicher. So it's best not to panic or stress if you've taken it many times or point to that as a cause of any fertility issues down the road.

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So why do the experts still advise against using Plan B regularly? Because it simply isn't as effective as other birth control methods.

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Unlike more reliable methods, the morning-after pill's effectiveness decreases the longer you wait to take it after unprotected sex, says Streicher. According to Plan B's prescribing information, it helps prevent nearly 7 out of 8 potential pregnancies (about 87%), but other studies on levonorgestrel have found the effectiveness can vary from 52–100%.

Compared with the efficacy of other birth control methods, this isn't really your best bet for pregnancy prevention. For instance, long-acting methods like the IUD and implant are both over 99% effective. Combined birth control pills are also over 99% effective with perfect use or 91% effective with typical use.

"So you really have a higher chance of getting pregnant if the morning-after pill is your primary birth control," says Dweck.

What can increase your risk of infertility is all the unprotected (so, without a condom) sex you have before taking the morning-after pill.

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"Frequent unprotected sex means you're more likely to get an STI, and we know that untreated STIs impact fertility and ovarian function," says Streicher. And it's easy for STIs to go untreated when many of them have no symptoms at all.

The number one cause of infertility is age, but the number one preventable cause of infertility is actually untreated chlamydia — which can also cause pelvic inflammatory disease (PID), potentially fatal ectopic pregnancy, and chronic pelvic pain.

"Even if taking emergency contraception frequently doesn't cause harm, it could still technically be harmful if it means you're having a lot of unprotected sex and exposing yourself to STIs," Dweck says.

Finally, emergency contraception can get pricey — up to $50 a pop — so frequent use will cost you a lot of money.

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"It's a very, very expensive way to provide contraception and there are so many better, cheaper options," says Streicher. For instance, Plan B sold over the counter at most pharmacies and grocery stores usually costs about $50 per pill, with generics usually priced around $40 (but we also recently found it on Seamless for almost $70).

So depending on how often you take it, you could be spending hundreds of dollars each month, and that's for a product that's less effective than other options.

There's definitely a time and place for the morning-after pill, but it's not the most effective or affordable option for reliable birth control.

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The morning-after pill is an amazing drug, Dweck says, and it exists because there are situations where it is necessary or the right option for some women.

"But it still shouldn't be used on a regular basis, because we have so many reliable forms of birth control that cause fewer side effects, cost less, and that are more effective at preventing pregnancy," Dweck says.

If you're on birth control pills but still take emergency contraception occasionally because you missed a few pills or your pack looks like a game of Connect 4, you might want to consider a long-acting method like the IUD or implant.

Remember, the ~right~ birth control option will vary from person to person, so talk to your doctor about your unique lifestyle and contraceptive needs, and they'll help you find something that works for you.

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