Is repeat use of emergency contraception safe?

Dear Reader,

If you took emergency contraception (EC), also frequently called the morning after pill, two months ago, you aren’t protected for any sex you had afterwards. So, if you want to reduce your risk of pregnancy at this point, it may make sense to take EC again. Emergency contraception offers a second chance to prevent a pregnancy after sex that occurred when a birth control method wasn’t used or failed. There aren’t any known risks of taking emergency contraception multiple times, but you may experience some associated side effects each time, such as affecting the timing of your next period (more on this in a bit). Additionally, it’s difficult to say the chances of getting pregnant, as there are many factors at play.

Though there are several methods of EC, the levonorgestrel emergency contraception pills are available on the shelves in the family planning aisle at many pharmacies and drugstores. They’re available without a prescription or a proof-of-age requirement (even though the packaging on the generic versions of EC says that it’s intended for use in women ages 17 and older). Other methods of EC may require prescriptions or a visit to a health care provider. Of note is the brand ella, which is the only brand that consists of a pill with ulipristal acetate. It's notable because ella is effective in people who weigh 155 pounds or more. The levonorgestrel pills have reduced effectiveness in those who weigh 155 pounds and more, so how much you weigh may be a factor to consider in deciding which EC is right for you. Another form is the copper intrauterine device, Paragard. In addition to functioning as a form of EC, this is a long-acting reversible contraceptive, which can help to prevent pregnancy continuously. It’s also consistent regardless of a person’s weight.

EC pills are a special formulation of hormones that are taken within 120 hours of sex to prevent pregnancy. However, if taking the levonorgestrel EC, it’s most effective when taken as soon as possible. While repeat use of EC has no known health risks, you may already be familiar with temporary side effects when you took them last; some people may have changes in the amount, duration, and timing of their next period, while others may experience nausea and vomiting. EC isn’t designed to be used as a regular form of contraception. However using EC twice in a couple of months doesn’t have any reported effects.

You also ask what your chances are of getting pregnant. Too many variables are involved to accurately predict any person's chances of becoming pregnant. Based on the information you provided, a couple of influential factors may be considered to help narrow the estimate of your risk of pregnancy. For example, did the sex in question occur during the most fertile days of your cycle? Typically, this period runs from five days before ovulation through the day of ovulation. Pregnancy is still possible for one to two days after ovulation, but it's less likely. If you know for sure that you’ve ovulated, and if the condom broke more than two days after ovulation, you're probably at lower risk for pregnancy. However, given that there's still a small possibility of becoming pregnant, using EC again may be a good idea. When the condom broke during sex is another factor that may decrease or increase your likelihood of becoming pregnant. Did it break before or after your partner ejaculated? Did your partner pull out before or after ejaculating?

It can be helpful to talk with your health care provider about whether you want to take EC again. If you find that you’re using it repeatedly, you may consider other birth control options in addition to condoms. There are a number of hormonal and non-hormonal contraceptive options that you can use with condoms in order to provide some additional protection. Your health care provider may also be able to speak with you about these options and which may be right for you. For more information about emergency contraception and contraception options in general, you can check out the Contraception category of the Go Ask Alice! Sexual & Reproductive Health archives.

Best of luck making your decision,