What is the difference between emergency contraceptive pill, morning after pill, post coital contraception, day after contraception, day after pill, or Plan B?
What Are The Different Types of Emergency Contraception Available?
What is Plan B?
Which birth control pills are used for emergency contraception?
What is the best contraceptive to use for emergency contraception?
More Frequently Asked Questions
There is no difference between these terms. The terminology of morning after pill, post coital contraception, day after contraception or day after pill can be confusing because it would allow some to believe that you can only take the Emergency Contraceptive Pill the day after unprotected intercourse. In reality it can be taken immediately after unprotected sex where it is most effective up to 120 hours after the incident to reduce the chance of an unwanted pregnancy through contraceptive failure, rape, or having sex without using contraception. The sooner the emergency contraception is used the better for the patient because it is most effective the sooner it is taken after unprotected intercourse:
- Taking Plan B (levonorgestrel) <24 hours after unprotected intercourse reduces the incidence of pregnancy by 95%
- Using Plan B up to 72 hours reduces the incidence of pregnancy by 85%
- Using Plan B >72 hours and up to 120 hours reduces incidence of pregnancy by 63%
Emergency Contraceptive Pills reduce the incidence of pregnancy that experts would expect to happen when their contraception fails, they do not use birth control, or they are raped. If 100 women have unprotected sex one time during the second or third week of their monthly cycle, 8 of them will become pregnant. If the same 100 women take Plan B after having unprotected sex and it is taken in the first 24 hours, then less than 1 person will become pregnant out of that 100 of people.
The Yuzpe method where combined oral contraceptives that contain both progestin and estrogen are used for Emergency Contraception reduces the risk of pregnancy by 75%. In other words, if 100 women use this type of pill after having unprotected sex, only 2 of them will get pregnant.
Emergency insertion of a copper-T IUD reduces the risk of pregnancy by more than 99% if inserted within 5 days of unprotected intercourse. It does not prevent ovulation nor does it cause an abortion. The primary effect of the IUD is through destroying the viability of the gamete.
Plan B one Step and combined estrogen and progestin oral contraceptives used for Emergency Contraceptive pills are effective and safe. They are not as good at preventing pregnancy as continuous birth control like the pill or condom. If one used emergency contraception as the primary method of birth control for an entire year, the annual risk of getting pregnant would probably be about 20% with Plan B One-Step, Next Choice and other progestin-only emergency contraceptive pills and 40% with regular oral emergency contraceptive pills. This assumes emergency contraceptive pills are used perfectly after each and every individual has unprotected sex. It is important to find a long term contraceptive to reduce the incidence of unwanted pregnancy.
Emergency Contraception pills, morning after pills, day after pills, post coital contraception, and day after contraception is not the same as the “abortion pill”. Other names for the “abortion pill” are RU486, Mifeprex, or mifepristone. RU486 is an anti-progesterone and at high dosages it is used as an abortifacient (causes termination of pregnancy). There is no estrogen or progesterone in RU486 as occurs in regular combined oral contraceptive pills. Emergency contraceptive pills and Plan B prevent pregnancy. They have no effect if the individual is already pregnant. They do not prevent Sexually Transmitted Disease (STD) or HIV.
Emergency contraception (morning after pill, day after pill, post coital contraception or day after contraception) are used interchangeably to describe safe and effective measures to prevent an unwanted pregnancy in patients who have unprotected intercourse. The incidence of pregnancy is reduced between 50 to 99% depending on the method and the day and the type of emergency contraception that is used. The Intrauterine Device has the highest percentage of success in preventing pregnancy which is near 99% if it is inserted within 5 to 7 days of unprotected intercourse. The least effective means of Emergency Contraception is the Yuzpe method which uses combined progestin and estrogen that is found in birth control pills. Using this method is around 75 percent effective if used in the first 72 hours of unprotected intercourse. The use of Plan B which is a progestin-only form of Emergency Contraception that is approved by the FDA for this particular reason is over 95% effective in reducing the incidence of pregnancy if it is given less than 24 hours after unprotected intercourse. The earlier after intercourse Emergency Contraception is given, the more effective it is in reducing the incidence of unwanted pregnancy. There are several methods of Emergency Contraception.
