Emergency Contraception Options: Hormonal Pills vs IUD

Emergency contraception is a form of birth control that prevents pregnancy after sex. It's also called 'morning after contraception.' Emergency contraception can be used if you had unprotected sex or if you think your birth control failed. However, it does not protect against sexually transmitted diseases or infections. Emergency contraception can be used immediately after intercourse and can be used up to five days after sex (three days in some cases).

All forms of emergency contraception make it much less likely that you will get pregnant, but it's not nearly as effective as regularly using birth control, such as birth control pills or condoms.

Emergency contraception is safe to use, though some individuals may have adverse reactions to different forms.

There are currently two forms of emergency contraception. These are hormonal emergency contraception and the insertion of a copper IUD.

Hormonal emergency contraception is frequently called 'the morning after pill.' It is the most well-known form of emergency contraception. According to Planned Parenthood, it reduces the risk of pregnancy by up to 95 percent.

Hormonal emergency contraception options include:

• Plan B One-Step: This must be taken within 72 hours of unprotected sex.
• Next Choice: It includes one or two pills. The first (or only) pill should be taken as soon as possible and within 72 hours of unprotected sex, and the second pill should be taken 12 hours after the first pill.
• ella: One single, oral dose that should be taken within five days of unprotected intercourse.

Plan B One-Step and Next Choice are both levonorgestrel (progestin-only) pills, which are available over the counter without a prescription. The other option, ella, is an ulipristal acetate, which is only available with a prescription.

How It Works

Because pregnancy doesn't occur immediately after sex, hormonal emergency contraception pills still have time to prevent it. Emergency contraception pills reduce likelihood of pregnancy by preventing the ovary from releasing an egg for longer than usual.

The morning after pill does not cause an abortion. It prevents pregnancy from ever occurring.

It is safe for most women to take hormonal emergency contraception, though it's always a good idea to ask your doctor about interactions with other medications if possible.

Side Effects

Common side effects of hormonal emergency contraception include:

• nausea
• abdominal pain
• unexpected bleeding or spotting, sometimes up until your next period
• fatigue
• headache
• dizziness
• vomiting
• breast tenderness

If you vomit within two hours of taking emergency hormonal contraception, call a healthcare professional and ask if you should retake the dose.

While hormonal birth control can make your next period lighter or heavier than normal, your body should return to normal afterward. If you don't get your period in three weeks, take a pregnancy test.

Some hormonal emergency contraception pills, like Plan B One-Step, are available to purchase without needing to show ID. Others, like ella, are available only with a prescription.

A copper IUD can be used as emergency contraception if inserted within five days after unprotected sex. The IUD will need to be inserted by a healthcare provider. Emergency IUD insertion reduces the risk of pregnancy by 99 percent. They are available only by prescription.

It's important to note that only copper IUDs, such as Paragard, are effective immediately as emergency contraception. They can also be left in for up to 10 years, providing lasting and highly effective birth control. This means that other hormonal IUDs, such as Mirena and Skyla, are not to be used as emergency contraception.

How It Works

Copper IUDs work by releasing copper into the uterus and fallopian tubes, which acts as a spermicide. It may prevent implantation when used for emergency contraception, though this has not been proven.

The copper IUD insertion is the most effective form of emergency birth control.

Side Effects

Common side effects of copper IUD insertion include:

• discomfort during insertion
• cramping
• spotting, and heavier periods
• dizziness

Because some women feel dizzy or feel discomfort immediately after the insertion, many prefer to have someone there to drive them home.

With a copper IUD, there is a low risk of pelvic inflammatory disease.

The copper IUD is not recommended for women who currently have a pelvic infection or get infections easily. If you think you could be pregnant once you have an IUD inserted, call your doctor immediately.

Because the IUD costs more up front and requires both a prescription and a doctor's appointment to insert it, many women prefer to get the hormonal emergency contraception even though the IUD is more effective.

All forms of emergency contraception can significantly reduce the risk of pregnancy, but they need to be taken promptly. With hormonal emergency contraception, the sooner you take it, the more successful it will be at preventing pregnancy.

If the emergency contraception fails and you still become pregnant, doctors should check for an ectopic pregnancy, which is when the pregnancy occurs somewhere outside of the uterus. Ectopic pregnancies can be dangerous and life-threatening. Symptoms of ectopic pregnancies include severe pain on one or both sides of the lower abdomen, spotting, and dizziness.

When used correctly, both hormonal emergency contraception and copper IUD insertion are effective at significantly reducing the risk of pregnancy. If you still become pregnant after taking emergency contraception, see a doctor right away to check for an ectopic pregnancy. If possible, consulting a doctor to choose an emergency contraception method can protect you from negative interactions with other medicines or pre-existing health conditions.