Top things to know
The emergency contraception pill should not be a replacement for traditional birth control options
It is probably okay to take an emergency contraception pill more than once in a cycle
Emergency contraception pills will not impact your future fertility
The most well known form of emergency contraception is the emergency contraception pill, sometimes called the morning-after pill, and the other is a copper IUD. In this article, we’ll be focusing on the emergency contraception pill, exclusively.
There are a couple different versions of the emergency contraceptive pill available. Those made from a progestin known as levonorgestrel are available over the counter in the United States. Another type, made with ulipristal acetate (an antiprogestin) are available by prescription only in the United States. Additionally, some types of combined oral contraceptives (“the pill”) can also be used as emergency birth control, but that won’t be discussed in this article either (1). (Learn more about how the emergency contraceptive pill works here).
Can I take the emergency contraception pill too often?
Probably not, you’ll probably be fine if you need to use an emergency contraceptive pill every once in a while—but continue reading, because the research is still unclear. And what is “too often”?
Can I use the emergency contraception pill instead of using a traditional form of birth control?
According to the manufacturers of the emergency contraception pill and The American College of Obstetricians and Gynecologists (ACOG), the emergency contraceptive pill isn’t designed to be used as a substitute for regular contraception (1-3).
ACOG does not recommend using emergency contraception pills as a long term contraception option because overall a person would be exposing themselves to repeated higher levels of hormones than they would normally receive using regular combined hormonal birth control or progestin-only birth control (4). Plus, frequent use could also lead to more frequent bouts of side effects and menstrual disturbances (see below) (4).
In contrast to these recommendations, a group of researchers studied how well the levonorgesterel emergency contraception pill worked for people having infrequent sex (6 days or less per month) used it as primary contraception. For women younger than 35 years, rates of pregnancy for exclusive perfect use (within 24 hours of intercourse in this study) of emergency contraceptive pills was 11 pregnancies over 1 year per 100 women. The rates were even lower for typical use (if combined with other forms of contraceptives or taken late) with only 10 pregnancies over 1 year per 100 women (5).
Can I take the emergency contraception pill more than once during a single menstrual cycle?
While manufacturers of the levonorgestrel pill do not recommend taking an emergency contraceptive pill more than once in a cycle (3), The American College of Obstetricians and Gynecologists (ACOG) and manufactures of the progestin-only pill contradicts this and states that it is okay (2,4). More research is needed into determining if there are any effects from consistent repeated use. If the emergency contraceptive pill is being used repeatedly, especially during the same cycle, it is advisable to use a different form of contraception that is more reliable.
Will it mess up my cycle?
Remember, when you take an emergency contraceptive pill, ovulation will be delayed by a few days or prevented (1-3). Because of this, your current cycle may be affected, and can be either a few days shorter or longer (2,3). 1 in 6 people taking the levonorgestrel emergency contraceptive pill may experience bleeding or spotting not related to their period within one week of taking emergency contraception (5). Irregular bleeding patterns are common among people taking levonorgestrel emergency contraceptive pill (5).
If your period is more than one week late, it is recommended to take a pregnancy test (3). Remember, the emergency contraceptive pill is not a guarantee against pregnancy.
Can I screw up my fertility?
Nope—the emergency contraceptive will not affect your fertility in the future (2,3).
Repercussions of taking the emergency contraceptive pills
No STI protection
Only barrier devices, like internal or external condoms, gloves, or dental dams, will offer protection against sexually transmitted diseases (STIs). This means that taking an emergency contraceptive pill after having unprotected sex won’t offer you help against STIs.
Taking emergency contraception is not a guarantee that you won’t get pregnant
Remember, the emergency contraception pill is not an abortifacient—this means it does not prevent a pregnancy if you have already ovulated and conception has happened.
Estimating the success rate of one-dose emergency contraception pills is difficult, but research suggests that it prevents pregnancy about 50-100% of the time (7,8). There are many reasons why the emergency contraception pill might fail (as explained in detail in this article), so for your best chances of success take emergency contraception as soon as possible after having unprotected sex.
Cost: the morning-after pill isn’t cheap
Prices will differ by country, state, and if insurance can be used. But in general, taking an emergency contraceptive pill every month is more expensive than just using regular birth control pills or getting an IUD. Consider in the United States, using a condom every time you have sex will cost you around $2, using the birth control pill will cost up to $50 per month, or even getting an IUD which can cost up to $1300, but split that up over 7 years and it’s really only $15 a month (9). In comparison, an emergency contraception pill will cost you $40-50 every time you have sex, which is rather expensive (10).
Possible side effects
Emergency contraception is safe and effective. However, some people do experience mild side effects including: nausea, abdominal cramping, fatigue, headache, breast tenderness, dizziness, menstrual pain, and acne (2,3,5).
Choosing to use emergency contraception is a personal choice that can have life-changing impacts on a person’s future. Armed with the knowledge about how emergency contraception pill works, it’s effectiveness, and any possible repercussions, this can help you make the best decision for yourself.
To learn more about other people’s experiences taking the pill, check out this article.