Emergency Contraception: Is Plan B® the Only Option?

Seunga (Jasmine) Han, PharmD Candidate

Let’s talk about emergency contraceptives

Emergency contraception, by definition, is any contraceptive method used after unprotected intercourse or potential contraceptive failure.^1,2 Sometimes, despite taking the right measures to be safe and cautious, accidents can happen. However, this isn’t always a topic that everyone’s comfortable talking about, which can make decisions all the more difficult during these stressful times. In today’s article, we hope to discuss the different emergency contraceptives currently available.

Before we begin, there is one thing that needs to be noted; that is, the choice of emergency contraceptives may vary based on different factors such as:¹

• Smoking status
• Age
• Breastfeeding
• Medical conditions
• Medications

So if any of these apply to you, it’s important to consult a healthcare provider to ensure an appropriate treatment option to prevent pregnancy.

Levonorgestrel (Plan B^®)

Levonorgestrel, commonly known as Plan B^® is one of the most commonly available options. There are two main forms of this medication:^1,2

• The dingle dose regimen, where you take a single 1.5mg levonorgestrel pill
• The double dose regimen, where you take a total of two 0.75 mg levonorgestrel pills, each taken 12 hours apart

It’s important to note that any emergency contraceptive will work best when taken immediately after unprotected intercourse, despite the common term “the morning after pill,” there is no reason to wait until the next day to take action. In the case of levonorgestrel, it works best when taken within the first 72 hours. Some advantages of this medication are that it’s available over-the-counter, safe, and very effective when taken early enough.^1,2 Unfortunately, there is increasing evidence showing that this may not be the best option for women who weigh more than 75-80kg.^1,2 Although this isn’t absolutely proven just yet, consult your healthcare provider if this applies to you.

Ulipristal Acetate (Ella^®)

Ulipristal acetate is one of the newer emergency contraceptives available in Canada but is currently only available with a prescription. That being said, this medication remains effective for a period of up to 120 hours (5 days) after unprotected intercourse and remains effective even in overweight individuals. Therefore, it’s a superior option compared to levonorgestrel-only medications. For those who are normally on hormonal contraception (birth control), it’s important to wait at least five days after using ulipristal before restarting regular birth control.^1,2

It’s important to note that while Plan B^® and Ella^® both may prevent pregnancy, neither method provides protection against sexually transmitted illnesses or future unprotected intercourse. Neither product should ever be relied on as a form of regular contraception. Additionally, if vomiting occurs within two hours of consumption, a second dose must be taken. 

Copper intrauterine device

Copper intrauterine devices (IUD) are the most effective emergency contraceptive option in Canada and can be used successfully up to seven days after unprotected intercourse. However, like other forms of emergency contraception, copper IUDs are most effective when used early, in fact, they’re up to 99% effective when used within the first five days.² This is a great option for women of different ages, or who are breastfeeding. Of course, this method also has its disadvantages. Copper IUDs can only be inserted by a trained healthcare professional, often a physician, and may cause pain during insertion, and longer or heavier periods for the first 3-6 months of use. For this reason, copper IUDs are often reserved as a last resort.

The Bottom Line

As you can see, Plan B^® is not the only option available for emergency contraception. However, as always, we recommend speaking to a healthcare provider to find the option that’s best suited for you. Lastly, for women who are sexually active, a regular form of contraception can be much more reliable than emergency methods and is generally the first-line recommendation. We will discuss these other topics shortly.

We hope you took away something valuable from this piece. If you have any questions or concerns regarding this article or others, feel free to reach out to us on Instagram, Facebook, or at ask@orbishealth.ca with your feedback. We’d love to hear from you.

RESOURCES

1. RxTx
2. DynaMed Plus