- Progestin only pills. Plan B one step, and Next choice which contain the progestin hormone levonorgestrel. Have essentially replaced combined contraceptive pills due to less side effects and more effective in preventing unwanted pregnancy.
- Combined estrogen and progesterone birth control pills. Plan B and Next Choice have less side effects and are more effective in preventing unwanted pregnancy.
- RU486 (Mifeprex, mifepristone). Progesterone receptor blocker. Only used in China for Emergency Contraception.
- Ulipristal Acetate. A progesterone modulator. Approved for Emergency Contraception in the US in 2010.
- Meloxicam and Indocin which are Nonsteroidal Anti-Inflammatories (NSAID). When taken over a 3 to 5 day period of time it reduces chance of ovulation, fertilization, implantation and decidualization of the lining of the uterine endometrium.
- Histamine Blocker (Ranitidine). Histamine important for implantation of the fertilized egg.
- Intrauterine Device (IUD). Insert within 5 to 7 days after birth control failed, had sex without using contraception, or was raped. The IUD as Emergency Contraception should be the number one choice because it is the most effective means of preventing pregnancy after unprotected sex (over 99%) and is very safe. It can also be used for long term birth control that can be placed for 12 years.
Plan B One Step and Next Choice are approved for women and men to purchase over the counter if they are 17 years or older. For patients that are age 16 or younger, a prescription is required. The cost of Plan B One Step or Next Choice is between $35.00 to $65.00.
Plan B is an Emergency Contraceptive (morning after pill, day after pill, post coital contraception, day after contraception) that only contains the single hormone progestin (levonorgestrel) and at the 1.5 mg dosage is available in just one pill instead of having to take one or several pills twelve hours apart. It decreases the incidence of pregnancy after sex that was unprotected or failure of the contraceptive used. The package insert says that Plan B must be taken within 72 hours (3days) of unprotected intercourse which reduces the incidence of pregnancy by 89%. In essence 7 out of 8 women who would have conceived will not become pregnant after using Plan B. Plan B has been shown to reduce the incidence of pregnancy by 63% in a World Health Organization study if taken between 72 and 120 hours after sex. No studies have been done to determine if Plan B is effective after 120 hours (5days) after intercourse. It is known that the sooner after intercourse Plan B is used; the more effective it will be as if taken in 24 hours or less, it is 95% effective in reducing the incidence of pregnancy after unprotected intercourse.
The safety of Plan B (levonorgestrel, Next Choice) alone has been studied for over two decades for Emergency Contraception usage. Combined birth control pills (ethinyl estradiol and levonorgestrel) have been studied and used since the early to mid 1970’s for emergency contraception. They both have been tested of hundreds of thousands of patients and found to be not only effective but safe. Plan B only uses 1 single pill and combined oral contraceptives use multiple pills where the dosage must be repeated in the 12th hour after the initial dose.
Plan B is not the abortion pill (RU486, Mifeprex, Mifepristone) nor should RU486 be called the abortion pill because it can be used to prevent and treat many different disease states such as severe depression, treat fibrocystic disease, breast cancer, gastric cancer, prostate cancer, and uterine fibroids. Plan B does not affect established pregnancies. There have been not teratogenic (abnormalities of the fetus) effects due to exposure to Plan B or combined oral contraceptive (birth control pills)
Plan B is not as effective as using regular birth control and even though safe, should not be used that way. It is calculated that 20% of patients will become pregnant within a year if they depend on Plan B as their primary form of birth control. Only 3 to 4 patients will become pregnant when using long term birth control pills consistently and correctly. Thus, the importance of only using Plan B as a backup Emergency Contraceptive method.
Plan B does not prevent Sexually Transmitted Disease or HIV. The only sure way to prevent them is to abstain from any type of sexual intercourse or skin to skin contact. Condoms (female or male) should be used each time one has sexual intercourse to prevent STDs or HIV. In order to eradicate HIV by the year 2050, every person in the world needs to be tested and placed on antiretroviral agents. Over 20% of the population in the US who have HIV do not know it and continue to spread it among the population.
