Morning-After Pill

What is the morning-after pill?

The morning-after pill is a type of emergency contraception. Emergency contraception isn’t the same as typical birth control. It’s for situations where your birth control has either failed or you were unable to use protection. These medications are a temporary way to prevent pregnancy — they aren’t long-term routine forms of birth control. There are better and more effective ways to prevent pregnancy like birth control pills, intrauterine devices (IUDs) and implants.

Some situations where you may need the morning-after pill are:

• Having sexual intercourse without any form of preventive birth control.
• Experiencing birth control failure (like a broken condom, forgotten birth control pills or missed dose of the birth control shot).
• Experiencing nonconsensual or forced sexual intercourse (rape).

The most important thing to know about emergency contraception is that how soon you take it has a big impact on how effective it is. Each type of morning-after pill has its own timeframe for when you should take it, but studies show that both types work best when you take it within 24 hours of unprotected sex.

Are there different types of morning-after pill?

There are two main types of morning-after pills approved by the FDA in the U.S. — each with popular brand names you may have heard of. Both types come as pills that you swallow. A third, less common type of emergency contraception involves taking combination birth control.

Levonorgestrel morning-after pills

Pills containing levonorgestrel (a type of progestin) work best when you take it within three days (72 hours) of unprotected sex. They’re available to purchase anytime at most drug stores. There are several brands you can buy, and the prices vary, but they all work the same way.

Common brands include:

• Plan B One-Step®.
• My Choice™.
• Option 2®.
• Take Action™.
• Aftera®.
• Preventeza™.

Ulipristal acetate

Pills containing ulipristal acetate work for up to five days (120 hours) after unprotected sex. It’s only available with a prescription. (You can fill the prescription and save it for when you need it.) The most common brand name for this medication is ella®.

Combined birth control

This type of emergency contraception involves taking birth control pills that contain both progestin and estrogen. Unlike the two other types of morning-after pills, this option typically involves taking two doses. When you use combination birth control as an emergency contraception option, you’re taking a typical birth control pill at a higher dose. It’s important to talk to your healthcare provider or pharmacist about the exact dosage you’ll need and how far apart you should take the two medications. This isn’t something you should do without talking to your provider.

Combined birth control (Yuzpe regimen)

This type of emergency contraception involves taking extra pills from a regular birth control pack. It’s referred to as the Yuzpe regimen. This method involves combining pills from an available birth control pack to total 100 mcg of ethinyl estradiol and 0.5 mg levonorgestrel. A second dose is then repeated in 12 hours. It’s important to know that this regimen is less effective and less well-tolerated than other forms of emergency contraception.

How does the morning-after pill work?

The morning-after pill doesn’t reverse pregnancy. Instead, it’s a type of emergency birth control that prevents pregnancy. The main way the morning-after pill works is by preventing or delaying ovulation. If you don’t ovulate, you can’t get pregnant. The morning-after pill won’t end a pregnancy that has already begun.

How effective is the morning-after pill?

All forms of emergency contraception pills are more effective the sooner you take them, ideally within 24 hours of unprotected sex. You don’t need to wait to take these medications until the next day — despite the name “morning-after pill.” So, if you have concerns about pregnancy after unprotected sex, it’s best to get emergency contraception as soon as you can.

Each type of morning-after pill has its own effectiveness. The data and studies are mixed on exactly how effective each one is:

• The levonorgestrel option should be taken within the first 72 hours (three days) after unprotected sexual intercourse. Studies show it can be around 94% effective if you take it in the first 24 hours. It’s about 58% effective within 72 hours.
• The ulipristal acetate option can be taken up to 120 hours (five days) after sex. Studies show it can be as high as 98% effective if you take it in the first 24 hours. It’s about 85% effective if you take it within 120 hours. Since you need a prescription for it, having it on hand is the best way to achieve that success rate.
• Combined birth control is the least effective emergency contraception.

Can you get pregnant if you take morning-after pill?

Yes. Even with perfect use, there’s no guarantee it’ll prevent a pregnancy.

How soon do I take the morning-after pill?

You don’t need to wait until the next morning to take the morning-after pill. Emergency contraception pills are most effective at preventing pregnancy when they’re taken as quickly as possible after unprotected sexual intercourse. The amount of time you have can vary between different medications.

• Levonorgestrel (Plan B): You typically have about a three-day window of time when Plan B will still be effective. It becomes less effective at preventing pregnancy the longer you wait.
• Ulipristal (ella®): You have up to five days after unprotected sex when it’s still effective at preventing pregnancy. It’s more effective the sooner you take it.
• Combined birth control pills: Combining birth control pills that contain progestin and estrogen can be taken for up to five days after unprotected sex. There can be a lot of variety between different brands of birth control pills, so you must talk to your healthcare provider about the exact timing and dosage.

What are the risks of the morning-after pill?

Emergency contraception is safe and effective. It won’t harm your chances of getting pregnant in the future or impact your fertility.

There are side effects, though. Some symptoms of taking a morning-after pill can include:

• Changes to your normal menstrual cycles (your period might be earlier or later than normal)
• Light vaginal bleeding (spotting)
• Nausea and vomiting
• Tiredness (fatigue)
• Headaches and dizziness
• Breast tenderness
• Pain or cramping in your abdomen

The side effects of the morning-after pill are mild for most people. But if you notice more severe symptoms or have concerns after taking the morning-after pill, reach out to your healthcare provider.

What are reasons the morning-after pill fails?

The most common reason for failure is timing. It’s always best to take emergency contraception as soon as possible. Other possible reasons for failure include:

• Vomiting within two hours of taking it
• Weight (levonorgestrel may be less effective if you have overweight)
• Interaction with other medications making it less effective (like certain barbiturates or St. John’s wort)

Can weight impact the effectiveness of the morning-after pill?

There’s research that suggests that your weight can impact how effective the levonorgestrel morning-after pill will be for you. People with a higher body mass index (BMI) may not experience the same level of effectiveness. Pills containing ulipristal seem to work the same regardless of having a higher BMI.

Is there bleeding after I take the morning-after pill?

You might experience light bleeding — called spotting — after taking emergency contraception. Even though this doesn’t happen to everyone who takes the morning-after pill, it isn’t something that should worry you. If you notice that the bleeding is heavier or happens after you’ve missed a period, reach out to your healthcare provider.

Can the morning-after pill make your period late or disrupt your cycle?

The morning-after pill can cause your next period to be irregular. If your period is late or abnormal, contact your healthcare provider and consider taking a home pregnancy test. Your provider will advise you on your next steps if your menstrual cycle doesn’t return to normal.

What are the signs that the morning-after pill didn’t work?

If you take the morning-after pill in the immediate time window after having unprotected sex, it can be very effective. One of the main signs that a morning-after pill hasn’t worked is a missed menstrual period. If your period is more than seven days (a week) later than you expected, take a pregnancy test.

Should I see my healthcare provider after taking the morning-after pill?

In most cases, you won’t need to see your healthcare provider after taking the morning-after pill. But if you haven’t gotten your period within a week of when you expect it, talk to your healthcare provider. A missed period is one of the early signs of pregnancy. You should also contact your provider if you have severe abdominal pain or heavy vaginal bleeding. These could be signs of a miscarriage or ectopic pregnancy.

The morning-after pill isn’t meant to be your primary form of birth control. Reach out to your provider about finding a birth control option that works best for you.

Does the morning-after pill work if I take it first and then have unprotected sex?

The morning-after pill was made to be taken after unprotected sex. It’s not effective if you take it before you have unprotected sex.