What is the morning after pill?

The morning after pill is a medication with a hormone (levonorgestrel) that prevents pregnancy from occurring up to 72 hours after unprotected sex. This is the same hormone used in many forms of birth control but in higher doses.

How does it work?

The way the morning after pill works to prevent pregnancy depends on where someone is in their cycle. The pill may delay an egg from being released by the ovary (ovulation) or change the uterine lining, so the egg does not implant. It will not work if someone is already pregnant and will not harm the baby.

How do I take it?

Take one pill by mouth once as soon as possible after unprotected sex. To prevent pregnancy, it must be taken within 72 hours of unprotected sex. If it has been over 72 hours call your doctor as there are some options that can be used up to five days after unprotected sex, however, this requires a prescription.

How effective is it?

Studies show that the morning after pill reduces your risk of pregnancy by 88% when taken as directed and by 95% when taken within 24 hours of unprotected sex. However, it is important to know that the morning after pill may not be as effective in individuals who are over 165 pounds or have a body mass index greater than 30. If you are concerned about this talk to your doctor or pharmacist about other options for emergency contraception.

What if I take birth control?

If you take birth control for pregnancy prevention you can still take the morning after pill in the instance that you have missed several doses or frequently forget to take your birth control. You can resume your birth control method the day after taking the morning after pill. It is recommended that you use a back up method for 7 days after taking the morning after pill because you can still get pregnant.

What if I recently took the morning after pill?

The manufacturer advises against taking the pill more than once every monthly cycle. You can still take the morning after pill if you have taken it recently, but you may have more side effects. If you find yourself needing the pill more frequently it may be a good idea to talk to your doctor about birth control options. The pill is great for emergency situations, but because of its higher dose of hormones, cost, and potential changes to your monthly cycle when used frequently, it is not recommended as a primary form of birth control.

Where do I get it?

Any pharmacy! Pharmacies may store it on the shelf with other over the counter medications, but it is usually behind the pharmacy counter. If you are unsure or afraid to ask, your local pharmacist is a great resource.

Who can access it?

Anyone! In Washington state anyone can buy the morning after pill regardless of age or gender.

How much does it cost? Will my insurance cover it?

Cost varies depending on which pharmacy you go to. It can be anywhere from $40-60 per dose. However, if you have a prescription for the morning after pill, it should be covered by insurance. Some pharmacists can write prescriptions for the morning after pill which can help with cost.

What are the most common side effects?

Nausea and vomiting are the most common side effects. If you vomit within 2 hours of taking the pill you can take another full dose. The morning after pill can also change your monthly cycle. Your period may come a little sooner or later than normal. Taking the morning after pill more than once per cycle increases the chances of cycle changes.

Other side effects:

  • Spotting
  • Dizziness
  • Breast tenderness
  • Feeling tired
How do I know if it worked?

Your period should come within 3-4 weeks of taking the morning after pill. If it has been over 4 weeks and you do not get your period take a pregnancy test.

Prepared by Jessi McKinney PharmD Candidate 2021

 

References:
  • Miss Morning After, missmorningafter.com/.
  • Plan B One-Step (levonorgestrel) Tablet. Package Insert. Duramed Pharmaceuticals, Inc; 2009.
  • Kaunitz, AM. Patient education: Emergency contraception (morning after pill) (Beyond the Basics). In: UpToDate, Post, TW (Ed), UpToDate, Waltham, MA, 2020.
  • Cleland, Kelly, et al. “Emergency Contraception Review: Evidence-Based Recommendations for Clinicians.” Clinical Obstetrics and Gynecology, U.S. National Library of Medicine, Dec. 2014, ncbi.nlm.nih.gov/pmc/articles/PMC4216625/.
  • “Emergency Contraception: Effectiveness of Emergency Contraceptives.” Princeton University, The Trustees of Princeton University, ec.princeton.edu/questions/eceffect.html.
  • Picture: https://helloclue.com/articles/sex/can-i-take-the-morning-after-pill-too-often