The Pharmacological Action of ellaOne
To understand the implications of repeated use, it's essential to know how ellaOne works. The active ingredient, ulipristal acetate, is a selective progesterone receptor modulator. Its primary mechanism is delaying or inhibiting ovulation, the release of an egg from the ovary. By postponing ovulation for at least five days, it prevents fertilization by any sperm present in the reproductive tract (sperm can survive for several days).
ellaOne is most effective when taken as soon as possible, but it remains a viable option for up to 120 hours (five days) after unprotected sex. Unlike some other emergency contraceptives, it retains its high effectiveness throughout this window. However, if ovulation has already occurred, no emergency contraceptive pill can prevent pregnancy.
Is it Safe to Take ellaOne Two Days in a Row?
Yes, it is possible and generally considered safe to take ellaOne twice within the same menstrual cycle, including on consecutive days, if you experience another incident of unprotected sex or contraceptive failure. Studies have looked into subjects who took ellaOne more than once in the same cycle and found no safety differences in the incidence or severity of adverse events. The key takeaway is that one dose of ellaOne protects against one incident of unprotected sex. If a second incident occurs, the initial dose does not provide ongoing protection, necessitating another dose to cover the new risk.
However, healthcare professionals emphasize that this scenario should be rare and is not a substitute for consistent, reliable contraception. Repeatedly relying on emergency contraception is more expensive, less reliable overall, and can lead to more frequent and intense side effects.
Potential Consequences of Repeated Use
- Increased Side Effects: The most common side effects of ellaOne include headache, nausea, abdominal pain, and menstrual cramps. Taking a second dose in close succession can increase the chance or intensity of these short-term side effects.
- Menstrual Cycle Disruption: ellaOne works by altering hormone levels to delay ovulation, which can temporarily disrupt your normal menstrual cycle. Repeated use makes it more likely to cause irregular periods, spotting, or a period that is earlier or later than usual.
- Not a Substitute for Regular Birth Control: Emergency contraception is a valuable backup but is significantly less effective than methods like the pill, implant, or IUD. Frequent use for primary contraception is not advised due to lower efficacy and convenience.
What to Do After Taking Repeat Doses
If you find yourself in a situation where you need emergency contraception twice within a short period, follow these guidelines:
- Re-dose Correctly: Take the second ellaOne tablet as soon as possible after the second incident of unprotected sex. The same 120-hour window applies, but speed is key.
- Use the Same EC: Do not take a different type of emergency contraceptive (e.g., levonorgestrel-based pills) within 5 to 7 days of taking ellaOne, as they can interfere with each other and reduce effectiveness.
- Take a Pregnancy Test: If your next period is more than a week late after taking ellaOne, take a pregnancy test to be sure. Even with repeat dosing, pregnancy is still a possibility if ovulation was not successfully delayed.
- Use Barrier Methods: After taking ellaOne, use a barrier method like a condom until your next menstrual period begins. Your fertility can return quickly, and ellaOne does not provide protection for future sexual encounters.
- Consider Long-Term Contraception: Repeatedly needing emergency contraception is a strong signal to re-evaluate your birth control plan. Talk to a healthcare provider about more reliable and consistent options. The copper IUD can even be used as an effective emergency contraceptive up to five days after unprotected sex and can then be left in place as a highly effective long-term method.
Comparison of Emergency Contraceptive Pills
| Feature | ellaOne (Ulipristal Acetate) | Levonorgestrel (e.g., Plan B) |
|---|---|---|
| Mechanism | Delays or inhibits ovulation; may prevent implantation. | Delays or inhibits ovulation. |
| Time Window | Effective up to 120 hours (5 days) after unprotected sex. | Effective up to 72 hours (3 days) after unprotected sex; less effective after 24 hours. |
| Repeat Use in Same Cycle | Can be repeated safely if needed, but not studied as extensively as single doses. | Can be repeated safely if needed; more data available on repeated use. |
| Interaction with Other EC | Do not take within 5-7 days of a levonorgestrel-based pill. | Do not take within 5-7 days of an ellaOne pill. |
| Effect on Next Period | More likely to cause a delay in your next period. | Also can cause a change in the timing and flow of your next period. |
| Availability | Prescription only. | Available over-the-counter. |
| Effectiveness with Higher BMI | More effective than levonorgestrel for individuals with a higher BMI, though effectiveness may still be reduced. | Less effective for individuals with a higher BMI. |
Conclusion
While the situation is not ideal, you can take ellaOne two days in a row if you have another incident of unprotected sex, as the first dose does not provide ongoing protection. It is important to know that ellaOne and other emergency contraceptives are intended for emergency use and are not designed to be relied upon as a primary form of contraception. Repeated use, though considered safe in the short term, can increase side effects and cause temporary menstrual irregularities. The most reliable way to prevent unintended pregnancy is through a consistent method of contraception. If you are frequently needing emergency contraception, consult with a healthcare professional to find a long-term birth control solution that fits your needs and lifestyle.
Resources
For more information on emergency contraception options and permanent birth control, consult the American College of Obstetricians and Gynecologists (ACOG) guidelines.
Authoritative Link
American College of Obstetricians and Gynecologists (ACOG) Guidelines
