Plan B and Other Emergency Contraception: What To Know

This is known as the “morning-after-pill”, but currently many women seek emergency contraception (EC) even before having unprotected sex. The focus on EC – like Plan B – comes in the wake of SCOTUS ‘landmark abortion decision in June. The majority opinion stated that abortion is no longer protected under the constitution. And Judge Clarence Thomas alluded in his corresponding opinion that a woman’s right to contraception may also come up soon.

The ruling led to an increase in demand for EC pills. CVS, Rite help, and Amazon earlier this week limited Plan B purchases to three per customer. (CVS has since dropped the purchase limit.) And Walmart has limited its online orders.

Do not try to scare you. At this point, emergency contraception is still widely accessible. But you may have questions.

Among them: What are the different types of EC? And do I have to store it in my medicine cabinet now before I need it?

We have dr. Amy Addante, a board-certified OB-GYN with expertise in complex family planning, called on to help Skimm EC.

What is emergency contraception?

Something your doctor may also refer to as “postcoital contraception.” EC is for immediately after – or a few days after – unprotected sex. This is a backup option if your usual contraceptive method failed or if you did not have one in place. Hence the popular brand name: Plan B.

Would you recommend getting the morning-after pill before it is needed?

“I do not think it is a bad idea to have emergency contraception in your medicine cabinet,” said Dr. Addante said. Her recommendation: keep at least one dose on hand and then replace it after use. This is something to consider, especially if you will be using a prescription-morning-after-pill (like Ella). Because it requires planning. And “you never know when you will have a [contraceptive] method failure, ”said dr. Addante said.

Would you recommend supplementing the abortion pill?

At the moment, dr. Addante does not recommend that women get abortion pills before they are needed.

“I do not have a good answer about holding that stock,” she said. Mostly because abortion laws are evolving rapidly. And she does not want to tell anyone to get a medication abortion in a state where it may be illegal.

Now for a quick refresher on the abortion pill. That term is typically used to describe the two pills – often mifepristone and then misoprostol – that are used in a medication abortion. Mifepristone blocks the hormone progesterone needed to support a pregnancy. And misoprostol “causes the uterus to cramp and contract to help you pass the pregnancy,” said Dr. Addante said.

Keep in mind: Morning-after-pills (like Plan B) differ from abortion pills. Plan B does not disrupt an existing pregnancy. Instead, it blocks ovulation (the release of an egg) so that the pregnancy has a lower chance of happening in the first place.

What are the different types of emergency contraception?

There are pills and IUDs (intrauterine devices). And they are all largely considered safe. Let’s break them down.

Levonorgestrel, or Plan B

How it works

Levonorgestrel is a progestin, which is a class of synthetic hormones commonly used in contraceptive methods such as the pill. It works by stopping ovulation. This means that an egg is not released immediately, so it has a lower chance of uniting with sperm. Aka fertilizer. Reminder: Sperm can live in the reproductive tract for up to about five days (And note: If you have already started ovulating before taking Plan B, it may not help you.)

For whom it is best

Someone who has had unprotected sex and weighs less than 155 pounds. Because studies suggest that Plan B may be less effective for women over that weight. Things to know: Levonorgestrel is up to 89% effective in preventing pregnancy when used within three days of unprotected sex – which is the recommended time frame. Although it is the most effective, the sooner you take it.

How to access

You can usually get it at your local pharmacy. Look “in the way of things like pregnancy tests and condoms,” Dr Addante said. Sometimes it is kept behind the pharmacy counter. But note: You do not need a prescription to get Plan B.

Plan B can cost about $ 50 without insurance, but a generic version can be cheaper: about $ 11. Dr Addante said you can get levonorgestrel in drug stores and online through “cute names” other than Plan B (think: Restart, My Choice, Take Action). The EC can come as one or two pills. Just make sure it has the standard 1.5 total milligram levonorgestrel.

