Understanding Emergency Contraceptive Pills
Emergency contraceptive pills (ECPs), also known as the morning-after pill, are a form of backup birth control used to prevent pregnancy after unprotected sex or contraceptive failure. It is crucial to understand that ECPs are not the same as abortion pills; they do not terminate an existing pregnancy. Instead, their primary function is to prevent or delay ovulation, which is the release of an egg from the ovary. By doing so, they prevent the sperm from having an egg to fertilize.
There are two main types of ECPs available: levonorgestrel-based pills (like Plan B) and ulipristal acetate-based pills (like ella). The hormonal content in ECPs is much higher than in regular birth control pills, which is why they are meant for occasional emergency use rather than regular contraception.
Common Side Effects to Expect
After taking an ECP, it is normal to experience a range of temporary side effects as your body adjusts to the hormonal surge. Most of these symptoms are mild and should resolve within a few days.
Common side effects include:
- Nausea and vomiting: This is one of the most frequently reported side effects. To help prevent nausea, some sources suggest taking the pill with food. If you vomit within two to three hours of taking the pill, you may need to take another dose; consulting a healthcare provider is recommended.
- Headache and dizziness: These can occur, often alongside fatigue. Over-the-counter pain relievers, like ibuprofen, are safe to take for headaches.
- Fatigue: Feeling unusually tired or having low energy is a common symptom that should pass within a couple of days.
- Breast tenderness: Your breasts may feel sore or tender due to the hormonal changes.
- Abdominal pain or cramping: Mild lower abdominal discomfort is normal. A heating pad can help alleviate the pain.
Impact on Your Menstrual Cycle
The hormonal shift from an ECP will likely affect your next menstrual period. It’s a common and expected outcome and is not necessarily a sign that the pill failed.
Potential changes include:
- Early or late period: Your period may come a few days earlier or up to a week later than expected. Ulipristal acetate, in particular, may delay your period. If your period is more than a week late, it is recommended to take a pregnancy test.
- Irregular bleeding or spotting: Light vaginal bleeding or spotting between periods can occur in the weeks following ECP use. This is not your period and is caused by the hormonal fluctuations.
- Changes in flow and duration: Your next period might be heavier, lighter, longer, or shorter than usual. These changes are typically temporary, and your cycle should return to its normal pattern in the following months.
Managing Side Effects
Most side effects are manageable with simple self-care techniques:
- For nausea, eat a small snack before taking the pill, or have some ginger tea.
- For headaches or breast tenderness, over-the-counter pain relievers can help.
- Rest and stay hydrated, especially if you feel dizzy or tired.
- Use a heating pad for abdominal cramps.
Levonorgestrel vs. Ulipristal Acetate: Key Differences
Choosing the right ECP often depends on the timing of unprotected sex and other personal factors. The two main types, levonorgestrel and ulipristal acetate, have different characteristics.
| Feature | Levonorgestrel (e.g., Plan B, My Way) | Ulipristal Acetate (e.g., ella) |
|---|---|---|
| Timeframe for Use | Up to 72 hours (3 days) after unprotected sex. Most effective when taken sooner. | Up to 120 hours (5 days) after unprotected sex. Effectiveness remains consistent throughout this period. |
| Active Ingredient | Levonorgestrel | Ulipristal Acetate |
| Availability | Available over-the-counter without a prescription. | Requires a prescription. |
| Effectiveness & Body Weight | Effectiveness may be reduced for those with a higher body mass index (BMI). | Effectivness is not believed to be impacted by body weight to the same degree as levonorgestrel. |
| Interactions with Other Birth Control | Can resume regular hormonal contraception immediately after use. | Wait 5 days after use before starting or resuming regular hormonal birth control. |
Knowing If the Pill Was Successful
The most reliable way to confirm the pill worked is when your next period arrives. You can expect it to be a bit different from your usual cycle, but it is a good indicator that the ECP was effective.
Key steps for confirmation:
- Watch for your period: A period, even if different, confirms the ECP was successful. Changes in the timing and nature of your next period are normal.
- Take a pregnancy test: If your period is more than a week late, or three weeks have passed since you took the pill, take a home pregnancy test.
When to Contact a Healthcare Provider
While most effects of ECPs are temporary and not serious, certain symptoms warrant a call to your doctor or a trip to a clinic.
- Severe abdominal pain: Intense pain, especially on one side, could indicate a serious issue like an ectopic pregnancy.
- Excessive or prolonged bleeding: Contact a provider if you are soaking through more than one pad or tampon per hour for several consecutive hours. Also, seek advice if bleeding is prolonged beyond a week, or if it is very heavy and happens after you've already missed a period.
- Allergic reaction: Seek immediate medical help if you experience symptoms of an allergic reaction, such as difficulty breathing, hives, or swelling of the face, tongue, or throat.
- Missed period with a positive pregnancy test: If your pregnancy test is positive, a healthcare provider can help you confirm the pregnancy and discuss your options.
Conclusion
Taking an emergency contraceptive pill can be an anxiety-inducing experience, but knowing what to expect can provide peace of mind. Most side effects, including menstrual cycle disruptions, are temporary and a normal part of your body’s response to the hormonal changes. While a highly effective backup, ECPs are not a substitute for regular contraception and do not protect against STIs. Always consult a healthcare provider for ongoing reproductive health needs and for any concerning symptoms after taking an ECP. For more detailed information, consider visiting authoritative sources like the American College of Obstetricians and Gynecologists (ACOG).
