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 Take Action)?
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 Take Action) 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 and its generic forms (like Next Choice One Dose and Take Action) are available directly on the shelf with no restrictions. ella is available by prescription only.
- ella is more effective than progestin-only pills like Plan B One-Step and Take Action, 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 Take Action, 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.
Not all pharmacies stock ella. If you need EC, call your pharmacy to ask if they stock ella, Plan B One-Step, Take Action, Next Choice One Dose, or My Way (click here for more tips for calling about EC). Anyone can buy Plan B One-Step and its generic forms without having to show ID; look for it in the family planning aisle. You can order a generic form of Plan B One-Step at www.afterpill.com for $20 + $5 shipping. This site does not offer expedited shipping, so it's not meant for emergency use, but you can stock up and keep it on hand for future use.
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 $59, 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, Take Action, Next Choice One Dose or My Way), 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 or a copper IUD .
- 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 or a copper IUD.
- 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, 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 or one of its generic forms (like Take Action) 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 (the generics generally cost about 10% less than Plan B One-Step. However, the makers of Plan B One-Step are offering a $10 coupon). You can order a generic form of Plan B One-Step at www.afterpill.com for $20 + $5 shipping, but this site does not offer expedited shipping, so it's not meant for emergency use. ella may cost at least $50 at the pharmacy. If you choose the online prescription option for ella, it will cost $59 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.