What are the main alternatives to Plan B?
If you find yourself needing emergency contraception, a few primary alternatives to Plan B exist, each with its own benefits and considerations. Understanding these can help you make an informed and timely decision.
- Other Levonorgestrel Pills: Many generic brands contain the same active ingredient as Plan B (levonorgestrel) and are available over-the-counter at a lower cost. These include products like Take Action, My Way, and Aftera. They work best when taken within 72 hours of unprotected sex, though they may still have some effect for up to 5 days. Their effectiveness can be reduced in individuals weighing more than 165 pounds.
- The Ella Pill (ulipristal acetate): This is a prescription-only emergency contraceptive pill that is more effective than Plan B. It can be taken up to 5 days after unprotected sex and its effectiveness does not decrease over this timeframe. It works by delaying ovulation, even if the process has already started. Its efficacy may be affected for those weighing over 195 pounds. Because it requires a prescription, you may need to act quickly to get an appointment with a healthcare provider or use a telehealth service.
- The Copper IUD (Paragard): Inserted by a healthcare provider within 5 days of unprotected sex, the copper IUD is the most effective form of emergency contraception available. It is more than 99.9% effective and can remain in place for up to 12 years to provide long-term birth control. It is a hormone-free option and its effectiveness is not impacted by body weight. Accessing an appointment for insertion can sometimes be a challenge due to the time-sensitive nature, so immediate action is crucial.
How each emergency contraceptive works
It's important to understand the different mechanisms of action for these medications. While they all prevent pregnancy, they do so in different ways.
- Levonorgestrel (Plan B, Take Action, etc.): This high dose of progestin works primarily by delaying or preventing ovulation. If ovulation has already occurred, it will not prevent pregnancy. It is a time-sensitive medication, and its effectiveness decreases significantly the longer you wait to take it after unprotected sex.
- Ulipristal Acetate (ella): This medication is a selective progesterone receptor modulator. Like levonorgestrel, it delays or prevents ovulation. However, it can delay ovulation even after the luteinizing hormone (LH) surge has started, which makes it more effective than levonorgestrel, particularly closer to ovulation.
- Copper IUD (Paragard): This small T-shaped device is inserted into the uterus. The copper ions released create a hostile environment for sperm, inhibiting their motility and viability. It can also interfere with fertilization and implantation. Because it is non-hormonal, it provides immediate and long-term protection against pregnancy, regardless of the user's weight.
Comparison of emergency contraception methods
| Feature | Generic Levonorgestrel Pills (e.g., Take Action) | Ella (ulipristal acetate) | Copper IUD (Paragard) |
|---|---|---|---|
| Availability | Over-the-counter | Prescription only | Doctor/clinic appointment |
| Timeframe | Most effective within 72 hours (3 days), but can be used up to 5 days | Effective up to 120 hours (5 days) | Effective up to 120 hours (5 days) |
| Effectiveness | 75-89% when taken within 72 hours | Up to 85% when taken within 5 days | >99.9% effective |
| Weight Impact | Potentially less effective for those over 165 lbs | Less effective for those over 195 lbs | No impact |
| Cost (without insurance) | $10-$50 | ~$50+ at pharmacy | $0-$1,300 (often covered by insurance) |
| Protection | Short-term; prevents this single incident | Short-term; prevents this single incident | Immediate and long-term (up to 12 years) |
Accessing emergency contraception
No matter which option you choose, timing and access are critical factors. While generic levonorgestrel pills are the most accessible for immediate over-the-counter purchase, other options require more advanced planning.
- Over-the-Counter: Levonorgestrel-based pills are available without a prescription at pharmacies, drugstores, and some superstores. While Plan B is the brand name, generics like Take Action are equally effective and often cheaper.
- Prescription: The ella pill requires a prescription. You can get this from a healthcare provider during an appointment or through a telehealth service, with options for online medical consultations and delivery. This can be a useful option to have on hand for the future if your body weight or time frame makes it a better choice.
- Healthcare Provider Insertion: The copper IUD is the most effective option, but it requires a visit to a healthcare professional for insertion. Since this needs to happen within 5 days of unprotected sex, it is essential to call for an appointment as soon as possible. Major health centers like Planned Parenthood and local clinics offer this service and can help you navigate insurance coverage or sliding-scale fees.
What if you cannot access a method quickly enough?
If you are nearing the 5-day window, or find access difficult, consider contacting a healthcare provider or a family planning clinic immediately. While emergency contraception pills work best the sooner they are taken, both ella and the copper IUD remain highly effective throughout the entire 5-day window. If one method is inaccessible, don't give up on the others. Discussing options with a healthcare professional is the best way to determine the right course of action based on your individual circumstances and timing.
Conclusion
For anyone asking, "Is there anything you can do besides Plan B?" the answer is a definitive yes. From other over-the-counter pills to a more effective prescription option like ella, and the most reliable long-term solution, the copper IUD, there are multiple avenues for preventing pregnancy after unprotected sex. The best choice depends on factors like timing, body weight, accessibility, and whether you desire long-term contraception. Acting quickly is crucial for all methods to ensure maximum effectiveness. For detailed and up-to-date information, the Centers for Disease Control and Prevention provides a comprehensive resource on emergency contraception at https://www.cdc.gov/contraception/hcp/usspr/emergency-contraception.html.
