ECPs are given in two doses of hormonal pills. Some ECPs are "combination pills" with estrogen and progestin — synthetic hormones like the ones a woman's body makes. Others are progestin-only. Women who can't take estrogen may be able to take progestin-only pills.

Some clinicians review your medical history before they prescribe ECP. Some may want you to give informed consent by signature or over the telephone.

How to Use ECPs
There are two options of ECPs [Plan B^® (progestin-only) and Preven^® (estrogen and progestin)]. They work best when taken within 120 hours of unprotected vaginal intercourse. Some are designed specifically for emergency contraception — Certain other birth control pills can be used for EC. Several brands have been shown to be effective. The number of pills in a dose depends on the brand. Use the same brand for both doses.

*Progestin-only

With a regular 28-pill birth control pack — of the pills listed above — use any of the first 21 pills for emergency contraception. Don't use the last seven pills in a 28-day pack. They are only reminder pills that contain no hormones. With Triphasil or Tri-Levlen, use only the yellow ones. With Trivora, use only the pink ones.

FIRST DOSE: Swallow the pills in the first dose within 120 hours — five days — after having unprotected sex. If you are not using progestin-only pills, you may want to eat saltines or soda crackers or drink a glass of milk 30 minutes before taking each dose to avoid vomiting. You can buy medication to reduce nausea, such as Dramamine^® or Bonamine^®.

With Plan B^® only, both pills may be taken in one single dose.

SECOND DOSE: Swallow the second dose 12 hours after taking the first dose. If you threw up after the first dose, be sure to use an anti-nausea medication 30 minutes before taking the second one. Or you may want to take the second dose as a vaginal suppository by inserting the pills with your fingers as high into the vagina as you can reach. (The medication will be absorbed through the vaginal tissue.)

If you vomit the second dose, do not take any extra pills. They probably won't reduce the risk of pregnancy. But they will probably make you sick to your stomach.

After You Take the Pills

• Your next period may be earlier or later than usual.
• Your flow may be heavier, lighter, or more spotty than usual.
• If you see other health care providers before you get your period, remember to tell them that you have taken emergency contraception pills.
• Schedule a follow-up visit with your clinician if you do not have your period in four weeks or if you have symptoms of pregnancy.
• Be sure to use another method of contraception if you have vaginal intercourse any time before you get your period again.
• Continue using the birth control method of your choice for as long as you want to avoid pregnancy.

Side Effects
Side effects associated with the use of ECPs usually taper off one or two days after the second dose has been taken.

• Half of the women who take the combined pills feel sick to their stomachs, but only for about 24 hours.
• Up to one out of three women throw up with combined pills.
• The risk of nausea and vomiting is lower with progestin-only ECPs (Plan B^®).
• Breast tenderness, irregular bleeding, fluid retention, dizziness, and headaches may also occur.

Frequent use of ECPs may cause periods to become irregular and unpredictable. The side effects of anti-nausea medication may include lightheadedness, dizziness, or feeling spacey. Please follow the precautions on the package insert.

Emergency contraception may not prevent ectopic pregnancy. An ectopic pregnancy is one that develops outside the uterus. It must be treated to prevent complications that may be fatal.

If you think you may have an ectopic pregnancy, get medical attention immediately. Signs of ectopic pregnancy include

• severe pain on one or both sides of the lower abdomen
• abdominal pain and spotting, especially after a very light or missed menstrual period
• feeling faint or dizzy

ECPs will not harm a fetus. Still, you should not use emergency contraception if you are pregnant.

How Well Emergency Contraception Works

• Combined ECPs reduce the risk of pregnancy by 75 percent. For example, eight out of 100 women will become pregnant after having unprotected sex once during the second or third week of their cycles. But only two out of 100 will become pregnant after taking ECPs.
• Progestin-only ECPs reduce the risk of pregnancy by 89 percent. Only one woman out of 100 will become pregnant after taking progestin-only ECPs.

Timing Is Important
Timing affects how well ECPs work:

• ECPs work best taken as soon as possible after unprotected intercourse.
• The closer a woman is to ovulation at the time of unprotected intercourse, the greater her chances of pregnancy.

Emergency IUD insertion reduces the risk of pregnancy by 99.9 percent. Only one out of 1,000 women will become pregnant after emergency IUD insertion.

Emergency contraception is meant for emergencies only. It is not as effective as the regular use of reversible contraception — Norplant^®, Depo-Provera^®, Lunelle^®, the IUD, or the Pill.

ECPs do not continue to prevent pregnancy during the rest of the cycle. Other methods of birth control must be used.

Emergency contraception offers no protection against sexually transmitted infections. Consider testing for sexually transmitted infections if there is a possibility that unprotected sex put you at risk.

Where to Get Emergency Contraception
Emergency contraception is available at Planned Parenthood, college, public, and women's health centers; private doctors; and hospital emergency rooms — unless they are affiliated with religions that oppose the use of birth control.

Some clinics and clinicians will prescribe ECPs over the phone and call the prescription in to a pharmacy.

You can get the names and phone numbers of five emergency contraception providers nearest you by calling, toll-free, the emergency contraception hotline — 1-888-NOT-2-LATE. Or contact the nearest Planned Parenthood health center at 1-800-230-PLAN.

Emergency Contraception to Go
Packs of ECPs are available from some women's health centers. Some may only provide them to women whose medical histories are well known to their clinicians. Take-home kits allow women to use ECPs in emergency situations without having to wait to see their clinicians.

Costs Vary Widely
Fees may be lesser at family planning clinics and health centers. Some use a sliding scale. Costs also depend on region and location and on which of the following services are needed. Here are some estimates:
 

You May Want Emergency Contraception If

• His condom broke or slipped off, and he ejaculated inside your vagina.
• You forgot to take your birth control pills.
• Your diaphragm or cervical cap slipped out of place, and he ejaculated inside your vagina.
• You miscalculated your "safe" days.
• He didn't pull out in time.
• You weren't using any birth control.
• He forced you to have unprotected vaginal sex.

Contact your health care provider immediately if you have had unprotected intercourse and you think you might become pregnant. Ask about Emergency Contraception.