Alternatives to Plan B: Other Emergency Contraception Methods, Explained

Alternatives to Plan B: Other Emergency Contraception Methods, Explained

After it was announced that the Supreme Court had overruled Roe v. After Wade repealed the law that guaranteed a person's federal right to a safe and legal abortion, drug traffickers saw a drastic increase in demand for emergency contraceptives like Plan B.

In response to the surge, CVS, Rite Aid and Walmart all moved to restrict purchases of Plan B and similar medications. But shortly after that announcement, CVS reset its purchase limit on the drugs as sales "returned to normal."

While the availability of Plan B may change as demand fluctuates, it's important to know that the well-known drug is not the only form of emergency contraception.

Here's what you should know about the most common types of emergency contraception, including how they work and who can benefit most from them.

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Ella

What it is:Ella is the brand name for ulipristal acetate and is available as a single 30-milligram tablet for oral use.

How it works: Ella is “a progesterone modulator,” Jamie Alan, PhD, associate professor of pharmacology and toxicology at Michigan State University, told Health. "It works by delaying or inhibiting ovulation and influencing the endometrium [the inner layer of the uterus] to make the environment 'hostile' for sperm."

How to use it: Ella is taken orally and is only available with a prescription. It can effectively prevent pregnancy for up to five days after unprotected sex, but is more effective the sooner you take it. Data shows that Ella reduces pregnancy rates to 9 in 1,000 (or 0.9%) when taken within 24 hours of unprotected sex.

What it costs: It depends on your health insurance coverage (if you have it), but Ella typically costs between $42 and $47, according to GoodRx. However, according to Healthcare.gov, the pill should be free with health insurance coverage.

Other factors to consider: According to Planned Parenthood, while Ella is the most effective type of morning-after pill you can get and has been shown to work more effectively than other options in people over 165 pounds, the drug's effectiveness may decrease in people over 195 pounds.

Ella may also interact with several medications, including some used to treat epilepsy, tuberculosis, HIV, and fungal infections.

Levonorgestrel pills

What they are:This is a large category of emergency contraception that includes Plan B One-Step, Aftera, Next Choice, Take Action, and AfterPill. Dosage varies depending on the brand, but the medications are available in oral tablet form.

How they work:These pills contain levonorgestrel, a type of progestin that prevents the release of an egg from the ovary or the fertilization of the egg by sperm, according to the US National Library of Medicine. It can also thin the uterine lining to prevent pregnancy.

"Levonorgestrel pills do not terminate an implanted pregnancy but work primarily by delaying or preventing ovulation," Lisa Masterson, MD, a board-certified gynecologist in Santa Monica, California, told Health.

How to use them:These medications are typically OTC – meaning you can usually find them on the shelves of your local pharmacy or large chain store. “You don’t need a prescription like Ella,” said Dr. Masterson.

The instructions for each medication vary by brand, but in general, take one tablet as soon as possible after unprotected sex. According to Planned Parenthood, these medications can reduce your risk of becoming pregnant by 75 to 89% if you take them within three days of unprotected sex. Levonorgestrel pills are "moderately effective" when taken within five days, ACOG said.

What they cost: Prices vary by brand, but according to GoodRx, the average retail price of Plan B One-Step and similar levonorgestrel tablets is about $23.

Other factors to consider:Like Ella, these medications are not the best option for women with larger bodies - especially those over 165 pounds. “It doesn’t work as well for these women,” said Dr. Lauren Streicher, clinical professor of obstetrics and gynecology at Northwestern University Feinberg School of Medicine, told Health. “People need to be aware of that.”

Should you stock up on Plan B?

Paragard

What it is:Paragard is a copper spiral. It is hormone-free and prevents pregnancy for up to 10 years.

How it works: The copper IUD works primarily by making sperm less able to fertilize the egg and is typically used as a more regular form of birth control, according to the American College of Obstetricians and Gynecologists (ACOG). It is the most effective form of emergency contraception and prevents pregnancy in 99.9% of cases.

How to use it:If used for emergency contraception, the copper IUD must be inserted by a doctor within five days of unprotected sex. After that, you can use the IUD for long-term contraception and have it removed at any time if you want to become pregnant.

What it costs: If you have health insurance and are in-network, the IUD should be free, according to Healthcare.gov. However, GoodRx lists the average price at $1,043 without insurance.

Other factors to consider:Paragard has no weight limit, so it works the same on every body. But it's not the most convenient method of emergency contraception. “Insertion can be painful, and it is more likely to be painful if you have not had a child,” Alan said. It is also one of the most difficult forms of emergency contraception to access. "Even if you want to get an IUD, it can be difficult to see someone quickly," said Dr. Strings.

Combined hormonal birth control pills

What it is:These are pills that contain both estrogen and progestin and are often used for daily contraception. But when taken in higher amounts, they can be used for emergency contraception, ACOG said.

How it works: When combined birth control pills are taken in higher amounts than usual, they may delay ovulation to prevent pregnancy.

How to use it:To use combined hormonal birth control pills as emergency contraception, you must take them as soon as possible, up to five days after unprotected sex. “You take two doses 12 hours apart,” said Dr. Strings.

The number of pills you need to take depends on the dosage of actual pills you have (or will be given), Dr. Masterson. "You may need to consult your doctor about how many pills you need to take depending on the brand," she added.

What it costs: If you have health insurance, it shouldn't cost you anything, according to Healthcare.gov. Without health insurance coverage, the cost really depends on the brand you use.

Other factors to consider:If you already have a pack of combined hormonal birth control pills at home, this can be an easy option, Dr. Strings. But it's also the least effective form of emergency contraception, according to ACOG. And if you're breastfeeding, it's not recommended to try this method, Alan said.

If you need emergency contraception and are not sure what to do, contact a doctor. They should be able to offer personalized advice. Just don't wait too long. “The sooner you act,” says Dr. Streicher, “the better for emergency contraception.”