What a Doctor Wants You to Know

By Scott G. Chudnoff, MD, told to Camille Noe Pagán

Many people think of emergency contraception (EC) as an abortion pill, but that is not how it works. If you are already pregnant and using it, it will not end your pregnancy. EC only reduces your chances of getting pregnant if you have had unprotected sex or have failed you in the past few days with contraception.

Most forms of emergency contraception contain hormones that prevent your ovary from releasing an egg. (Some examples of hormonal ECs are plan B, one-step plan B, action, and ella.) If you don’t release an egg, the sperm can’t fertilize it. It prevents pregnancy. But what a lot of women don’t realize is that there is a non-hormonal EC option. This is the Paragard copper IUD (intrauterine device). An IUD is a T-shaped device that is inserted into your uterus through the cervix. Sperm don’t like copper, so they don’t go past Paragard to reach and fertilize an egg.

The problem with EC is that the earlier you use it, the better it works. This is especially true if you are close to ovulating in your menstrual cycle. Most women don’t know exactly when they’re ovulating, which is another reason it’s best to take emergency contraception as soon as possible after having unprotected sex. If you know that you have just ovulated or are about to ovulate, ella and Paragard are more effective than other forms of EC. Ella and Paragard are also more effective if it has been more than 3 days since you had unprotected sex. But they only really work in about 5 days. If it’s been more than 5 days, they are much less likely to work.

Ella requires a prescription and you will need a doctor to insert Paragard. But most ECs are available over the counter. That doesn’t mean you’ll find it on the drugstore or grocery store shelf, however. In many cases, you need to ask a pharmacist for it.


It is always a good idea to talk to your doctor before taking any new medicine, including emergency contraception. They may have specific tips that can help you. For example, if you are overweight or tall with a tall build, it is more likely to work than Plan B. But when you call your doctor’s office, be sure to tell them you are calling about. of EC, then it puts you contact your doctor immediately.

Having said that, if you are on vacation or it is a vacation or a weekend and your doctor is not available, do not wait to take EC. The longer you wait, the higher your chances of getting pregnant. Plus, research shows EC is safe for women of all ages. The only real reason not to use it would be if you are already pregnant or have had a negative reaction to CE in the past.

The most common side effects of hormonal EC are nausea and vomiting, while an IUD can cause cramping and bleeding. You might feel a little uncomfortable for a day or two after taking it. It’s normal. The same goes for irregular menstrual bleeding afterwards. Your next period might be heavier or lighter than it normally is. It could also be later than usual, which could make you think you are pregnant. If you are worried, consider taking a pregnancy test. And trust your instincts: if something is wrong, like really heavy bleeding, call your doctor or go to the emergency room.

Emergency contraception is intended for emergencies. It is not a replacement for birth control. Unfortunately, doctors see patients who rely on EC to prevent pregnancy because they don’t want to use, for example, condoms. But you are more likely to get pregnant if you rely on EC. Most ECs are only 75% effective, while most contraceptives are closer to 90% to 98%.

Birth control also tends to be less expensive than EC. The price for EC may vary depending on where you live. Some over-the-counter ECs can cost as little as $ 10 a pill. But other types can cost as much as $ 90 per pill. Most health insurance covers the full cost of an IUD. Ultimately, if you don’t want to get pregnant, you need to have a reliable form of contraception that you use regularly. Accidents do happen and emergency contraception is a great option for them. But it is not for everyday use.



Scott G. Chudnoff, MD, Chairman, OB / GYN Department, Stamford Hospital, Stamford, CT; Clinical Professor of Obstetrics and Gynecology, Columbia University Vagelos College of Physicians and Surgeons, New York.

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