There are several brands of birth control pills that can be used for emergency contraception that are safe and effective. They are not sold specifically as Emergency Contraceptive pills, but have been studied since the early 1970’s in preventing unwanted pregnancies. The pills are taken as soon as possible up to 120 hours after unprotected intercourse due to birth control failure, you were forced to have sex, or if you had sex without birth control. The second dose is taken 12 hours after the first dose. Emergency contraceptive pills are most effective the sooner they are taken after sex. Emergency Contraceptive Pills have no long-term serious side effects and are safe for the majority of women to use. Birth Control Pills are approximately 75% effective in preventing unwanted pregnancies.
Plan B One Step and Next Choice are progestin-only hormonal pills. They are the only hormonal pills in the U.S. approved for Emergency Contraception pills. There are 89% effective in reducing the incidence of an unwanted pregnancy.
Side effects of Emergency Contraception are headache, nausea, vomiting, breast tenderness, abdominal pain, ankle swelling, dizziness, and weakness, delayed or early menses that can be lighter or heavier. 50 percent of women have nausea with 20 percent have vomiting for patients who take birth control pills for Emergency Contraception. 14% percent of women have nausea and 1% vomit after taking Plan B. If patients vomit within two hours of taking them, you may need to take an additional dose. 80% of patients will begin bleeding by the end of the week that their menses is supposed to start. If it does not start within 3 weeks of when the Emergency Contraception was used, then an intrauterine or ectopic pregnancy should be suspected. The use of a long term form of birth control should start almost immediately (within 24 hours) after the use of Emergency Contraception. Once used for 7 days, no other form of a contraceptive method is necessary.
The chart below contains the dosage information for some common brands of oral contraception in the U.S. that can be used for Emergency Contraception:
|1st Dose – Take within 72 hours of intercourse||2nd Dose – Take 12 hours after 1st dose|
|Plan B – One Step. Specially designed for use as EC||1 white pill||N/A|
|Next Choice||2 peach pills||N/A|
|Regular Birth Control Pills||1st Dose – Take within 72 hours of intercourse||2nd Dose – Take 12 hours after 1st dose|
|Alesse||5 pink pills||5 pink pills|
|Levlen||4 orange pills||4 orange pills|
|Levlite||5 pink pills||5 pink pills|
|Levora||4 white pills||4 white pills|
|Lo-Ovral||4 white pills||4 white pills|
|LoSeasonique||5 orange pills||5 orange pills|
|Nordette||4 orange pills||4 orange pills|
|Ogestrel||2 white pills||2 white pills|
|Ovral||2 white pills||2 white pills|
|Ovrette||20 pills (take within 48 hours of intercourse)||20 pills more|
|Seasonale||4 pink pills||4 pink pills|
|Tri-Levlen||4 yellow pills||4 yellow pills|
|Trivora||4 pink pills||4 pink pills|
|Triphasil||4 yellow pills||4 yellow pills|
*Plan B and Next Choice are the only two Emergency Contraceptive pills on the US market that are approved by the FDA. They both can be purchased over the counter by men or women that are 17 years of age or older. If less than 17 years old, a prescription is required for purchase.
** Plan B, and Next Choice indicate in their pamphlets that the pills can be taken up to 72 hours after unprotected intercourse. Recent studies by WHO show that incidence of pregnancy are reduced up to 120 hours (5 days) after unprotected sex. The oral contraceptive pills noted above have also been shown to reduce the incidence of pregnancy up to 120 hours (5 days) after unprotected intercourse.
The best contraceptive to use in our opinion for Emergency Contraception as long as there are no contraindications to its use is the Copper T Intrauterine Device (IUD). The reasons are the following:
- The Copper T IUD is more effective than any other form of Emergency Contraception if preventing an unwanted or unintended pregnancy. It is over 99% effective in preventing pregnancy if inserted less than 120 hours (5 days) after unprotected sex.
- The IUD can be used as a continuous form of reversible birth control for up to 12 years if the woman chooses to keep it in the uterus that long. This is the only form of Emergency Contraception that can be used as a primary form of birth control. Using Plan B, or Next choice (levonorgestrel, or progestin-only), or combined oral contraceptive pills (birth control pills) as a primary form of birth control in Emergency Contraceptive dosages, are not very effective in preventing pregnancies over a one year period of time. 40% of patients will become pregnant if they use combined birth control pills and 20% of patients that use levonorgestrel (Plan B, Next Choice) will become pregnant during a 1 year period of time which is higher than the withdrawal or the calendar methods of birth control.
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