Understanding the Morning After Pill: 10 Things You Should Know

You may already be familiar with the good ol' morning-after pill, but there may be a few pieces of information you might be missing about this emergency contraceptive. Maybe you need a refresher on what it does, how it works, or if it is even the right option for you. Well, don't fret—we've got you covered. Whether you've had a recent "whoopsie" while getting hot or heavy or just rather be safe than sorry in the future, here are ten things you need to know about the morning-after pill. 

1. What is the Morning After Pill?

Just so we cover our bases, let's discuss what the morning pill is. The morning-after pill is an emergency contraceptive used to prevent pregnancy following unprotected sex or a birth control failure, such as a missed pill or broken condom. It’s not meant to replace your birth control pills, but it is a great backup for when things go awry.

Think of this pill as your safety net. So, if you've done the deed without a condom or don't feel certain that your birth control did the job, this emergency contraception can lower your chances of pregnancy.  

Types of Morning After Pills

There are two types of morning-after pills available: levonorgestrel and ulipristal acetate. Here's a breakdown of these two medications:

  • Levonorgestrel (Morning After Pill™ by Cadence OTC, Plan B One-Step, Take Action): This is the most common morning-after pill available over the counter at your nearest pharmacy or convenience store. It contains the hormone levonorgestrel, which delays the release of an egg from your ovary. It is most effective if you take it within 72 hours of unprotected sex.
  • Ulipristal acetate: Sold under the brand Ella, this is an emergency contraceptive pill available by prescription only. Unlike levonorgestrel-based pills, ulipristal acetate can work up to 120 hours or five days after unprotected sex (but the sooner you take it, the better!). This pill prevents pregnancy by blocking the hormone progesterone. 

Both levonorgestrel- and ulipristal acetate-based pills are effective. Still, ulipristal acetate tends to be a bit more reliable closer to the five-day mark, while levonorgestrel needs to be taken ASAP to prevent pregnancy. 

Over-the-Counter Availability

Good news—many morning-after pills are available over the counter at your nearest pharmacy or convenience store. You can simply walk in, grab a box off the shelf, and make your way to the register without any issue (hopefully). But if you're not comfortable going in person, many brands sell this morning-after pill online.

Ella (ulipristal acetate), on the other hand, requires a prescription from a healthcare provider. If you'd like to keep some on hand, ask your healthcare provider about getting a prescription so you can have it ready when needed. 

2. How Does the Morning After Pill Work?

Now that we've covered the basics of the morning-after pill, let's look at the science. Don't worry—we won't bore you with the often complicated science lingo. 

So, the morning-after pill works by preventing ovulation—or the process of your ovaries releasing an egg. If there's no egg available for the sperm, no pregnancy happens. 

While the morning-after pill can prevent pregnancy, it will not end an existing pregnancy. This is an emergency contraceptive pill, not an abortion pill. 

Also, the morning-after pill will not protect you from sexually transmitted infections (STIs). You'll need to use barrier methods, like condoms, to lower your risk of getting an STI.

Preventing Pregnancy

The morning-after pill's role is to prevent pregnancy from occurring to keep that sneaky sperm from meeting an egg to fertilize. Simply put—no fertilization, no pregnancy.

But you might be wondering, "What if I'm already ovulating?" Well, this is where it gets a bit tricky. If you're ovulating and a sperm connects with an egg, the morning-after pill may not have the chance to stop a pregnancy from proceeding. That's why it's the most effective when taken right after unprotected sex.

Comparison to Regular Birth Control 

A very big misconception surrounding the morning-after pill is that it's the same as a regular birth control pill. News flash: it's not. Birth control pills offer long-term pregnancy prevention with daily use, whereas the morning-after pill provides an emergency, single-use solution.

Because the morning-after pill doesn't provide ongoing protection against pregnancy, we recommend using regular birth control methods like the pill, intrauterine device (IUD), or condoms to stay protected in the long run. Remember, the morning-after pill is just a nice backup for when your normal, regular birth control methods fail on you or they aren't used. 

3. When to Take the Morning After Pill Correctly

Timing is key when it comes to the morning-after pill. We highly recommend taking it as soon as possible after doing the deed or contraception failure.

