Curious: What are my options for emergency contraceptives?

Dear Sexpert,

Can you tell me more about the different types of emergency contraceptives that are out there? I know about the morning-after pill (Plan B), but I’ve heard that there are a few others. Also, where can I get emergency contraceptives on campus (if needed)?

–Curious about Contraceptives

Dear Curious,

What you have heard is correct – there are indeed several different emergency contraceptives, which can prevent pregnancy in you (or your partner) if you have had unprotected intercourse, or if protection fails. Options for emergency contraception include two different types of pills – sold under the brand names Plan B and Ella – as well as a copper intrauterine device (IUD) called ParaGard. All three of these are available on campus through Sexual Health and Wellness Services at UHS (SHAW), but a physician’s prescription is required for Ella and ParaGard. In addition, you can purchase Plan B, which is also sold under a few other generic names, over the counter at any pharmacy.

You might also be curious as to how each of these emergency contraceptives work. Both Ella and Plan B work by inhibiting or delaying ovulation, although by different mechanisms. Plan B contains a drug called levonorgestrel, an ingredient also found in birth control pills. Levonorgestrel mimics the female hormone progesterone, and high levels of this hormone inhibit ovulation. In order to be most effective, Plan B should be taken as soon as possible after unprotected intercourse. Although its effectiveness diminishes over time, Plan B is still recommended up to 72 hours after intercourse. Ella contains the drug ulipristal acetate, which primarily acts on progesterone receptors on the ovaries to delay ovulation. Ella is slightly more effective than Plan B, and although its effectiveness also decreases over time, Ella can still be somewhat effective up to 5 days after unprotected intercourse. For women with a BMI (body mass index) over 25, the risk of an accidental pregnancy has been shown to be greater with Plan B than with Ella, so it is recommended that these women take Ella or use ParaGard.

Unlike Plan B and Ella, ParaGard (a copper IUD) works not by blocking ovulation but by impairing sperm function and preventing fertilization, as well as preventing the implantation of a fertilized egg. In general, IUDs are used as regular contraceptives, but ParaGard is also effective as an emergency contraceptive even when implanted up to five days after unprotected intercourse. As an emergency contraceptive, Paragard is much more effective than either of the two pills; studies have shown that it can prevent 99% of possible pregnancies. Since both Plan B and Ella work by inhibiting ovulation, as you might guess, neither of these drugs are terribly effective if ovulation has already occurred. However, ParaGard can still protect from an unwanted pregnancy even if an egg has been released.

Lastly, remember that emergency contraceptives are indeed for emergencies, and that using a regular forms of birth control  is the best way to protect you and your partner from unwanted pregnancies. Also, remember that only barrier methods (condoms, dental dams) can reduce your risk of sexually transmitted infections.

I hope this answers some of your questions about the different forms of emergency contraceptives that are out there. As usual, if you have any other questions about emergency contraceptives or any other sexual health issues, don’t hesitate to write to the Sexpert, ask one of your neighborhood PHAs, or get in contact with the staff at SHAW!

~The Sexpert