No matter how reliable your preferred form of birth control may be, knowing you have backup options can provide some major peace of mind. Condoms can break, birth control pills can be missed, or we can simply become lost in the moment.
Don’t panic—emergency contraception is available to safely, quickly, and effectively reduce the risk of unwanted pregnancy.
Emergency contraception (EC) is a method of preventing pregnancy directly after unprotected sex or failed means of birth control. They can be ingested orally or inserted into the uterus. Oral EC uses hormones to prevent ovulation (the release of an egg), while an intrauterine device (IUD) disables sperm from fertilizing an egg.
Now, let’s compare everything you need to know about two viable oral EC options—ellavs. Plan B—so you can worry less and sigh-of-relief more.
What is ella?
Ella is an oral emergency contraception pill made with a hormone called ulipristal acetate. Ulipristal is a progesterone agonist/antagonist that can slow or stop the release of an egg, giving sperm nothing to fertilize after unprotected sex, which can prevent pregnancy.
Like other forms of EC, ella is intended for emergency contraception only, as an addition to your normal birth control pill when you’ve missed a pill or two. EC is not a replacement for your everyday birth control methods. EC is also not an abortion method: it cannot end a pregnancy once it has started.
Advantages of using ella
Ella is considered the most effective of any oral EC. It’s effective for up to five days after unprotected sex. In addition, ella has been shown to retain peak effectiveness all five days, unlike other pills.
But is ella emergency contraception pill better than Plan B? In fact, ella demonstrates some advantages:
Ulipristal is the most effective EC pill for preventing pregnancy in the U.S.
Some studies have shown ella to have pregnancy prevention efficacy rates of 97–99%.
Ella is 85% effective at preventing pregnancy within five days (120 hours) after unprotected sex.
This EC method has been shown to retain effectiveness over time within the five-day window.
Ella has few reported side effects, and all were temporary.
This method is moderately priced, at about $50 per pill.
The cost may be covered by your health insurance.
Disadvantages of using ella
The one major downside of ella is that it’s prescription-only, meaning you cannot purchase it over the counter at a pharmacy. Where ella earns efficacy points, it loses in convenience.
Take a look at the disadvantages of ella when considering ella vs. Plan B:
It cannot be bought over the counter –You won’t be able to buy ella by yourself at your local pharmacy. Instead, you’ll need a prescription from your healthcare provider.
Ella may cause temporary side effects –Reported side effects may include headache, nausea, stomach pain, menstrual cramping, tiredness, and dizziness.
This method isn’t well-suited for women over 195 lbs –Planned Parenthood reports that ella may not be as effective for women who weigh more than 195 lbs.
Some medications may decrease its effectiveness – Certain medications, like rifampin, griseofulvin, certain epilepsy medications, ritonavir and other HIV medications, and St. John’s Wort may reduce ella’s efficacy in preventing pregnancy.,
If you’ve already found your emergency contraception match made in heaven in ella, fantastic! But if not, don’t fret. We’re moving on to take a look at another popular EC option—Plan B.
What is Plan B?
Although this option might be more well known, there may still be questions around it like what is Plan B exactly, how often can you take Plan B, or how effective is it? To answer the first question, Plan B, commonly known as the morning-after pill,is a well-known, FDA-approved oral emergency contraceptive pill. It’s made with levonorgestrel, a kind of progestin that can delay your body’s release of an egg after unprotected sex.
Advantages of using Plan B
Plan B does not require a prescription, so you can skip the visit to your gynecologist and head straight for the pharmacy. When used quickly after unprotected sex, it can be an effective form of emergency contraception.
Plan B pill steps up to the plate with these advantages:
You can buy it without a prescription from a healthcare provider.
It’s widely available at most pharmacies and some grocery stores.
Plan B can be 87% effective when taken within 72 hours of unprotected sex.
Some studies have shown pregnancy prevention efficacy rates of 96–99%.
Plan B is moderately priced at about $50 per pill.
The cost may be covered by your health insurance.
Disadvantages of using Plan B
The most significant disadvantage to Plan B is that it loses a few points in terms of overall efficacy. If you take it more than three days post-unprotected-sex, Plan B can lose some of its effectiveness.
Other disadvantages of Plan B contraceptive pill include:
It may be less effective than ella or an IUD – In clinical studies, levonorgestrel (Plan B) has proven the least effective EC compared to ulipristal (ella) and a copper IUD.
Plan B loses efficacy after three days – Plan B, unlike ella, does not work as well in preventing pregnancy after day three of unprotected sex.
Not well-suited for women over 165 lbs – Even if taken directly after unprotected sex, Plan B may be less effective for people weighing over 165 lbs.
This method may cause side effects – Plan B shares similar side effects to ella, including headache, nausea, abdominal cramps, dizziness, tiredness, and breast tenderness.
Some medications may decrease its effectiveness – Medications including but not limited to barbiturates, carbamazepine, griseofulvin, oxcarbazepine, phenytoin, rifampin, St. John’s Wort, and certain HIV/AIDS medications may reduce the effectiveness of Plan B.