Ulipristal acetate, also known as Ella

How it works

Ulipristal acetate works similarly to levonorgestrel. This prevents ovulation and dilutes the uterine lining (so that an egg does not implant there). Things to know: Using hormonal contraceptives and Ella (a common ulipristal brand) at the same time can lower the effectiveness of both. So if you have to use Ella and are already on hormonal contraceptives – maybe you missed a dose – doctors recommend that you stop your hormonal contraceptives for about five days. And when you have sex, use a barrier contraception method.

For whom it is best

Ella is most effective for those weighing up to about 195 pounds. And like Plan B, it works better the sooner it is used after unprotected sex. But it can be used further than Plan B. Read: It is about 98% effective when taken within five days of unprotected sex.

How to access

Ella needs a prescription, which you can get from your doctor, “or anywhere that has reproductive health as part of care,” said dr. Addante said. She warned that not every pharmacy keeps Ella in stock, but clinics like Planned Parenthood usually do. In terms of price, Ella can be covered by your insurance. Or it could cost you about $ 50. Things to know: Dr. Addante said the shelf life of both Plan B and Ella is about four years (and the individual dose should have an expiration date on the box).

Yuzpe method

How it works

The Yuzpe method involves the out-of-label use of birth control pills. Yes, the same thing that people use monthly as their regular contraceptive. But this regimen for EC requires the taking of multiple birth control pills – specifically those containing both estrogen and progestin – in two doses, 12 hours apart. (And if you’re wondering: This method is named after a Dr. Albert Yuzpe. Because are not often women-centered health terms named after men?)

For whom it is best

Someone who does not have access to other forms of EC because it is generally the least effective EC method. Efficiency ranges from 56% to 86% when used within the first three days of unprotected sex, according to one review. It is considered safe when used as directed, and can be used for up to five days. In other news, if you regularly take birth control pills and miss one, here is what you need to know.

How to access

The pill – as usual birth control or taken as an I – needs a prescription. And you might get it online, from your doctor, or from a reproductive clinic. A doctor or pharmacist will be able to tell you how many pills to take (as well as which). Costs can range from free with insurance to about $ 50 per package, according to Planned parenting.

Copper or hormonal IUD

How it works

It is typically considered a long-acting reversible contraceptive option (LARC) – because it is. But for information: an IUD can also work as an EC. It thickens mucus in the cervix (to prevent sperm from entering), dilute the uterine lining (so that eggs do not get stuck), and sometimes suppress ovulation. Regarding the active ingredients: Copper is toxic to sperm. And the hormonal IUDs release levonorgestrel, the same hormone in Plan B.

For whom it is best

Someone who is looking for their contraceptive to stay put for a few years. Think: three to 10 years, depending on the type. Know that IUDs are over 99% effective in preventing pregnancy. And dr. Addante said that although the copper IUD has been used longer than an EC than the hormonal species have, the hormonal IUDs are “just as good.”

How to access

If you get an IUD, you need to schedule a doctor’s appointment to let it in. Which means if you use it as an EC, make sure your clinic offers appointments or something close to it the same day. (Dr. Addante previously worked at a clinic that offered one time slot per day for EC appointments.) IUDs are most effective as emergency contraception when inserted within five days after unprotected sex. They can be fully or partially covered by insurance, but can become expensive without it. See: Prices can go as high as $ 1,300.

If you’re wondering: The copper IUD is called Paragard. While hormonal IUDs sound like reality TV siblings: Mirena, Kyleena, Liletta and Skyla.

the skimm

EC is still legal and available in all 50 states. But because a number of people are concerned about the impact of the SCOTUS decision and are looking for early-morning pills, some stores have limited the quantity you can buy. All types of EC work differently and some may require you to schedule same day appointments to get a prescription or a procedure. It is therefore worthwhile to have a plan, whatever your situation and needs may be.

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Skimm’d by Carly Mallenbaum, Eleanor Goldberg, Anthony Rivas, Alicia Valenski and Niven McCall Mazza

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