Dear S&B: Last time I had sex with my boyfriend the condom broke. I was prescribed Plan B. Is it the same as birth control pills? I have also heard this is the same thing as an abortion. Is this true?
Emergency contraception means contraception after sex (post-coital) or contraception used after another form has failed (broken condom). If you have sex around ovulation (three days before or two days after ovulation) you have a 12 to 30 percent chance of becoming pregnant. There are many forms of emergency contraception. A popular one is Plan B, which prevents 75 to 80 percent of these pregnancies. Plan B is high dose of progesterone called Levonorgestrel (also used in the IUD Mirena). According to the New England Journal of Medicine, women naturally make progesterone in the last phase of ovulation and during pregnancy.
Plan B works by preventing ovulation (if you take it before ovulation) or preventing fertilization of an embryo. If you are already pregnant Plan B does not end that pregnancy. Embryos already implanted are not disrupted. Plan B does not prevent pregnancy for the rest of your cycle so another form of contraceptive should be used (condoms), and you should still perform a pregnancy test if your period does not start on time.
Plan B is given as a 0.75mg Levonorgestrel pill twice 12 hours apart. If you vomit the dose up you must repeat the therapy (both doses) with another drug to prevent vomiting. The Plan B pack costs approximately twenty bucks.
With any drug there are risks and side effects. The most common side effects of Plan B are nausea, abdominal pain, headache, fatigue, dizziness and acne. You may also have increased menstrual pains, breast tenderness and missed periods. You should not use Plan B if you have had a blood clot (or any history of clotting problems), had a prior reaction to levonorgesterel, have a uterine infection, PID, or renal disease. You are at increased risk of heart and vessel problems if you smoke or are over 35.
Emergency contraception has been around for several decades. Previously doctors would advise sexual assault victims to take several oral contraceptive pills (OCP) to prevent pregnancy. That is no longer recommended because it isn't as effective as Plan B and has more side effects. There are several forms of emergency contraception including Preven (which is no longer made because the company is focusing on Plan B), Yuzpe regimen, Mifepristone and IUD placement. Progesterone-only pills (Plan B) have a lower incidence of nausea and vomiting than combination pills (Yuzpe).
In 2004, advisory committees to the FDA recommended that Plan B should be available over the counter. This was denied. That same year the FDA decided to increase safety requirements for girls under 16. The concern is that women will use Plan B as a primary form of birth control. If you find you are using Plan B frequently (more than a couple times a year), you should really think about another form of birth control. Plan B is much less effective than BCP. Plan B is emergency contraception. It does not prevent pregnancy even 90 percent of the time. More importantly, you are still at risk for STDs, including HIV and hepatitis B &C. Always use barrier contraception!
Lisa Hermann is a Health and Sexuality columnist. She can be reached at lisa@cavalierdaily.com. This column is used for educational purposes only and is not meant to substitute advice from your doctor.
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