If you are considering emergency contraception and are currently prescribed other medication, the best rule of thumb is to talk to your healthcare provider first. They’ll be able to help you make sure your medicine keeps working the way it should—and confirm that it won’t reduce the effectiveness of your EC.
Plan B vs. ella
In the end, is ella better than Plan B? It can be a tough choice between the two. The good news is that each can be extremely effective when taken immediately after unprotected sex. The ultimate decision depends on your unique situation, health, and preferences.
Here are the category winners for some of the most common decision factors:
For convenience: Plan B – For those times when you need something fast or you can’t see your healthcare provider quickly, Plan B offers the most convenience. It’s readily available at stores like CVS, Walgreens, Target, and Walmart at a cost that won’t dig too deeply into your savings account.
For effectiveness: ella – Not only does ulipristal prove more effective in delaying egg release to reduce pregnancy risk, it also works more effectively for a few days longer than Plan B. For those times when you need a little more of a grace period, ella can provide extra peace of mind.
For your budget: Either –Plan B and ella are comparable in price. Plan B goes for about $50 at CVS and Walgreens. Ella costs about the same—between $40–$60—and both have a strong chance of being covered by your medical insurance.
Alternatives to emergency contraceptives
While Plan B and ella can be solid choices for someone seeking EC, there may be times when you need an alternative. For example, when your medications would make them ineffective, or other life or health circumstances cause you to require other options.
There are two medically-acknowledged alternatives to emergency contraceptive pills:
Copper IUD – A T-shaped device inserted into the uterus that works without hormones to render sperm inefficient or incapable of fertilizing an egg.
Combined birth control pills – Known as the Yuzpe method, which involves taking multiple daily contraceptive pills in split doses. It is important to first consult with your healthcare provider for more information on this alternative emergency contraception method, as the number of pills will vary by pill brand for this intended purpose.
How does a copper IUD work?
When used as emergency contraception, a copper IUD is placed inside the uterus where the copper helps prevent sperm from fertilizing an egg. Copper IUDs have been shown to be over 99% effective in preventing pregnancy up to 5 days after unprotected sex.
A copper IUD is a form of long-term birth control, meaning that once you have it, you can rely on it to prevent pregnancy for up to 10 years. However, note that copper IUDs must be inserted by your gynecologist or healthcare professional. When it comes to this method, it’s best to compare the IUD pros and cons to determine if it’s right for you.
How does the Yuzpe method work?
This method involves taking more than one of your regular birth control pills in a series of doses to mimic large contraceptive hormonal doses found in Plan B or ella.
The Yuzpe method can work, but it’s not as effective as EC pills or an IUD. Talk to your healthcare professional about how to combine your specific birth control pills for EC as well as your best options for emergency contraception.
How to use emergency contraceptives
How you should use ECs depends on what kind you decide to use. Pills like Plan B and ella are the easiest to use. On the other hand, copper IUDs and the Yuzpe birth control combination method usually require healthcare clinic appointments or consultations.
Oral EC pills –Using oral emergency contraceptive pills is easy. Both Plan B and ella require only a single-use tablet you can swallow just like an aspirin.
Copper IUD –Copper IUDs require application by a healthcare provider. The procedure can be uncomfortable, but once it’s inserted, it can prevent pregnancy for up to ten years.
The Yuzpe method –Combining birth control pills looks different for every person as birth control varies so widely. It requires direct communication with your healthcare provider to formulate dosage amounts and timing.
Just remember that emergency contraceptives are meant to be an additional safety option to your birth control method after unprotected sexual intercourse. They're not meant to replace your normal birth control method.
Empower your choice in emergency contraception with The Pill Club
Like there are different types of birth control options, there are also a few types of emergency contraceptives. When you need emergency contraception, the most important thing to remember is that you are not alone. We know it can be a scary time for so many women and people who menstruate, but we’ve got your back. We’re here to help you make the choice that feels right for you.
At The Pill Club, we’re disrupting the old-age standards of reproductive healthcare. We’re creating a truly inclusive, judgment-free space for people to seek healthcare, share their stories, and empower one another.
We offer everything from birth control, to skincare, to emergency contraceptive pills like Plan B and ella, all shipped right to your door. And don’t worry about health insurance—we offer affordable pricing for people without insurance, too.
The American College of Obstetricians and Gynecologists. Emergency Contraception. https://www.acog.org/womens-health/faqs/emergency-contraception
National Library of Medicine. Emergency contraception review: evidence-based recommendations for clinicians. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216625/
University of Michigan. Emergency Contraception. https://uhs.umich.edu/contraception-emergency
National Library of Medicine. Ulipristal Acetate (ella). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3138379/
Ella. ella® Side Effects. https://www.ella-now.com/side-effects/
Planned Parenthood. What’s the plan B morning after pill? https://www.plannedparenthood.org/learn/morning-after-pill-emergency-contraception/whats-plan-b-morning-after-pill
Plan B One Step. Possible plan B side effects. https://www.planbonestep.com/plan-b-possible-side-effects/
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