A Complete Guide to Your Emergency Contraception Options
If you’ve recently had unprotected sex and feel worried about becoming pregnant, emergency contraception can help you safely prevent pregnancy.
Designed to prevent pregnancy after sex, emergency contraceptives use medication or specific substances to prevent your partner’s sperm from fertilizing an egg. Used correctly, emergency contraception is highly effective at preventing you from becoming pregnant.
There are three different types of emergency contraceptive: the morning-after pill, which comes in two different varieties (ulipristal acetate and levonorgestrel), and the copper IUD.
Below, we’ve explained how each of these options work. We’ve also provided scientific data on how effective each form of birth control is, potential side effects you might encounter with each option and other information you should be aware of.
The Morning-After Pill
The emergency contraceptive pill (more commonly known as the “morning-after pill”) is the most popular form of emergency contraceptive in the United States.
There are two different types of morning-after pill available. The first, Ella, contains an ingredient called ulipristal acetate. The second, sold as Plan B One-Step or in generic forms such as Next Choice One Dose and Take Action, contains a progestogen hormone called levonorgestrel.
Below, we’ve explained how each of these options works:
Ella (Ulipristal Acetate)
Ella is the newest, most effective morning-after pill. It contains an ingredient known as ulipristal acetate, which prevents you from becoming pregnant by changing the way your body produces certain sex hormones.
Ella is the most effective morning-after pill. Used properly, Ella reduces your risk of becoming pregnant after unprotected sex by about 85 percent. According to the World Health Organization, almost 99 percent of women who use Ella after unprotected sex do not become pregnant.
Ella is effective when used up to five days (120 hours) after the time you had sex. For example, if you had unprotected sex on a Monday, you can take Ella on Friday and still lower your risk of becoming pregnant by a significant amount.
Most morning-after pills are only fully effective if used within three days (72 hours) of the time you had unprotected sex. This makes Ella a good emergency contraceptive option if several days have passed since you had sexual contact with your partner.
Ella is significantly less effective as a form of emergency contraception if you have a body mass index (BMI) of 30 or higher. If you have a high BMI, other methods of emergency contraception, such as the copper IUD, are more effective at preventing pregnancy.
In some cases, Ella can interfere with your regular birth control pill and make it less effective than normal. Our Ella 101 guide explains why this happens and how you can avoid it.
Ease of Use
Ella is very easy to use. It consists of only one pill, which you can take with or without food at any time within five days of the time you had unprotected sex. Unlike some older emergency contraceptives, you do not need to take a second dose of Ella.
Ease of Purchase
Ella is a prescription medication, meaning you’ll need to see your doctor before you can use it as a form of emergency contraception.
However, we offer Ella online. You can speak discreetly with one of our in-house doctors to learn more about whether Ella is a viable option for you — without needing to talk to your family doctor or regular healthcare provider.
In some states, a pharmacist might be able to prescribe you Ella directly. Our Ella FAQ contains a list of states in which pharmacists are permitted to directly prescribe Ella and other emergency contraceptives to patients.
You do not need to have recently had unprotected sex to purchase Ella. If you’re concerned about pregnancy, it can be a good option to get a prescription for Ella before you have sex, then keep it in a safe location as a ready-to-use contraceptive for emergencies.
Side Effects and Safety
Ella is a safe, effective medication with no serious side effects. The most common side effects are headaches, nausea, abdominal discomfort, fatigue and dizziness. These are typically mild and rarely cause anything other than minor discomfort and inconvenience.
Because of Ella’s effects on your hormones, your period might be slightly early or late after you use Ella. Overall, Ella is very unlikely to cause anything other than mild, tolerable side effects.
Our guide to the side effects of the morning-after pill goes into more detail on the side effects of Ella, as well as alternative emergency contraception options such as Plan B One-Step.
Ella is the most effective morning-after pill, especially if more than three days have passed since you had unprotected sex. With a high effectiveness rate and no major side effects, Ella is a safe, effective and convenient way to prevent pregnancy in emergencies.
