Birth Control Pills as Emergency
Contraception

Using birth control pills as emergency contraception prevents pregnancy in up to 89 percent of cases.

Only certain pills should be used as emergency contraception

Emergency contraception works to prevent pregnancy following unprotected sex. Also referred to as "morning after contraception" or "the morning after pill," emergency contraception pills are taken immediately after sex or at anytime within five days following sexual intercourse. They are not 100 percent effective, but they can significantly reduce the likelihood of a pregnancy occurring.

Emergency contraception works in several ways, depending on where a woman is in her menstrual cycle. When taken prior to ovulation, they may prevent or delay the release of an egg. They may also prevent fertilization from taking place or interfere with implantation after fertilization occurs.

Neither type of emergency contraception pill available in the United States will end an established pregnancy. They do not cause an abortion, but instead prevent pregnancy from occurring.

There are currently four types of emergency contraception pills on the market, but only two are available in the United States.

Progestin-Only Pills: These pills contain a type of progestin hormone called levonorgestrel, and they help prevent pregnancy in approximately 89 percent of cases. Progestin-only emergency contraception is sold in the United States under three names: Plan B, Plan B One-Step, and Next Choice. Next Choice is only available by prescription.

Combined Pills: Combined emergency contraceptive pills contain both estrogen and progestin and are effective at preventing pregnancy in about 75 percent of women. In most cases, women can use daily birth control pills as emergency contraception. However, each dose must contain a minimum of 100 mcg of estrogen and .5 mg of progestin. Using the combined pills in high enough doses to prevent pregnancy may cause severe nausea and vomiting. To reduce the risk of these negative side effects, please contact your healthcare provider to learn more about the proper use of birth control bills as emergency contraception.

Ulipristal Acetate: This medication, also known as CDB-2914, is currently available only in Europe. Marketed under the name EllaOne, the pills are well tolerated and highly effective.

Mifepristone: This medication, sold only in China for emergency contraception, has proven to very effective at preventing pregnancy following unprotected intercourse. Because the pill contains only small doses of mifepristone, it causes few or no side effects in most women. This is also used by physicians in the United States in conjunction with other medications for early-term abortions.

No long-term side effects are associated with progestin-only or combined hormonal pills. For many women, the side effects of combined pills are more severe than those caused by progestin-only pills.

Using emergency contraceptive pills may cause side effects similar to PMS symptoms.

Common side effects include:

• Nausea, with or without vomiting
• Headaches
• Fatigue
• Dizziness
• Lower abdominal pain
• Breast tenderness
• Unexpected spotting or bleeding

Side effects are temporary and typically disappear within a few days. Some women may experience a late or early period after using emergency contraception.

Rarely, hormonal emergency contraception may cause severe nausea and vomiting. Women can reduce the chance of developing this side effect by taking an over-the-counter anti-nausea medication at least one hour before using emergency contraception.

Serious side effects and complications are extremely rare, but any medication may potentially cause an adverse reaction.

The following symptoms may indicate a serious condition that requires prompt medical evaluation and treatment:

• Severe pain in the leg or arm
• Chest pain, shortness of breath, or cough
• Blurred vision or difficulty speaking
• Severe abdominal cramping or pain
• Severe headaches, weakness, numbness, or dizziness
• Jaundice (yellow eyes, skin, or mucus membranes)

The only effective alternative to emergency contraception pills is the use of a Copper-T IUD. The Copper-T IUD reduces the risk of pregnancy following unprotected intercourse by more than 99 percent when inserted by a trained physician within 5 days after sex. Once inserted into the uterus, the Copper-T IUD can remain in place for as long as ten years to prevent future pregnancies.

You should discuss the benefits and risks of emergency contraception with your doctor before use.

• To determine if you can use your current birth control pills as emergency contraception, visit the Princeton University, Office of Population Research website.

• The U.S. Department of Health & Human Services, Office on Women's Health offers excellent information on emergency contraception.

• Planned Parenthood provides information on obtaining Plan B, and assists women attempting to purchase emergency contraception.

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