Emergency Contraception

Emergency Contraception (EC) is contraception that is used to reduce the risk of unintentional pregnancy after either unprotected vaginal intercourse or a known/suspected birth control failure such as a broken/slipped condom, missed pill, delayed insertion of ring, detached patch, late injection, etc. The effectiveness of EC will vary depending on the type of method used and timing of use. The Copper IUD is the most effective EC method to reduce risk of unintentional pregnancy and has the longest timeframe (w/i 7days) to utilize while Emergency Contraceptive Pills (ECP) vary in effectiveness and time frame depending on type. EC does not offer any protection against STIs.

There are currently 2 EC options available: 

1. Copper IUD

2. Emergency Contraceptive Pill (ECP)

   • Ullipristal Acetate (sold as Ella)
   • Progestin Only (sold as Plan B, Contingency ONE, Norlevo, Backup plan One Step, Option 2)

1. Copper IUD

The copper IUD can be inserted within 7 days after intercourse and is 99% effective against pregnancy. Another great benefit of using Copper IUD as emergency contraception is that it can remain in the uterus for any period of time up to 5-10 years (depending on the model) becoming a very effective longer term birth control method. Unlike Emergency Contraceptive Pills, users of higher body weights can use the copper IUD without any reduction in effectiveness.

The copper creates an inflammatory reaction in the uterus which prevents fertilization and/or implantation. The copper IUD may increase cramping and flow for longer term users and it must be prescribed and inserted by a health care provider. The cost of a Copper IUD varies from $100-150 for device. There is no cost for insertion if user has MSP.

This option is not available as a drop-in service and is only available with an appointment at our Quadra Street location.

Emergencyiud.com and raice.ca list other service providers offering emergency IUD insertions in Western Canada.

Call us for an appointment if you are interested in pursuing this option.

 

2. Emergency Contraceptive Pill

Emergency contraceptive pills are also known as Morning After Pill (MAP) or ECP Emergency Contraceptive Pills.

At ISHS, we have 2 different types of Emergency Contraceptive Pills available:

Ullipristal Acetate (sold as ELLA) **Ella is only available with a prescription**

 ~64% effective if taken within 120 hrs (5 days) after single act of unprotected vaginal intercourse. Ella is slightly more effective than progestin only pill but remains equally effective throughout the 120 hours following unprotected intercourse. Ella interferes with progesterone so it’s not the best choice for clients who are using it as back up with the pill, patch, ring, or shot. Ongoing hormonal contraception cannot be started for 5 days after using Ullipristal. Back up with a barrier method for 14 days.May be more effective than progestin only pill in users who weigh more than 165lbs or have a higher BMI

• Progestin only (sold as BACKUP PLAN ONESTEP; Plan B; Contingency ONE; Norlevo; or Option 2) No prescription necessary – can be bought at ISHS, youth clinics, most pharmacies by anyone.
  • ~50% effective. Most effective if taken within 72 hrs after a single act of unprotected vaginal intercourse. The sooner you take emergency contraceptive pill(s), the more likely they will successfully reduce the risk of pregnancy as effectiveness decreases over time but may be taken up to 120 hours following.
  • Ongoing hormonal contraception can be started immediately after taking this type of ECP. Use Back up with a barrier method for the first 7 days.
  • May be less effective in users who weigh more than 165lbs or have a higher BMI. 

How do Emergency Contraceptive Pills (ECP) work?

• Both types of ECP work by delaying ovulation. Neither type of ECP work to prevent pregnancy if ovulation has already occurred.

There is an increased risk of pregnancy if user has unprotected sex after taking ECP without using a back up method prior to their next period.

ECP may not work if:

• a fertilized egg has already implanted in the uterus before taking the pills
• too much time passed between unprotected intercourse and taking the pill and ovulation still occurs

Health Canada states that progestin only “pills are less effective in women weighing 165 to 176 pounds (75-80 kg), and are not effective in women over 176 pounds (80 kg). Women who weigh 165 pounds or more are advised to ask a health professional, such as a doctor or pharmacist, for advice on alternative methods of emergency contraception.”

ECP does not work if you are already pregnant; it does not cause abortion.

How much does ECP cost?

• Ullipristal (ELLA) – $27 here at ISHS  but pharmacies generally charge more ($27-$45) *User must see a Dr to receive a prescription for ELLA*
• Progestin Only (Backup Plan One Step) $17 here at ISHS but pharmacies generally charge more ($28-45) *No prescription necessary

Are there side effects from ECP?

Most people tolerate ECP well; however it can cause minor side effects in some users such as fatigue, breast tenderness, headache, and abdominal pain. Rarely, people feel nauseated after use.

There is no evidence that ECP would harm a developing fetus should it be taken accidentally during early pregnancy. It is not the same as an abortion pill.

ECP will not protect you from pregnancy if you have unprotected sex after you take it. It has only been developed to reduce the risk of pregnancy after a single event of contraceptive failure/interruption. You must use back up if you have sex after using it.

Common Questions about ECP:

• When will my period come after taking ECP?
  • You should expect to have your period around the time you expect next it although sometimes ECP can make your period come a little bit earlier or later. If your period is more than a week late, you may want to take a pregnancy test.
• If I take more than one box of ECP at a time, will it be more effective?
  • No, taking more than a single dose will not make it more effective. If you are concerned about effectiveness, you may want to consider the use of an emergency Copper IUD which is 99% effective as emergency contraception.
• If I take ECP more than once, will it become less effective if I need to take it again?
  • No, but remember it’s not meant to be used as a regular method of birth control only a backup method of birth control for situations when there has been a problem with another method or no method has been used.

It’s a good idea for all sexually active people at risk of becoming or causing someone to become pregnant to keep a dose on hand for emergencies. The Emergency Contraceptive Pill(s) are not suitable for regular birth control use because: they are less effective than other methods, only intended to be effective for a temporary period of time, and do not protect against sexually transmitted infections.