Plan B One-Step (Levonorgestrel)
Morning-after pills containing the hormone levonorgestrel are also used to prevent pregnancy after unprotected sex. These pills are available under several brand names, the most common of which is Plan B One-Step.
Other common brands of levonorgestrel-based emergency contraception include My Way, Take Action and AfterPill. For simplicity’s sake, we’ve used “Plan B” as a general term for all pills of this type below.
Plan B is slightly less effective at preventing pregnancy than Ella. Used properly, it lowers your risk of becoming pregnant after unprotected sex by 75 to 89 percent. Between 97.9 percent and 98.8 percent of women who use Plan B according to the medication’s instructions do not become pregnant.
Plan B is most effective when used up to three days (72 hours) after the time you had sex. It’s best to take Plan B as soon as possible. This gives the medication the highest chance of being fully effective as an emergency contraceptive.
Because Plan B needs to be taken closer to the time you had sex than Ella, it’s not the preferred option if several days have passed since you had unprotected sex.
Plan B is significantly less effective as a form of emergency contraception if you have a BMI of 30 or higher. If your BMI is greater than 30, the copper IUD — which is not affected by body weight — will provide more effective protection against pregnancy.
Like Ella, the active ingredient in Plan B can interfere with your birth control pill. Our guide to the side effects of the morning-after pill explains why this happens, as well as the best ways to keep yourself protected after using Plan B.
Ease of Use
Older versions of Plan B consisted of one pill to be taken within 72 hours of sex, plus another pill to be taken 12 hours later.
The current version of Plan B, called Plan B One-Step, only consists of a single pill taken within 72 hours after unprotected sex. Plan B One-Step should be taken with food.
Although Plan B can be used within 72 hours of the time you had unprotected sex, it’s best to take it as early as possible.
Ease of Purchase
Plan B is not a prescription medication, meaning you can freely buy it from a pharmacy without having to meet with your doctor if you’re 17 years of age or older.
You do not need to be pregnant to purchase Plan B. People of any gender can purchase Plan B from a pharmacy. This means that it’s okay for your partner or friend to buy Plan B for you if you feel uncomfortable or embarrassed about asking for an emergency contraceptive.
Just like with Ella, it’s totally alright to buy Plan B before you need it and keep it in a safe place for use in an emergency.
Side Effects and Safety
Like Ella, Plan B is a safe medication with few side effects. The most common side effects of Plan B are nausea, tiredness, dizziness and abdominal cramps. These are typically mild and rarely last for longer than a few hours after using the medication.
Of the millions of women who’ve used Plan B, none have reported any significant side effects that affected their health.
Levonorgestrel, the progestogen hormone in Plan B, can affect your period. It’s common for your period to start earlier or later than normal after you use Plan B. Many women also get a lighter or heavier period after using Plan B — which typically only affects one period.
The levonorgestrel in Plan B can also cause certain temporary side effects, such as soreness and tenderness in your breasts. Like the other side effects of Plan B, this is temporary and will pass on its own as the level of levonorgestrel in your body gradually decreases.
Overall, the side effects of Plan B are rare and mild. Our guide to the morning-after pill’s side effects goes into more detail on how and why they happen, as well as what you can do if you experience side effects after using Plan B.
The Copper IUD
The copper intrauterine device (IUD) is a small, T-shaped device that’s inserted into the uterus in order to prevent pregnancy. It contains a small amount of copper wire, which is toxic to both eggs and sperm.
In the United States, the copper IUD is most commonly known as the Paragard IUD. It’s both a form of emergency contraception and a form of long-term contraception, with the typical copper IUD lasting for about 12 years after it’s inserted.
The copper IUD is by far the most effective form of emergency contraception. Inserted correctly by a doctor or nurse, it’s more than 99.9 percent effective at preventing pregnancy after unprotected sex.
You’ll need to get the copper IUD placed inside your uterus within five days (120 hours) of the time you had unprotected sex in order for it to be fully effective. This means you have roughly the same amount of time to get a copper IUD as you would to take the Ella morning-after pill.
The copper IUD needs to be fitted by a doctor or nurse. If you don’t have enough time to get it inserted by a medical professional within 120 hours of the time you have unprotected sex, use Ella or Plan B instead.
