Health

16 Things No One Tells You About The Morning-After Pill

Take that, broken condom.

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1. Emergency contraception comes in a few different forms.

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You probably know it best as the morning-after pill (like Plan B One-Step, Next Choice, Ella, etc.) but your other options are the copper IUD or a high dose of regular birth control pills — but more on all these later.

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

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Emergency contraception delays ovulation (when an egg is released from your ovary and could maybe get fertilized by sperm) and may, in some cases, prevent a fertilized egg from implanting in your uterine lining. What it won’t do is end an existing pregnancy. The abortion pill, or Mifeprex, terminates an early pregnancy. “You couldn’t take enough levonorgestrel [Plan B One-Step] to cause an abortion,” James Trussell, Ph.D., senior research demographer of the Office of Population Research at Princeton University, tells BuzzFeed Life. “It’s not physiologically capable of doing so.”

3. You don't need to take it the morning after unprotected sex. You can take it that night or even a few days later.

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The labeling on Plan B One-Step and its generics say that you should take it within 72 hours of unprotected sex, and that it’s most effective the sooner you take it. That’s a solid suggestion, but more recent research found that it might be just as effective on days one through four. And it’s possible that it might still be effective on day five, depending on where you are in your cycle, Dr. Alyssa Dweck, certified OB-GYN, co-author of V Is for Vagina, tells BuzzFeed Life. Obviously you should never wait to take emergency contraception, says Trussell, but if you think you’re too late, call your doctor or a pharmacist to ask about your options. You might still have some time.

4. The most effective form of emergency contraception isn’t a pill.

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It’s actually the copper IUD, which has the added bonus of offering pregnancy protection for up to 10 years. If inserted within five days of unprotected sex, it’s extremely effective at preventing pregnancy (in a review of 42 studies between 1979 and 2011, the pregnancy rate was just 0.1% when women used an IUD for emergency contraception), says Trussell.

Science still isn’t sure exactly how it works, but the really high effectiveness implies that it’s probably a combination of preventing fertilization and preventing a fertilized egg from implanting in the uterine wall. The hormonal IUD might work too, but that research is still being done, says Trussell. Of course, use this option only if you actually want the copper IUD (because now you’re stuck with it), and talk to your doctor to make sure you’re a good candidate.

5. You might feel absolutely fine after you take the morning-after pill.

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The most common side effects are nausea and some spotting (less common effects are vomiting, fatigue, headache, breast soreness, dizziness, and cramps). But you might not feel any side effects at all. For most people, both pills are really well tolerated, says Dweck.

6. But your period could be a little ridiculous afterward.

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It should still come within a week of its normally scheduled arrival, but it might be earlier or later than normal, says Dweck. If it’s more than a week late, take a pregnancy test.

7. You can get emergency contraception without any prescription or ID.

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Plan B One-Step and its generic forms (any emergency contraception with the main ingredient levonorgestrel) are now available over the counter for all ages. Whether they’re on the shelves or behind the cash register depends on the pharmacy (some stores lock them up to prevent shoplifting), but you no longer need to show an ID or prove you’re over 17 to buy this kind.

8. There’s also a prescription-only pill option if you have more time/need more time.

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Another option, Ella, can prevent pregnancy when taken up to five days after sex, but you need a prescription to get it. This pill’s ingredient is ulipristal acetate, and it can delay ovulation with the same effectiveness on days one through five. There’s also research that this option works closer to the time that ovulation would occur, so it can buy you some extra time, says Trussell.

9. And as a last resort, you could use SOME versions of regular old birth control pills.

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Maybe you’re already on the pill but you missed like five of them this month. Depending on which pill you use, you might be able to just take them instead of buying Plan B, BUT this doesn’t work for all pills, says Dweck. Look at this chart to see if there are instructions for your prescription. If you go this route, make sure to call your doctor ASAP to let them know you’ll need a new prescription for next month. Also, you’re more likely to experience nausea and vomiting with this method, since the birth control pills contain estrogen (which you won’t find in regular morning-after pills).

