Everything You Need to Know Before Taking Plan B

Plan B.
Plan B. Photo: Plan B

Whatever precautions you and your partner take before jumping into bed, there’s always a chance that something could go awry: The condom you snagged at a public-health clinic could tear, someone could “forget” to pull out, or you might realize after the fact that you missed a pill in your birth-control pack. In cases like these, many of us turn to emergency contraceptive pills like Plan B.

But what exactly is Plan B, and how does it work? Will your insurance cover it? Do you need a prescription? Here’s everything you need to know about taking the morning-after pill.

What is Plan B?

Plan B One-Step — as well as its generic counterparts, including Take Action, Next Choice One Dose, and My Way — is an emergency contraceptive pill containing levonorgestrel, a concentrated synthetic version of the hormone progestin. According to Dr. Tara Shirazian, a gynecologist at NYU Langone Health, levonorgestrel works by inhibiting the hormone surge that triggers ovulation. In other words, when taken soon after unprotected sex, Plan B prevents you from ovulating, thereby preventing you from getting pregnant. (This is different from an abortion, which terminates a pregnancy.)

There’s also another emergency contraceptive pill called Ella, which contains the progesterone receptor modulator ulipristal acetate, which works similarly to levonorgestrel. The main difference is that Ella requires a prescription, mainly because it’s a newer drug in the United States. (However, it’s long been popular in Europe, where it’s sold as EllaOne.)

Where can I buy Plan B?

Any person, regardless of age, can buy Plan B One-Step and generic emergency contraceptive pills over the counter at your local pharmacy or drugstore, or at a health clinic, such as Planned Parenthood. (There used to be age restrictions to purchase emergency contraception, but the Food and Drug Administration struck them down in recent years.) While most stores carry the emergency-contraceptive pills on shelves, some keep them behind the pharmacy counter, so be sure to check both places.

You can also buy Plan B and its generic forms on Amazon. (However, depending on how recently you had unprotected sex, this may not be the most efficient way to get the pill, which is more effective the sooner you take it. More on that below.)

How much does Plan B cost?

While prices vary, according to a recent survey, Plan B One-Step usually costs about $48. (According to the same survey, generic levonorgestrel pills are slightly cheaper, at $42.) However, according to Planned Parenthood, “You may be able to get the morning-after pill for free or low cost from a Planned Parenthood health center or your local health department.”

It’s also possible that your health-insurance plan will cover the pill, but you’ll likely need a prescription. So it’s not a bad idea to check with your provider, if time permits.

How effective are emergency contraceptive pills?

According to Planned Parenthood, a levonorgestrel morning-after pill can “lower your chance of getting pregnant by 75-89 percent if you take it within five days after unprotected sex.” However, the sooner you take the pill, the more effective it is, which is why it’s not a bad idea to stock up in advance — especially if you’re having unprotected sex, or if you can’t easily get to a pharmacy. (Plan B has a shelf life of up to four years.)

How often is it safe to take emergency contraceptive pills?

There is no limit to how often you can take Plan B or its generic forms. Dr. Katherine Farris, affiliate medical director at Planned Parenthood South Atlantic, told Cosmopolitan that you could theoretically take Plan B every single day and it wouldn’t hurt you. However, medical experts do not recommend using the morning-after pill as an ongoing form of birth control, as it’s not as effective at preventing pregnancy as other forms of contraception, such as condoms, birth-control pills, or IUDs. Also, doctors recommend against using two different emergency contraceptive pills, like Plan B and Ella, within five days of each other, as the hormones could counteract.

Can I take Plan B if I’m on birth-control pills?

Yes, and you shouldn’t have any complications. So, if you took Plan B because you missed a birth-control pill, either before or after having unprotected sex, you should continue taking your birth control on your normal schedule.

Do I need to take Plan B if I missed a birth-control pill?

If you realize that you’ve forgotten to take a birth-control pill, you should take it as soon as possible, and take your next pill at the same time you normally would.

In general, if you missed one pill, but took it within 48 hours of your normally scheduled time, you probably don’t need an emergency contraceptive. However, if you find yourself in this situation, it’s worth talking to your doctor.

Is it true that Plan B is only effective for women under a certain weight?

There’s some conflicting information out there about whether Plan B is effective as an emergency contraceptive for heavier women. In 2013, the European manufacturer of emergency contraceptive Norlevo issued a warning that the drug is “completely ineffective” for women who weigh more than 176 pounds, and that it loses effectiveness when taken by women who weigh more than 165 pounds. The manufacturer based its warning on a 2011 study; however, in 2014, the European Medicines Association found that “these emergency contraceptives can continue to be used in women of all weights,” noting that “the benefits are considered to outweigh the risks.”

“What we know is that the heavier you are, the more likely it is that the pill will be metabolized and absorbed into your bloodstream, and it might not be as effective,” Shirazian told the Cut. So, if your BMI is 30 or higher — which doctors classify as obese — Shirazian says that rather than taking Plan B, she recommends that women who need an emergency contraceptive get a non-hormonal ParaGard IUD. “I know a lot of people don’t use IUDs in that context, but it can be a form of emergency contraception,” Shirazian says. According to Planned Parenthood’s website, for a copper IUD to be an effective emergency contraceptive, you must have it inserted within five days of having unprotected sex. So, if you decide to take this route, call your doctor or local family-planning clinic soon as possible.

Does Plan B have any side effects?

On its website, Plan B claims that its “very unlikely that you will have any severe reactions” to the morning-after pill. The most common side effects include nausea, abdominal pain, fatigue, and headaches.

Will it affect my menstrual cycle?

Shirazian says that you shouldn’t be surprised if taking Plan B affects your period, but that any differences will likely be minor. “Your next period could be delayed, or you could experience some spotting,” she says.

Everything You Need to Know Before Taking Plan B