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Olivia Ware - October 1, 2020

Preparing for Plan B: Emergency Contraceptives Explained

What to Know About Emergency Contraceptives

Ever wake up in the morning and realize there are a couple more pills in your birth control pack than are supposed to be in there? Did I miss a pill (or two) recently? Forgetting to take a pill is common, but it ALWAYS makes me nervous—especially if I had unprotected sex recently.

When it comes to pregnancy, feeling anything less than protected is alarming. Most women know that skipping even one pill can increase their chances of getting pregnant. Thankfully, there are options if you have unprotected sex, or have reason to suspect contraceptive failure, e.g. the dreaded “broken condom.”  

The two most popular forms of emergency contraception, commonly known as “the morning-after pill,” are Plan B and Ella. These options are used as a last line of defense to prevent pregnancy after unprotected sex, or when other forms of birth control have failed. Plan B and Ella work differently, so we’ll discuss the main differences below.

What is Plan B?

Plan B is a pill taken after unprotected sex to prevent unwanted pregnancy. The active ingredient in Plan B is a hormone called levonorgestrel. To increase effectiveness, Plan B should be taken as soon as possible, but no later than 3 days (72 hours) after contraceptive failure. Levonorgestrel is available under many labels, Plan B being one of the more universally recognizable. Others include: 

  • Take Action 

  • My Way 

  • Option-2

  • Next Choice

To keep things simple, levonorgestrel will be referred to as Plan B for the scope of this article. The same information pertains to levonorgestrel pills marketed under any name.

Where Can I get Plan B?

Plan B is available online without a prescription, which means you can order it online and have it delivered to your home to keep on hand in case you need it. Ordering Plan B ahead of time increases its effectiveness by allowing you to take it immediately following unprotected sex. You may also buy Plan B over the counter at a drugstore, however due to certain state contraception laws, Plan B isn't always stocked and available. Ordering Plan B online ensures you have it before you actually need it—if you need emergency contraception due to recent unprotected sex, then talk to a doctor about ella ASAP.

What Does Plan B Cost?

The cost of Plan B varies depending on the brand label and where you buy it. Typically, levonorgestrel pills range from $20-65.

With wisp, you can buy Plan B emergency contraception online for $17. Your meds are packaged by a US pharmacy and shipped discreetly to your home a few days after ordering.

How Does Plan B Work? 

Plan B and other emergency contraceptives prevent pregnancy before it begins. They do not terminate an existing pregnancy–it is not the same thing as an abortion pill. Plan B does not protect against STIs and is not as effective as standard methods of birth control.

Ok but, what exactly does Plan B do? Plan B stops an egg from being released, preventing fertilization. It works similarly to standard birth control pills, but at a much higher dose. 

All medications have side effects that impact users differently. Plan B is no exception.

Common Plan B side effects include:

  • Nausea

  • Vomiting

  • Fatigue

  • Headache

  • Abdominal pain

  • Irregular bleeding

  • Breast tenderness

How long can I wait to take Plan B? 

Though Plan B can be taken up to three days (72 hours) after having unprotected sex, it is recommended to take Plan B as soon as possible. The sooner Plan B is taken after unprotected sex, the more effective it will be. 

If this sounds like a headache, it might be a good idea to purchase Plan B ahead of time. That way, if something unexpected happens, you won’t have to sweat the details in the moment. Being prepared is never a bad thing. 

Are There Alternatives to Plan B? 

Yes. Ultimately, there are three types of emergency contraception. Each has its benefits and drawbacks depending on the user. There are two kinds taken orally (as a pill) and one that is slightly more invasive, requiring insertion by a medical professional.

What is Ella?

Ella is a prescription-only emergency contraceptive that is taken after unprotected sex to prevent unwanted pregnancy. Ella (ulipristal acetate) is a progesterone agonist/antagonist and is not intended for routine use as birth control. For maximum effectiveness, ella should be taken as soon as possible, but no later than 5 days (120 hours) after contraceptive failure.

How Much Does Ella Cost?

Ella is available generically or by brand name and varies in price. Wisp connects you with a doctor who, if safe and appropriate, can prescribe you ella for $22. Once a doctor reviews your medical form, they'll call in the prescription to a local pharmacy for you to pick up. If you have health insurance, it may be possible to bill the remaining cost of prescription.

How Long Can I Wait To Take Ella?

Ella works differently than Plan B and therefore can be taken up to 5 days following contraceptive failure. Despite this, it is recommended you still take ella as soon as possible. If you just recently experienced contraceptive failure, it is recommended you take ella and not Plan B.

How Does Ella Work?

Ella is works by stopping (or delaying) the release of the egg from an ovary. It's also believed that ella works by stopping implantation to the uterus.

The Three Forms of Emergency Contraception:

  • Plan B (levonorgestrel pill)

  • ella (ulipristal acetate pill)

  • Copper-T IUD

First, let’s compare the two types of ECs taken orally (in pill form).  Ella and Plan B work in roughly the same way, but the active ingredient in ella is ulipristal acetate, not levonorgestrel. 

What is the Difference Between Plan B and ella? 

 Plan B

  • Sold over the counter

  • The longer you wait, the less effective it will be (recommended within 72 hours of unprotected sex)

  • Less effective for people over 165 pounds or who have a BMI over 25

ella

  • Requires a prescription

  • Will be equally effective up to 5 days after unprotected sex

  • Less effective for people over 195 lbs or who have a BMI over 35

  • Not recommended if currently taking hormonal birth control pills or breastfeeding

Ella is consistently more effective over a longer period (up to 5 days) and has a higher weight threshold. While totally lame that both kinds of pills have weight limitations impacting their effectiveness, body weight is a factor that influences the effectiveness of both drugs—here again, ella is considered the more effective choice.

Another thing to consider when comparing ella and Plan B is cost. Depending on your health insurance coverage, ella might be free!

It is important to note that if the egg has already been fertilized, neither Plan B nor ella are effective. This is why it is important to take the morning-after pill as soon as possible after having unprotected sex.

The third form of emergency contraceptive is not a pill. Copper-T IUDs inserted by a medical professional up to five days after unprotected sex are 99% effective in preventing pregnancy. This means that Copper-T IUDs are the most effective form of emergency contraception. Copper-T IUDs are also most effective for people with a BMI higher than recommended for Plan B and ella. Not only will a Copper-T IUD protect you from that last little slip-up, but it will continue as ongoing birth control for up to 10 years. Now that’s a bonus! A Copper-T IUD may be a good option if you are interested in long-term birth control. 

Emergency Contraception Wrap Up 

Life is unpredictable. If you find yourself having had less-than-safe sex, emergency contraception is available! Emergency contraceptives are not to be used as a primary form of birth control. They are not as effective as other forms of birth control. Emergency contraceptives, like Plan B, fail if taken more than once within a single menstrual cycle. ECs won’t work after ovulation (when an egg has already been released). Do not take more than a single dose of Plan B or an alternative. It will not increase effectiveness–using two forms of emergency contraception could counteract one another. 

Remember that a certain kind of emergency contraception (Plan B, ella, Copper-T IUD) may work better for you depending on factors such as weight, health insurance coverage, how much time has passed since having had unprotected sex, your regular birth control method, whether or not you are breastfeeding, etc. It is worthwhile to consider which EC is best suited for you before waking up in panic mode. Knowing your options can make an accident feel less catastrophic.