10. You can take it even if you’re on another form of birth control and you effed it up.

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Maybe you forgot a few birth control pills or didn’t replace your ring or patch on time. Or maybe the condom ripped in half like those cheap little water balloons. You can still take the morning-after pill, says Dweck.

11. You can keep the pill version on hand like condoms.

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You know how it never seems to rain when you actually remember to bring your umbrella? Well, maybe you won’t ever need Plan B if you have it tucked in your nightstand. If you do need it, you’ll be really glad you don’t have to trek to the drugstore or doctor’s office to get it — especially since timing is so important. And definitely consider packing it if you’ll be traveling and might not be able to get to a doctor. Just pay attention to expiration dates on the package insert to make sure it’s still effective.

12. You might be able to get your insurance to pay for it.

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If your insurance covers birth control prescriptions without a co-pay, it should cover the full cost of any FDA-approved method — including emergency contraception. That said, you’ll probably have to get a prescription for your company to cover it, so this is only helpful if you know you can see your doctor ASAP. If you think you might EVER need the morning-after pill, call your insurance company now to find out their policy, so you’re not stuck on hold for an hour when you actually need it. If it'll be covered (even at a reduced cost), it might be worth getting and filling the prescription now, just so you have it in case of an emergency.

13. Your weight probably doesn’t have anything to do with its effectiveness.

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There were rumors going around that the morning-after pills were less effective in women over 165 pounds and basically useless in women over 176 pounds. This was based on new labeling information on Norlevo, the European version of Plan B One-Step, which happened in late 2013. But in 2014, the European Medicines Agency conducted a review and determined that there wasn’t enough evidence to suggest that this was true, and Norlevo got rid of the extra warning label.

14. Taking the morning-after pill won’t protect you from more unprotected sex.

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So you slipped up once and took the morning after pill immediately. Can you...hypothetically…have more sex and still be protected? So far no studies have looked at this, so Trussell suggests not tempting fate. Is it possible that it could still protect you if have unprotected sex again 10 minutes after taking it? Maybe. But there’s really no research right now to back that up. Instead of speculating, just settle on a reliable method of birth control instead. Also, condoms, because emergency contraception does NOT protect against STIs.

15. You can take it again and again and again, but you shouldn't use it in place of regular birth control.

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You can even take it twice in one month if you need to, says Dweck. There’s no research to show that it has any long-term effects on your health or fertility. “Repeat use is not a safety issue at all,” says Trussell. That said, it’s definitely not as effective as having a reliable, continuous method of birth control (like the pill, ring, patch, implant, IUD, shot, condoms, etc.). Plus, it’s way more expensive when you’re talking about cost per sex. And again, it does NOT protect against any STIs — condoms are the only way to limit your exposure to those.

16. They’re not totally effective, so you might still get pregnant.

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No form of emergency contraception is 100% effective (though the copper IUD comes close). So if your period is more than a week late, you might be pregnant. It’s hard to say exactly how effective each method actually is, especially since placebo-controlled studies would be super unethical here. But here’s what we do know about the effectiveness of each:

Copper IUD: When inserted within five days of unprotected sex, it can reduce your risk of getting pregnant by 99%, according to research.

Plan B One-Step/levonorgestrel: According to Plan B One-Step’s prescribing information, 7 out of every 8 women who would have gotten pregnant will not get pregnant if they take this method correctly. And studies on levonorgestrel emergency contraception found effectiveness rates anywhere from 52% to 100%, according to an academic review of the research by Trussell and his colleagues.

Ella/ulipristal acetate: Studies have shown effectiveness rates anywhere from 62% to 85%, according to Trussell. And in studies comparing it to levonorgestrel, it was found to be more effective: When taken within 24 hours of unprotected sex, the chances of getting pregnant were 65% lower than if they took levonorgestrel, and the risk was 42% lower when taken within 72 hours.

Combined oral contraceptives (as long as they’re on this list): Using certain kinds of regular birth control pills as emergency contraception can reduce your chances of getting pregnant by about 75%, according to Trussell.

Mifeprex is the medication used to nonsurgically terminate an early pregnancy. An earlier version of this article only referred to mifepristone (the ingredient in Mifeprex) which is often used in conjunction with misoprostol.