sexual health || women health
pregnacy
Emergencies happen, and sometimes contraception isn’t on your mind when it should be. However, if you find yourself in a situation where you need to prevent pregnancy after unprotected sex, emergency contraceptive pills (ECPs) can be an option. But what if 72 hours have already passed? Is it still possible to prevent pregnancy? Let’s dive into everything you need to know about emergency contraceptive pills, including how to use them after 72 hours, and what your options are.
Understanding Emergency Contraceptive Pills (ECPs)
Emergency contraceptive pills are used to prevent pregnancy after unprotected sex or contraceptive failure (like a condom breaking). There are two main types of emergency contraception available: over-the-counter pills and prescription-only pills. Both types work by preventing or delaying ovulation, and in some cases, by interfering with fertilization or implantation of a fertilized egg.
Types of Emergency Contraceptive Pills
1. Ella (Ulipristal Acetate)
Ella, a prescription-only emergency contraceptive, is one of the most effective options available. The active ingredient, ulipristal acetate, works by blocking or delaying ovulation, giving sperm less time to fertilize an egg. Ella is highly effective up to 120 hours (5 days) after unprotected sex, making it a good option even if you’ve missed the 72-hour window that many other pills recommend.
For those with a BMI of 30 or lower, Ella tends to be the most effective. However, effectiveness may decrease for people with a BMI of 35 or higher. It’s important to note that Ella is available only with a prescription, so you’ll need to visit a healthcare provider to obtain it.
You can get Ella from a primary care doctor, gynecologist, or clinics like Planned Parenthood, or through telemedicine platforms like Nurx. The cost for Ella is typically around $50, but there are often options for those with insurance or Medicaid to get it at no cost.
2. Plan B and Other Levonorgestrel Pills
One of the most widely known emergency contraceptives is Plan B. This over-the-counter pill contains levonorgestrel, a synthetic version of progesterone that works to delay ovulation. You can find Plan B and other generic versions (such as AfterPill, My Way, and Take Action) without a prescription at most pharmacies like CVS, Walgreens, and Rite Aid.
While Plan B and its generic versions can be effective up to 72 hours (3 days) after unprotected intercourse, they remain less effective the longer you wait. Studies show that these pills have an 89% effectiveness rate within 72 hours but decrease in efficacy after this time, especially beyond 120 hours.
Like Ella, Plan B and its generics are also influenced by body weight. If you have a BMI of 25 or higher, Plan B may be less effective for you. Many pharmacies offer these pills for around $50, and discounts or financial assistance may be available.
3. Combination Birth Control Pills (Yuzpe Method)
In some cases, combination birth control pills containing both estrogen and progestin can be used as emergency contraception. The Yuzpe method involves taking a higher-than-usual dose of these pills within 72 hours, followed by a second dose 12 hours later.
While this method can be effective, it’s typically less efficient and comes with more potential side effects compared to Plan B or Ella. Experts don’t typically recommend the Yuzpe method when other options are available. Studies have shown the Yuzpe method’s effectiveness ranges from 56% to 86%, depending on how soon the medication is taken.
How Emergency Contraceptive Pills Work
Regardless of the specific pill you take, the primary function of emergency contraceptives is to prevent pregnancy by:
- Delaying or inhibiting ovulation, preventing the release of an egg from the ovaries.
- Changing the cervical mucus to make it more difficult for sperm to reach the egg.
- Thinning the uterine lining, which prevents the fertilized egg from implanting, even if fertilization has occurred.
Taking Emergency Contraceptive Pills After 72 Hours
So, you’re past the 72-hour mark but still want to prevent pregnancy. What now?
Can You Take Emergency Contraceptive Pills After 72 Hours?
Yes, it’s possible to still prevent pregnancy after 72 hours — but your options become limited, and effectiveness decreases as time passes.
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Ella can be effective up to 120 hours (5 days) after unprotected sex. While still effective, its success rate diminishes as time goes on, so it's better to take it as soon as possible.
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Plan B (Levonorgestrel) and similar pills are most effective within 72 hours. However, they can still be taken up to 120 hours but will be significantly less effective. The further beyond 72 hours you wait, the less likely they are to work, particularly for individuals with higher body mass indexes.
Can You Use Emergency Contraception After 120 Hours?
Once you’ve passed the 120-hour window, emergency contraception pills are unlikely to work. However, there’s still hope: Copper IUDs can be used up to 5 days after sex (and in some cases, up to 7 days in countries like Canada). IUDs are a highly effective form of emergency contraception, especially when used within this time frame.
How to Maximize the Effectiveness of Emergency Contraceptive Pills
- Take It as Soon as Possible: Emergency contraception is most effective the sooner you take it. Don't wait beyond the recommended time window.
- Consult a Healthcare Provider: If you're unsure which method is best for you, talking to a healthcare provider can provide guidance based on your individual needs.
- Avoid Using Pills as Regular Contraception: ECPs should not be used as a primary birth control method due to their lower effectiveness and potential side effects compared to regular contraceptive methods like birth control pills, IUDs, or implants.
1. Can You Make a ‘Homemade Morning-After Pill’?
While the Yuzpe method is sometimes referred to as a "homemade morning-after pill," it is less effective and comes with more side effects. It is always better to use products like Plan B or Ella if possible.
2. Are There Other Forms of Emergency Contraception?
Yes! Besides emergency contraceptive pills, Copper IUDs can be used as emergency contraception up to 5 days after sex. In some cases, hormonal IUDs may also offer a good option for preventing pregnancy.
3. How Effective Is Plan B After 72 Hours?
While Plan B is most effective within 72 hours of unprotected sex, it can still work up to 120 hours. However, its effectiveness diminishes significantly after 72 hours, and it's not suitable for people with a BMI above 25.
4. Can Emergency Contraception Be Used Regularly?
Emergency contraception should only be used in emergencies, as it’s not as effective as regular birth control methods. If you're concerned about contraception, consider consulting a healthcare provider about options that are better suited for regular use.
Conclusion
Emergency contraceptive pills are an essential tool for preventing pregnancy in emergencies. Whether you're looking for a prescription pill like Ella or an over-the-counter option like Plan B, understanding your options and how to use them is key.
The sooner you act, the more effective the pill will be. But don’t worry if you miss the 72-hour window, as options are still available up to 120 hours after unprotected sex, and copper IUDs may be the most effective choice after this period. Always consult a healthcare professional for guidance on which method suits your needs best.
Takeaway: Act quickly, know your options, and be informed about the best ways to prevent pregnancy after unprotected sex.