As a quick reminder, levonorgestrel-based pills should be taken within 72 hours or three days after unprotected sex, and ulipristal acetate pills can work up to 120 hours or five days after unprotected sex.

The quicker you pop one of these bad boys, the better they work. When you wait too long—especially if ovulation has occurred—the chances of this emergency contraception preventing pregnancy are very low.

4. How to Take the Morning After Pill

Taking the morning-after pill doesn't have to be rocket science. You simply take one pill, and you're good to go. Both pills are in a single dose, and you can take them with water. You don't have to take the morning-after pill with food, but if you're feeling a bit queasy, you may want to eat a light snack to settle your tummy.

Once you've taken it, you can resume your daily routine, but keep an eye on how you're feeling (don't worry—we'll get to that in the next section). 

5. What are the Morning After Pill's Side Effects?

With any medication you take, the morning-after pill can come with some lovely side effects (insert sarcasm here). For most folks, the morning-after pill side effects are very mild and will disappear on their own. But to give you a little more reassurance, let's discuss the common and rare side effects of the morning-after pill.

Common Side Effects

  • Nausea: You might feel a little queasy after downing the pill. But relax—this is a common side effect that goes away after a few hours.
  • Tiredness: Another common side effect is feeling tired. This occurs due to the pill's effect on hormones.
  • Headache: You might experience a headache after taking the emergency contraceptive pill.
  • Breast tenderness: Your breasts might be a little sore or sensitive—similar to how they might feel before your period starts.
  • Dizziness: You could experience a dizzy spell, but it shouldn't last too long.
  • Cramps: You may experience some mild cramping that's similar to your typical period cramps. 

Rare Side Effects

Here are some very rare side effects of the morning-after pill:

  • Vomiting: There's a chance you may throw up after taking the pill. If you vomit within two hours of taking it, you'll likely need to take another dose, as the medication didn't have enough time to absorb in your system.
  • Severe cramps: If you're having severe, almost debilitating cramps that don't go away, please visit your healthcare provider ASAP.

Other than these very undesirable side effects, there aren't any real dangers of morning-after pills you need to worry about, so you can take a nice deep breath and let that anxiety go. 

Managing Side Effects

"What can I do to manage morning-after pill side effects?" Typically, side effects of this emergency contraceptive disappear within a day or so, but if you're feeling nauseous, try to eat a light meal and stay hydrated. If you're having headaches or cramps, try over-the-counter pain relievers like ibuprofen (Advil, Motrin) or acetaminophen (Tylenol). And if you're feeling a bit tired, take it easy by lying down or taking a quick nap. 

6. How Effective is the Morning After Pill?

Now, you're likely wondering, "What's the success rate of the morning-after pill?" Let's be clear—while the morning-after pill is very effective, it does not fully guarantee protection against pregnancy. Levonorgestrel pills like Morning After Pill™ by Cadence OTC, Plan B One-Step, and Take Action have a 95% success rate when taken within 24 hours after unprotected sex, which drops to 87% when taken within 72 hours. Ella (ulipristal acetate) is a bit more consistent and works just as well up to five days after doing the deed—holding up to a 98% success rate.  

Factors Affecting Effectiveness 

There are a few factors that could affect how the pill works in your body, including: 

  • Timing: We've said this several times, but it's really important to understand that the sooner you take the pill, the better it works in your body. The pill becomes less effective when you wait until after that 24-hour window. This is especially true if you're ovulating. Remember, the pill works to prevent ovulation, so if it's already happening, there's not anything it can do to stop pregnancy from happening.
  • Body weight and BMI: One of the primary factors that impact how well the morning-after pill works is your body weight. There's research that shows that the morning-after pill can be ineffective for people who weigh more than 165 pounds and (or) have a BMI over 25.
  • Current medications (drug interactions): Certain meds can lower the morning-after pill's effectiveness. Anti-seizure medications, St. John's wort (a supplement), certain antibiotics, antifungal medications, and HIV medications are some of the medications that can mess with the pill's effectiveness. If you're taking any of these, talk to your doctor before you use an emergency contraceptive.
  • Vomiting after taking the pill: As a reminder, if you're throwing up two hours after taking the morning-after pill, it's likely that it didn't have a chance to absorb in your body. When this happens, just take another pill to ensure you're protected.  

