Did you forget to take your birth control or insert your diaphragm? Did you have a wild night and skip the condom in the heat of the moment? Maybe you both finished (yay!) and your stomach sank when you realized the condom broke.
Whatever happened, your usual contraception may have failed and you’re here wondering just how reliable the morning-after pill is. Reya is here to help! Take a deep breath, and let’s get into it.
What Is Plan B?
Plan B is an emergency contraceptive pill containing 1.5 milligrams of a synthetic hormone called levonorgestrel. It was the first emergency contraceptive pill of its kind to be authorized for sale in Canada. It’s meant to be taken within 72 hours (3 days) after unprotected sex, but the sooner you take it, the more effective it will be. Plan B usually costs $30-$40 at a pharmacy, and you don’t need a prescription to pick it up.
A Note About Insurance
If you live in Ontario and you’re 24 or younger, you’re insured by OHIP+! There are generic alternatives available under OHIP+, while PlanB itself is only covered under “specific clinical circumstances.” Your healthcare provider will be able to let you know what you’re eligible for.
How Does Plan B Work?
In a nutshell, Plan B works by temporarily delaying ovulation. Ovulation occurs when the ovary releases an egg through the fallopian tubes and into the uterus. If there’s no egg present in the uterus, fertilization cannot happen. And if fertilization doesn’t happen, no pregnancy! And on the off chance that an egg does get fertilized, PlanB makes it more difficult for that egg to implant into the wall of the uterus.
*Just a note, emergency contraceptive pills, regardless of the brand, will not abort an existing pregnancy, and will not treat or prevent sexually transmitted infections or diseases. If you need to end a pregnancy, or you’re concerned about STDs or STIs you should speak to your healthcare provider or head to a clinic right away.
Okay, Got lt. But Can Plan B Fail?
Here’s the deal. If you take Plan B within 24 hours of unprotected sex, it’s 95% effective, which is pretty promising! That being said, here are some things that can decrease its effectiveness.
Waiting too long: The sooner you take Plan B, the better. As time passes, the chances of it preventing pregnancy decrease. And after 72 hours, you might get lucky, but all bets are off.
Taking certain medications can reduce the effectiveness of PlanB and other emergency contraceptive pills. They include:
Rifampin (antibiotic)
Griseofulvin (antifungal)
Efavirenz (HIV medication)
Topiramate (anti-seizure drug also sometimes used to treat mood disorders)
Carbamazepine (anti-seizure)
Phenytoin (anti-seizure)
Phenobarbital (anti-seizure)
St. John’s Wort (herbal supplement commonly used to relieve depressive symptoms)
Weight: Planned Parenthood Toronto explains that Levonorgestrel may not work if you weigh more than 165 pounds.
Other Options
If you’re taking one of the listed medications or if you weigh over 165 pounds, don’t panic! Other options for emergency contraception may work better for you. You may want to consider another morning-after pill like ella or having a copper intrauterine device (IUD) inserted.
ella: The Other Morning After Pill
Meet ella: an emergency contraceptive pill very similar to Plan B with a few key differences:
It’s made of ulipristal acetate. It stops or delays ovulation like Plan B, but it can also thin the lining of the uterus so that even if an egg does get fertilized, you’re less likely to get pregnant.
You can take ella up to 120 hours (5 days) after unprotected sex, but like Plan B, it’s also more effective the sooner you take it. PlanB and ella are most effective within the first 3 days after unprotected sex, however, if ella is taken after that 3-day window, it’s actually more effective than PlanB according to this clinical trial.
While ella is a better oral emergency contraceptive if you weigh over 165 pounds, it may be less effective over 195 pounds. It may also be made less effective by the same medications listed above.
You need a prescription for ella, so make sure you call your doctor before heading to the pharmacy. It usually costs around $50 but you may be able to get it for less with health insurance or at a Planned Parenthood health center.
Copper IUD as Emergency Contraception
Copper produces an inflammatory reaction that prevents pregnancy by changing how sperm cells move so they can’t get to an egg. Copper IUDs like Paragard must be inserted within 5 days of unprotected sex to work as emergency contraception. When they are, they reduce your chance of getting pregnant by 99.9% and work regardless of your BMI. Additionally, copper IUDs work as an extremely effective birth control method for 8-12 years!
IUDs can cost between $50-$350 depending on where you buy them. If you have health insurance, that may offset the cost. Also, keep in mind that it can be difficult to get a short-notice appointment for an IUD insertion, so make the call as soon as you know you need emergency contraception!
In a nutshell: yes, Plan B can fail, though it’s unlikely, and there are really great alternatives available if Plan B isn’t for you. With all this in mind, it may be worth planning ahead! If you keep emergency contraception on hand, you won’t have to run to the pharmacy in a panic if the day comes when you need it. In the meantime, the Reya app can help you find the right contraception to keep sex fun and safe. Your birth control bestie is coming soon to the Apple App Store and Google Play Store!
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