Emergency contraception
EC - Ella - "morning after pill"
Need emergency contraception now?
Emergency contraception — what you need to know
Had unprotected sex or birth control didn’t go as planned?
Emergency contraception can help prevent pregnancy—but timing and proper use really matter.
Timing matters
- Ella works up to 5 days (120 hours) after unprotected sex
- The sooner you take it, the better it works
- It’s best to use once per menstrual cycle
How Ella works
Before ovulation
After ovulation
⚠️ Important: don’t mix hormones
Do not mix Ella with other hormonal pills for 5 days
For the 5 days after taking Ella, you should not use:
- Plan B or other levonorgestrel emergency contraception
- Regular birth control pills (combined or progestin-only)
- Any other hormonal emergency contraception
These can interfere with Ella and lower its effectiveness, increasing the risk of pregnancy. After 5 full days, you and your clinician can decide when and how to start or restart regular birth control safely.
Efficacy
- This medication is less effective in people weighing over approximately 195 pounds.
- It is also less effective during or after ovulation.
How often can I use Ella?
Ella is not intended to be used more than once in the same menstrual cycle. Repeated use in a single cycle can:
- Disrupt hormone levels and cycle timing
- Cause irregular or heavy bleeding
- Make it harder to know when you ovulate
- Lower overall pregnancy prevention reliability
Emergency contraception is designed for occasional, unexpected situations—not as a primary birth control method. Regular birth control methods are much more reliable when taken correctly (pills, patch, ring, shot, implant, or IUD).
Keeping Ella “on hand”
Some people prefer to keep Ella at home so they can take it right away if needed. This can:
- Reduce delays
- Make timing easier
- Provide peace of mind
Even when you have it on hand, the same usage rules still apply.
Ella vs. Plan B (OTC)
There are two main types of emergency contraception pills available in the U.S.: Ella (prescription) and levonorgestrel-based pills such as Plan B and its generics (over-the-counter). They are not the same and work best in different situations.
| Feature | Ella | Plan B (OTC) |
|---|---|---|
| Active ingredient | Ulipristal acetate | Levonorgestrel |
| How long it works | Up to 5 days (120 hours) | Up to 3 days (72 hours); best within 24 hours |
| Effective near ovulation? | Yes – still effective close to ovulation | Much less effective near or after ovulation |
| Impact of weight | Less impacted by weight compared with Plan B | Less effective over about 165–175 lb |
| Prescription needed? | Yes (prescription required) | No (over-the-counter) |
| Can start birth control right away? | No – must wait 5 days after Ella | Yes – may start immediately |
Most effective backup option: copper IUD
A copper IUD (Paragard) placed within 5 days is the most effective form of emergency contraception.
- Works even after ovulation
- Provides ongoing birth control
- Requires an in-person visit
Pregnancy testing and follow-up
Because emergency contraception isn’t 100% effective:
- Take a pregnancy test if your period is more than 1 week late
- Or test 2–3 weeks after taking Ella
- If positive, seek care promptly
🚫 What emergency contraception does not do
- It does not work if you are already pregnant
- It does not protect against STIs
- It is not as reliable as regular birth control
This page is for education only and is not personal medical advice. Emergency contraception does not treat sexually transmitted infections and does not work if you are already pregnant. If you have severe pain, heavy bleeding, dizziness, chest pain, trouble breathing, or feel very unwell after taking EC, seek urgent or emergency care.
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Every visit is a flat $30 and reviewed by our dedicated caring clinicians.
Get care now $30 visit →Emergency contraception — what you need to know
Emergency contraception (EC), often called the “morning-after pill,” is a backup option to help prevent pregnancy after unprotected sex or birth control failure. It is time-sensitive and has important rules to follow so it actually works.
Timing is critical
- Ella must be taken no later than 5 days (120 hours) after unprotected intercourse.
- Ella should only be taken once per menstrual cycle, and only after you’ve had a normal period since the last time you used it.