7. Does the Morning After Pill Make You Bleed?

It is possible to experience some morning-after pill bleeding, but it's not a major cause of concern. After taking the pill, some people experience light bleeding or spotting a few days later. However, this is a normal side effect that happens because the pill is messing with your hormones.  

8. Can the Morning After Pill Cause Spotting?

Absolutely. Spotting is very common after popping a Morning After Pill™. These symptoms typically happen a few days to a week later. Spotting is way lighter than your typical menstrual blood and has a pinkish or brownish color. This spotting is just a side effect from the surge of hormones flowing through your body and should go away on its own. 

Bleeding vs. Spotting: Understand the Difference

So, how can you tell the difference between bleeding and spotting? Well, bleeding after the morning-after pill can resemble a much lighter version of your period. It's a bit more than just a few spots of blood in your underwear, but it's typically not as heavy as a full menstrual period.

Now spotting, on the other hand, is just a tiny bit of blood mixed with your usual vaginal discharge. It usually has a pink, brown, or even light red hue to it. 

If you ever are confused about what's going on down there, just pay attention to the flow. If you're experiencing much heavier bleeding, like soaking through pads and tampons type of bleeding, this could indicate a more serious problem, and we highly suggest visiting your healthcare provider or an urgent care clinic to see what's up. 

9. How Long After Will the Morning After Pill Work?

Fortunately, this emergency contraceptive pill won't sit in your system for too long. Once you've taken the pill, it works very quickly to prevent or delay ovulation. After a few days, the pill leaves your system without any trouble, so there are no long-term impacts you need to worry about.

Please note that the morning-after pill won’t protect you from pregnancy if engage in unprotected sex later in the same cycle. For ongoing and reliable protection, please return to or consider getting on regular birth control.

10. Does the Day After Pill Affect Your Period or Ovulation?

Yes, the morning-after pill can mess around with your usual period (sorry about that!). But don't worry, it's nothing too crazy. Your menstrual cycle may feel slightly "off" for about a month. So, for example, you might notice that your period starts a little sooner or later than usual or that it's lighter or heavier than normal. The good news is that these menstrual irregularities are only temporary and usually balance themselves out by your next cycle. Cheers to that!

As for ovulation, because the morning-after pill works to delay it, you may not ovulate as you typically would. So, if you're someone who likes to track your cycle, be aware that this emergency contraceptive pill can throw off your timing; it may take a while for things to go back to normal.

Other Myths and Misconceptions

As we previously mentioned, there are many myths and misconceptions about the morning-after pill. So, without further ado, let's get those straightened out.

    1. Myth: Taking a morning-after pill causes an abortion.
      • Fact: Not at all. The morning-after pill is designed to prevent pregnancy from occurring by delaying or preventing ovulation. If you're already pregnant, it won't harm you or the embryo. If you're seeking an abortion, there's medication available that can safely end a pregnancy. Seek abortion care services or ask your healthcare provider to discuss your options.
  • Myth: You can only take it the "morning after."
        • Fact: Despite the name, you don't have to take it immediately after doing the deed (although we recommend you take it as soon as you can). While it's most effective within 72 hours, it can still work up to five days later (if you're taking Ella).
  • Myth: The morning-after pill makes you infertile.
        • Fact: This is completely false. The morning-after pill won't mess with your fertility at all. Once it's out of your system, your body goes back to normal, and you can get pregnant in the future if you'd like to.
  • Myth: The morning-after pill works well as regular birth control.
      • Fact: Although it's a wonderful backup option, the morning-after pill isn't as effective as good ol' regular birth control methods like the ones we previously mentioned. Using it frequently can be pretty expensive and less reliable than birth control pills or an IUD. So, when it comes to how often you should take the morning-after pill, it should only be used for rare emergencies. 

    The morning-after pill is a very safe, effective, and reliable way to prevent pregnancy when things don't go as planned. Remember, it's not something you should rely on for regular birth control, but it's great to know it's there when you need it the most. And the sooner you take it, the better it works in your system.

    And while it can cause a few unpleasant side effects, like nausea, spotting, and tender breasts, know that these symptoms clear up pretty quickly. If you're ever unsure about the side effects you're experiencing or whether or not you actually need the morning-after pill, reach out to a healthcare provider or pharmacist for medical advice or schedule a visit to your nearest Planned Parenthood center for assistance.