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Emergency Contraception: What To Do When Plan A Fails

Emergency Contraception: What To Do When Plan A Fails

7 minute read

It's always good to have a back up plan.  In this article, Condom Depot will give you everything you need to know about Plan B One-Step, a form of emergency contraception.

What is Plan B and Plan B One-Step?

Both Plan B and Plan B One-Step are types of emergency contraception. Both contain the progestin levonorgestrel, a naturally occurring hormone. This is different from other forms of emergency contraception which can contain both progestin and estrogen and have an increased likelihood of causing nausea.

Plan B can be taken up to five days after having unprotected sex whereas Plan B One-Step should be taken within four days. However, with both pills, the earlier you take it, the more effective it is.

What's the difference between Plan B and Plan B One-Step?

Plan B One-Step is available over the counter at your local pharmacy to any woman of any age. Plan B is available without prescription only to women over the age of 17. There are other alternatives to this brand, including generics but if you are under the age of 17, they will not be available to buy without a prescription for a few years.

Plan B is a two step treatment whereas Plan B One-Step is a single pill. Both should be taken as soon as possible after having unprotected sex, but the second pill in Plan B is taken twelve hours after the first.

Many pharmacies are gradually phasing the original Plan B out of their cabinets and opting to keep Plan B One-Step instead as it is easier to use and available to more people.

When should I use Plan B or Plan B One-Step?

Plan B and Plan B One-Step should not be taken as an alternative to other types of birth control, and should only be used when you absolutely need it.

Why? First of all, it can be very expensive. My normal monthly pack of birth control used to cost me $5 with health insurance each month (Planned Parenthood has some great options for women without insurance and the Affordable Health Care Act have or will soon make many plans completely co-pay free). Plan B One-Step from my local pharmacy is ten times as much-- $50. And it only protects against one instance of unprotected sex, meaning if I had unprotected sex, then took a pill and had more unprotected sex later that week, it would not work. And it is far, far more expensive than a box of condoms.

Second, they are not as effective as other types of birth control. In fact, they only prevent about seven out of eight pregnancies. On the other hand, using a hormonal contraception and/or condoms 100% correctly can nearly eliminate your chances of getting pregnant-- when either are used correctly, you only run about a 2% chance of conceiving. Using both correctly is even better.

Finally, like other hormonal contraception, they do not prevent the spread of HIV and other STIs. Barrier methods work best for that, and condoms are proven most effective.

So, when should you use emergency contraception, like Plan B or Plan B One-Step? When you absolutely have to:

  • if you had a condom break or you think it may have been tampered with or you think you were stealthed;
  • if you missed a few days with your hormonal contraception and had unprotected sex;
  • if you were intoxicated and had unprotected sex;
  • if you were intoxicated and think you may have had unprotected sex;
  • if you were intoxicated and do not know if you had unprotected sex;
  • if you were sexually assaulted and are not using other forms of hormonal contraception.

Does Plan B or Plan B One-Step cause an abortion?

Plan B and Plan B One-Step both have no effect on an established pregnancy. If you think you are already pregnant, they will not cause you to have a miscarriage, nor will they harm your pregnancy or cause birth defects. Their job is to delay ovulation so that conception never even occurs, which is why it is so important that you take them as quickly as possible after having unprotected sex, otherwise they are completely ineffective. Plan B and Plan B One-Step will not work if conception has already occurred, so if you know your ovulation time is near and you have had unprotected sex, take the pill as soon as possible or you may need to seek out other options.

Many people confuse Plan B and other emergency contraception with RU-486. RU-486 is not an evil robot from outer space, but actually Mifepristone (also marketed as Milfeprex or Milfegyne), a pill that can be taken up to nine weeks after the first day of your last period prior to conception as an alternative to a suction abortion. Unlike Plan B or Plan B One-Step, the purpose of Mifepristone is to induce abortion. Mifepristone works by blocking the body’s production of progesterone, a hormone essential to pregnancy. The decrease in progesterone softens the uterine lining making the fertilized egg unable to stay attached, softens the cervix, and helps the uterus to contract, expelling the developing tissue.

Is Plan B or Plan B One-Step dangerous?

While it is possible to have an allergic reaction to either treatment, neither pill is necessarily dangerous. When I was in school, my sex ed teacher told me that taking Plan B more than twice would render you infertile. This has never been proven. It is also a common myth that it is dangerous to take either pill after ingesting large amounts of alcohol or taking drugs. This is also not true.

Plan B and Plan B One-Step are very high doses of hormones that already occur naturally in the female body. There are even times in your life when you could have these hormones at even higher rates than if you had taken Plan B or Plan B One-Step. According to the Food and Drug Administration’s report, there have been no deaths associated with using Plan B or Plan B One-Step, although there were a small number of cases where pregnancy outcomes were ectopic.

Be warned though, taking either treatment could potentially make you feel very ill for a day or two. Cramps, bleeding (like when you get your period), breast tenderness, fatigue, and vomiting are well-known symptoms. It’s like having all the crappy parts of your period intensified.

Norlevo, a brand of emergency contraception in Europe that is identical to Plan B One-Step,  has been found to be ineffective in women who weigh more than 175 lbs. and less effective in women weighing more than 165 lbs. If this is a concern for you, it may be a good idea to consult a doctor or pharmacist about an alternative brand.

Can my boyfriend/friend-who-happens-to-be-a-boy/husband buy Plan B for me?

Totally. If he is 17 or under, however, he can only purchase Plan B One-Step. You can also get it online, but there’s a chance you might miss your 5-day window if you don’t choose one-day shipping so it may be better to bite the bullet and pick some up at your local pharmacy. It is also a good idea to keep some on hand just in case.

How will I know if my emergency contraception worked?

Sometimes taking emergency contraception can screw up your period and make it early, or, even worse, super late. If you are concerned that Plan B or Plan B One-Step didn’t work, it may be a good idea to take a pregnancy test four to five days after your missed period just to be sure. As we mentioned above, emergency contraception has a success rate of 7 out of 8. Good, but not perfect.


Disclaimer: I am not a doctor, just a person interested in informing the world about safe sex. Please speak to your doctor or pharmacist before making a final decision about what type of emergency contraception is right for you.

[Sources: bedsider.org, plannedparenthood.org, ec.princeton.edu]

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