How emergency contraception works
Before ovulation
Before the ovary releases an egg (ovulation), Ella can delay or prevent that release. No egg released means there is nothing for sperm to fertilize, which prevents pregnancy.
After ovulation
Once ovulation has already occurred, Ella is less effective. Some forms of emergency contraception, such as the copper IUD placed by a clinician, can make the uterus less welcoming to a fertilized egg and help prevent implantation. If implantation does not occur, pregnancy does not occur.
Key safety rules with Ella
Do not mix Ella with other hormonal pills for 5 days
For the 5 days after taking Ella, you should not use:
- Plan B or other levonorgestrel emergency contraception
- Regular birth control pills (combined or progestin-only)
- Any other hormonal emergency contraception
These can interfere with Ella and lower its effectiveness, increasing the risk of pregnancy. After 5 full days, you and your clinician can decide when and how to start or restart regular birth control safely.
Weight, timing, and effectiveness
Emergency contraception works best when taken as soon as possible after unprotected sex. The closer you are to ovulation, or the higher your weight, the lower the overall effectiveness.
- This medication is less effective in people weighing over approximately 195 pounds.
- It is also less effective during or after ovulation.
How often can I use Ella?
Ella is not intended to be used more than once in the same menstrual cycle. Repeated use in a single cycle can:
- Disrupt hormone levels and cycle timing
- Cause irregular or heavy bleeding
- Make it harder to know when you ovulate
- Lower overall pregnancy prevention reliability
Emergency contraception is designed for occasional, unexpected situations—not as a primary birth control method. Regular birth control methods are much more reliable when taken correctly (pills, patch, ring, shot, implant, or IUD).
Keeping Ella “on hand”
For some people, it makes sense to keep Ella at home so they can take it quickly if needed. Having Ella available can:
- Help you take it as soon as possible after unprotected sex
- Reduce delays from pharmacy hours, travel, or scheduling
- Provide a sense of control and peace of mind
Even when kept “on hand,” Ella should still only be used once per menstrual cycle and the same timing and safety rules apply. Clinicians may provide an advance prescription or refill so you can keep a dose at home, while also helping you choose a reliable routine birth control method for ongoing protection.
Ella vs. Plan B (OTC)
There are two main types of emergency contraception pills available in the U.S.: Ella (prescription) and levonorgestrel-based pills such as Plan B and its generics (over-the-counter). They are not the same and work best in different situations.
| Feature | Ella | Plan B (OTC) |
|---|---|---|
| Active ingredient | Ulipristal acetate | Levonorgestrel |
| How long it works | Up to 5 days (120 hours) | Up to 3 days (72 hours); best within 24 hours |
| Effective near ovulation? | Yes – still effective close to ovulation | Much less effective near or after ovulation |
| Impact of weight | Less impacted by weight compared with Plan B | Less effective over about 165–175 lb |
| Prescription needed? | Yes (prescription required) | No (over-the-counter) |
| Can start birth control right away? | No – must wait 5 days after Ella | Yes – may start immediately |
In general, Plan B is best for very early use (within 24–48 hours) and lower body weight. Ella is often the better choice closer to ovulation, later in the window (up to 5 days), or for higher body weight.
Most effective backup option: copper IUD
The most effective form of emergency contraception is a copper IUD (Paragard) placed by an OB/Gyn or other trained clinician within 5 days of unprotected sex. A copper IUD:
- Is one of the most effective emergency contraception options
- Provides long-term birth control once placed
If you are close to or after ovulation or weigh above about 195 pounds, a copper IUD may be a better choice than relying on Ella alone. This requires an in-person visit with a clinician.
Pregnancy testing and follow-up
Because emergency contraception is not 100% effective, it is important to monitor your cycle and test if your period is late.
- Take a pregnancy test if your period is more than about one week late.
- You can also test about 2–3 weeks after using Ella to confirm.
- If any test is positive, seek in-person care promptly to discuss your options and next steps.
If you are unsure where you are in your cycle, or have questions about timing, weight, or repeat use, it is always appropriate to reach out to a clinician rather than guessing.
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