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There’s got to be a morning after...

Dear Lucy: How effective are “morning after” pills? Are they available on campus? —The Clock Is Ticking

Dear Ticking: Thank you for asking a very important question. The “morning after” pill—more commonly referred to as “emergency contraception”—is intended to help women prevent pregnancy after unprotected sex or birth-control failures. To learn more about available options, Lucy spoke with MIT Medical OB/Gyn Nurse Coordinator Nicole Napier.
According to Napier, two kinds of emergency contraception (EC) are currently available: progestin-only Plan B One-Step (and its generic forms, such as Next Choice One Dose, My Way, and Take Action) and ella (ulipristal acetate). Both kinds of EC are effective, and both work primarily by delaying or inhibiting ovulation. 
But, as Napier tells Lucy, there are some important differences. “Plan B is available over the counter,” she notes. “But ella is available by prescription only.” And while both types of EC are equally effective (about 95%) when taken within 12 hours after unprotected intercourse, Plan B is somewhat less effective after that. “Plan B is about 75 percent effective in preventing pregnancy if taken within 72 hours,” Napier says. “But research suggests that ella may be more effective then progestin-only pills when taken as directed—and up to 120 hours after unprotected sex.”
In addition, ella appears to be more effective than Plan B when a woman is close to ovulating and in women who are overweight or obese. “However,” Napier cautions, “it can only be taken once during a menstrual cycle, which is not the case for progestin-only pills.”
And, she adds, “It’s important to remember that EC does not prevent sexually transmitted infections. That’s what condoms are for!”
Napier confirms that both types of EC are available at the MIT Pharmacy. “Any member of the MIT community can purchase over-the-counter medications, like Plan B, at the MIT Pharmacy,” she explains, “but students who have waived the Extended Plan will probably need to use an outside pharmacy to fill prescriptions.”
When it comes to the best type of EC, there’s no single answer, Napier emphasizes. “The EC that will work best for you in any particular situation depends on a number of factors,” she says. “Any woman interested in EC should contact a nurse for a full assessment to determine the best option.”
To Napier’s excellent answer Lucy would add only that MIT Medical is available at all times to help women who find themselves in need of assistance with these questions or others. Our walk-in Urgent Care Service is open every day from 8 a.m.–8 p.m.,  and medical advice from trained nurses is always available through our 24-hour helpline at 617-253-4481. —Lucy


Back to Ask Lucy Information contained in Ask Lucy is intended solely for general educational purposes and is not intended as professional medical advice related to individual situations. Always obtain the advice of a qualified healthcare professional if you need medical diagnosis, advice, or treatment. Never disregard medical advice you have received, nor delay getting such advice, because of something you read in this column.