Little Known (Yet Essential) Facts About Emergency Contraception
The most common and well known option for emergency birth control is Plan B (a medication called levonorgestrel) . In BC this is available without prescription over the counter at the pharmacy, making it a readily accessible choice. What is NOT well known however, is that in 2014 Health Canada stated that Plan B is not effective for use in anyone with a BMI above 25. (Now, BMI is a flawed scale and methodology, but that should be the subject of another article). Given that a “normal” BMI is 18.5-24.9, it doesn’t take much to be above 25. To get an idea how this roughly corresponds to weight, this means that Plan B is less effective in those weighing 165-176lbs and not effective in anyone over 176lbs. This was quite shocking new information at the time (and may still be for you today). The alternative option is Ella (ulipristal) which is effective for those with a BMI above 25.
A second important note with both Plan B and Ella is that they are NOT effective if taken the day of ovulation or after ovulation. WHAT?! How many of you knew that? Plan B is often misused during this time (because of course, most frequently people seek emergency contraception during ovulation, when they are most fertile). This doesn’t mean it’s not ever worth using, because sperm can live in the vagina for up to 5 days, and if you ovulate during that window you may become pregnant. Plan B & Ella work by suppressing ovulation, so if you have already ovulated, they won’t work.
There is one more option. The copper non-hormonal IUD can actually be used as a form of emergency contraception. This works because the copper creates an inhospitable environment for sperm implantation. As a result, the copper IUD is effective at any time during the cycle, not just prior to ovulation. Another advantage here is that with proper use Plan B/Ella are 95% effective if taken 24hrs after intercourse, and 85% within 1-2 days, declining to 58% within 2-3 days. The copper IUD can be inserted up to 7 days following the unprotected intercourse, and is more effective than either of these methods. Another advantage of this IUD is that then you have an ongoing effective contraceptive method (99.7% efficacy) that last 10 years.
The disadvantage of the copper IUD is it can be difficult to access. If you do not have a GP who is trained to provide IUDs you can seek this care through my practice at Madrona or at the Vancouver Island Women’s Clinic in Victoria.
Copper IUDs are recommended as the best form of emergency contraception for all women who have unprotected intercourse. Surprising but true! I hope you found this information enlightening, and I encourage you to tuck it away in your back pocket for when you or someone you know may need it!