One advantage of the copper IUD is that it’s effective regardless of your weight. While Ella and Plan B are less effective for women with a BMI of 30 or higher, the copper IUD is fully effective for women of any size.
Ease of Use
Overall, the copper IUD is very effective. However, it’s also the most difficult form of emergency birth control to use, at least in the short term.
While Ella and Plan B are available as easy-to-use pills, the copper IUD is a medical device that needs to be inserted into your uterus by a qualified health professional. This means you’ll need to schedule an appointment to have it fitted as soon as you can after having unprotected sex.
The actual process of fitting the copper IUD is quick and simple. Most doctors and nurses can fit the copper IUD in five to 10 minutes. Aside from some minor cramps and discomfort on the day the IUD is placed, most women don’t report any significant pain or discomfort from the IUD.
Ease of Purchase
The copper IUD is a medical device that needs to be fitted into your uterus by an experienced medical professional, meaning you can’t order it online or purchase it over the counter at your local pharmacy like Ella or Plan B One-Step.
To have a copper IUD fitted, you’ll need to schedule an appointment with your doctor. If you’d prefer not to discuss emergency contraception options with your doctor, you can contact your local family planning clinic or Planned Parenthood center.
The copper IUD needs to be inserted within five days after having unprotected sex in order to be effective. Contact your doctor or family planning clinic as quickly as possible after having unprotected sex in order to make sure yours can be fitted in time.
If it’s not possible to have the copper IUD fitted within five days, use Ella or Plan B One-Step instead of waiting.
Just like with Ella and Plan B, you can get the copper IUD placed even if you haven’t recently had unprotected sex. This means that you’ll be protected in the future and won’t need to use emergency contraceptives such as Ella or Plan B after unprotected sex.
Side Effects and Safety
The copper IUD is a safe and effective form of contraception that’s used by millions of women around the world without any significant side effects.
The most common side effects of the copper IUD are mild pain and discomfort during the initial fitting of the IUD. This could persist for several days after the IUD is fitted. Some women report cramps, backaches and other mild pain for several days to a week after the IUD is inserted.
These symptoms can be treated using over-the-counter pain medication, such as Ibuprofen or Paracetamol.
The copper IUD might affect your period. Some women who use the copper IUD for long-term contraception report heavier-than-normal periods, as well as spotting between periods. It’s also possible for the IUD to contribute to premenstrual syndrome (PMS) symptoms such as cramps.
Most of the time, any side effects of the copper IUD are temporary and disappear in three to six months after the device is fitted.
Other Forms of Emergency Contraception
In addition to morning-after pills like Ella and Plan B and the copper IUD, there are several other methods of emergency contraception. The most common of these is the Yuzpe regimen, which involves using several combined oral contraceptives (birth control pills) to prevent pregnancy.
The Yuzpe Regimen
The Yuzpe regimen is one of the oldest methods of emergency contraception. It involves using several doses of a combined birth control pill (significantly higher than the typical dose) within a short period of time after unprotected sex.
This method of emergency contraception is significantly less effective than Ella, Plan B or the copper IUD and is not recommended. The failure rate of the Yuzpe regimen is high, meaning you’re more likely to become pregnant with this than with any of the options listed above.
The Yuzpe regimen is also significantly more likely to result in side effects than Ella, Plan B or the copper IUD.
Used properly, options such as Ella, Plan B and the copper IUD are all effective at reducing your risk of becoming pregnant after unprotected sex.
Since the window in which emergency contraception works is short, it’s important to take action as as soon as possible following unprotected sex. This means using Ella or the copper IUD in five days or less, or levonorgestrel-based contraception like Plan B within 72 hours.
Learn More About Emergency Contraception
Concerned about pregnancy? While emergency contraception isn’t designed for regular use, it can provide the protection you need when you need it if you forget to take your birth control pill or use a condom.
Our guide to Ella goes into more detail on how Ella, the most effective morning-after pill, works to prevent you from becoming pregnant. You can also learn more about the morning-after pill in our complete guide to emergency contraceptive side effects.