Answers to Frequently Asked Questions About...
Types of Emergency Contraception
When would I use ella instead of progestin-only EC (like Plan B One-Step, Next Choice One Dose, or Levonorgestrel Tablets)?
If you have had unprotected sex, your birth control fails, or you have been made to have sex against your will, you still have a chance to prevent pregnancy - so take action right away. There are two different types of emergency contraceptive pills available for sale in the United States: progestin-only (Plan B One-Step, Next Choice One Dose, My Way and Levonorgestrel Tablets) and ulipristal acetate (ella). Both types are effective, and both work primarily, or perhaps exclusively, by delaying or inhibiting ovulation. There are some important differences between these types of pills:
- Plan B One-Step is available directly on the shelf with no restrictions, and soon the generic one-pill products (Next Choice One Dose and My Way) will be available on the shelf for those aged 17 or older. ella is available by prescription only.
- ella is more effective than progestin-only pills like Plan B One-Step and Next Choice, particularly on the 5th day after sex, when progestin-only EC may not be effective.
- ella is effective closer to the time of ovulation than Plan B One-Step or Next Choice, and this is the time when women are most at risk of pregnancy and most likely to be having sex.
- ella may be more effective for overweight or obese women.
Because ella is a newer product, it may take a while for pharmacies to routinely stock it. If you need EC, call your pharmacy to ask if they stock ella, Plan B One-Step, Next Choice One Dose, My Way or Levonorgestrel Tablets (click here for more tips for calling about EC). Anyone can buy Plan B One-Step without having to show ID; look for it in the family planning aisle. Soon, the one-pill generic forms of Plan B One-Step (Next Choice One Dose and My Way) will be available on the shelf too, but you need to be 17 or older to purchase these (be prepared to show ID). If you want to use ella, call your health care provider; you will need to get a prescription, and s/he may know of a pharmacy that has ella in stock. You can also purchase ella from this online prescription service for $42, including next-day shipping.
Here are some things to consider when choosing an emergency contraceptive pill:
- Effectiveness: ella is more effective than progestin-only EC (such as Plan B One-Step, Next Choice One Dose, My Way or Levonorgestrel Tablets), particularly on the 5th day after sex.
- Your body weight: There is evidence that progestin-only EC (like Plan B One-Step) may be less likely to work for women with a body mass index of 26 or more. If you are overweight, you may want to consider using ella.
- Timing since unprotected sex: Sperm can live in the body for 5 days after sex. Research shows that ella is effective up to 5 days after unprotected sex, while progestin-only EC may be effective only through the 4th day. If it has been 4 or 5 days since you had unprotected sex, try to make an extra effort to get a prescription for ella.
- Your cycle: Although studies show that EC can work up to 120 hours after sex, what matters for each individual woman is where you are in your menstrual cycle. ella works closer to the time of ovulation than progestin-only EC (although most likely neither will work if you have already ovulated). If you think you might be close to ovulation, or don't know where you are in your cycle, ella may be the best choice. If you can’t get a prescription for ella in time, but you can get to the pharmacy (and you’re 17 or older), it’s still a good idea to get progestin-only EC over-the-counter and take it as soon as possible.
- The calendar: If it is a weekend or holiday, your best option may be to get Plan B One-Step, Next Choice One Dose, My Way or Levonorgestrel Tablets from the pharmacy, as your clinic or health care provider’s office may not be open to provide you with a prescription for ella. You can also use the online prescription service for ella, but note that your delivery options are limited by the FedEx schedule - FedEx does not deliver on Sunday, and may not deliver on Saturday, depending on where you live. If delivery is not an option within your 5-day timeframe, you can get the prescription service to transfer your prescription to a local pharmacy for a $35 fee.
- Availability: Not all pharmacies carry EC. Call ahead to find out which brands your pharmacy has in stock (click here to find a pharmacy or clinic near you). And many pharmacies still do not stock ella, so you may find it easier to get progestin-only EC.
- Cost: EC can be expensive. Plan B One-Step, Next Choice One Dose, My Way and Levonorgestrel Tablets can cost between $35 and $60 when you buy it OTC at the pharmacy (Next Choice and Levonorgestrel Tablets generally cost about 10% less than Plan B One-Step. However, the makers of Plan B One-Step are offering a $10 coupon). ella may cost at least $50 at the pharmacy. If you choose the online prescription option for ella, it will cost $40 including next-day shipping. If your insurance covers EC, using your insurance is probably the least expensive option for you.
If you have had unprotected sex, take action right away and find out what your options are. If you are sexually active, it’s always a good idea to have EC available in case you need it. You can ask your health care provider for a prescription to keep on hand until you need it, or purchase EC at the pharmacy to keep at home.