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BA from Columbia College in NYC. MD from Northwestern University in Chicago. Trained in Internal Medicine. Mom of two kids. Medical experience in research, teaching, and patient care. Interested in public health education and in correcting medical misinformation in the media. So, I am a Real Doctor with Real Talk about Real Health for Real Teens. Real Talk doesn't replace a conversation with your doctor, your parent, or another supportive adult in your life, but Real Talk with Dr. Offutt can be a place to get involved in your own health!

Saturday, August 30, 2014

Plan B. Morning After Pill. Emergency Contraception.

A long time ago I got a question that has taken me far too long to answer.  Summer and August and Vacation kind of do that to you.  But back with more info for you now.

Here’s the question:  Is there a limit to the amount of times one can take plan b, or "the morning after pill", before it's a health risk?

So, let’s take a few minutes to talk about the Morning After Pill, which is another name for “emergency contraception”.

What is it?
The Morning After Pill refers to the use of drugs as an emergency measure to prevent pregnancy.  It is used after unprotected sex, or after the birth control you are using fails (like the condom tears, etc).

What it is not….
It is not regular birth control that can be used as the primary and regular means of preventing pregnancy.  It is not an abortion.  It is not 100% effective.  It does not prevent sexually transmitted diseases.

How does it work?
Taking the pill or pills (depending on which regimen is used) delivers a high dose of female hormones (estrogen and/or progesterone). This sudden high dose of hormones delays ovulation, or the release of the egg.  The idea is that the sperm that are hanging around looking for an egg to fertilize will swim off a die before they can get to an egg that has been released looking for a sperm with which to be fertilized.  So, no fertilization, no pregnancy. 

Keep in mind:
If the egg has already been released (ovulation has occurred), it won’t work, since the egg and the sperm will be swimming towards each other trying to make a baby.  There are other reasons it might not work as well.  For instance, in girls and women who weigh more than 165 pounds (75kg) , the morning after pill may not work because of the doses of the hormones that are needed are affected by body weight.

Where can you get emergency contraception?
Some forms of the Morning After Pill are available over the counter, and other types of drugs are available only by seeing your doctor or health care provider.  Plan B One Step is sold over the counter, without a prescription, to any one, any age.  There are different brands and how they are all sold is changing everywhere all the time, so when you read this the rules might have changed.  There are some birth control pills that you can take as emergency contraception too.  You can always ask the drug store pharmacist. You can ask to have it on hand in case you DO need it. But better yet, plan ahead so you don’t need it!!!  Birth control should never be an emergency.  It should be a plan.

What are the side effects?
OK, so at last I get to the question – the biggest side effects are nausea and vomiting (feeling queasy and throwing up).  If you throw up the pills within an hour of taking them, you need to take them again.  If the pills don’t prevent the pregnancy from occurring, they don’t appear to cause birth defects or ectopic (tubal) pregnancy.  It doesn’t interfere with getting pregnant later.  So if you have unprotected sex after taking the Morning After Pill, you can still get pregnant.

What happens next?
You should get your period within a few days of taking most versions of the morning after pill.  If 3 – 4 weeks go by and no period – get a pregnancy test.   You should also make sure the next time you have sex, you are using effective birth control.  Which gets me to the next section:

Anything else?
OK,  back to where we started.  Plan B is not Plan A.  Plan A is planning ahead.  And any situation that lets the sperm in., lets the germ in (we're talking STDs).

For more on birth control methods, click here 

How to use a condom, click here :

For a great tool from Planned Parenthood to help you choose a birth control method, click here .

That's it for today,

Dr. O