Plan B and ella® morning after pills: How they work, common side effects and when each expires

photo of a woman taking a pill

With the uncertainty surrounding the recent Supreme Court ruling on Roe v. To overturn Wade, many women buy extra doses of birth control pills, also known as morning-after pills.

There are two types of emergency contraceptive pills:

Plan B –

  • Over the counter available without a prescription. Some pharmacies have it behind the counter, others have it on the shelf in the “family planning” section
  • Must be taken within 72 hours after unprotected sex
  • Works by blocking ovulation with a high dose of progesterone
  • Will only prevent pregnancy before ovulation has occurred

Ella® –

  • Requires a prescription from a doctor
  • Must be taken within five days after unprotected sex
  • Works by blocking the production of progesterone, which either stops ovulation or prevents an egg from attaching to the uterus
  • Will pregnancy occur both before ovulation has occurred and a little later in the cycle after the luteinizing hormone surge (the change in hormones that initiates ovulation)

Plan B and ella® side effects

Both pills can delay your period, or cause bleeding to come a little sooner than you expected. Both can cause nausea.

If you experience heavier than normal bleeding, contact a doctor.

Can emergency contraception cause infertility or ectopic pregnancies?

No, there is no evidence that birth control pills like Plan B and ella® cause infertility.

And no, they do not cause or increase the risk of an ectopic pregnancy. They actually reduce the risk of an ectopic pregnancy by preventing pregnancy in the first place.

When to get help from a doctor

Please contact your doctor, or call us to make an appointment with one of our OB-GYNs, if you:

  • Experience bleeding that soaks a pad every hour, lasting for two hours or longer
  • The severe abdominal pain. It could be a sign of an ectopic pregnancy
  • Struggling to hold the pills or feeling nauseous. A doctor may prescribe anti-nausea medication to help

If you have not had a period within three weeks of taking Plan B or ella®, take a pregnancy test. Contact your doctor if it is positive.

Emergency contraceptive pills have no adverse effect on a pregnancy if the pills do not prevent a pregnancy.

When emergency contraception expires, and where to buy it

Plan B has a shelf life of four years, and ella® has a shelf life of three years.

Contraceptive pills are sold at most pharmacies, including all of our Nebraska Medicine pharmacies:

If you are having trouble getting emergency contraceptive pills at your local pharmacy, try After entering your zip code, the website lists online stores that will send the pills to your door.

Do you have questions for an OB-GYN?

If you would like to talk to a doctor about birth control or any other women’s health topic, please call 800.922.0000 to schedule an appointment.

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