What are the options for emergency contraception after unprotected sex?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: June 8, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

From the Guidelines

Emergency contraception options after unprotected sex include hormonal pills, copper IUDs, and ulipristal acetate, with the copper IUD being the most effective option when inserted within 5 days of unprotected sex, providing ongoing contraception for up to 10 years 1. The most effective emergency contraception method is the copper IUD, which can be inserted within 5 days of unprotected sex and provides ongoing contraception for up to 10 years 1. Other options include hormonal pills such as Plan B One-Step (levonorgestrel 1.5 mg) and Ella (ulipristal acetate 30 mg), which can be used up to 5 days after unprotected sex, though their effectiveness decreases with time 1. For women weighing over 165 pounds, Ella or a copper IUD is recommended as Plan B's effectiveness decreases with higher body weight 1. These methods work by preventing ovulation, fertilization, or implantation, but won't disrupt an existing pregnancy. Some key points to consider when choosing an emergency contraception method include:

  • The copper IUD is the most effective option, with a failure rate of less than 1% 1
  • Ulipristal acetate may be more effective than levonorgestrel for women who weigh more than 165 pounds 1
  • Hormonal emergency contraception pills can cause side effects such as nausea, headache, and fatigue, and may need to be repeated if vomiting occurs within 2 hours of taking the pill 1 It's essential to consult a healthcare provider to determine the best emergency contraception option based on individual needs and circumstances.

From the FDA Drug Label

Ellais a prescription emergency contraceptive that reduces your chance of becoming pregnant if your birth control fails or you have unprotected sex. Take ellaas soon as possible within 5 days (120 hours) after unprotected sex or if you had a birth control failure. Ellacan be taken at any time during the menstrual cycle Ellais meant for emergency contraception only and is not to be used frequently or as a regular birth control.

The options for emergency contraception after unprotected sex include ulipristal acetate (ella), which can be taken as soon as possible within 5 days (120 hours) after unprotected sex. It is essential to note that ella is meant for emergency contraception only and should not be used frequently or as a regular birth control method. After using ella, a reliable barrier birth control method should be used until the next menstrual period 2.

From the Research

Options for Emergency Contraception

The options for emergency contraception after unprotected sex include:

  • Ordinary combined oral contraceptives containing ethinyl estradiol and levonorgestrel taken in a higher dose for a short period of time and started within a few days after unprotected intercourse 3
  • Levonorgestrel-only tablets used similarly 3, 4, 5
  • Copper-bearing intrauterine devices inserted within approximately 1 week after unprotected intercourse 3, 6, 7
  • Ulipristal acetate, which requires a provider's prescription 6, 7

Effectiveness and Safety

The effectiveness and safety of these options have been studied, with evidence showing that:

  • Emergency contraceptive use is safe for women of all ages, and there are no medical contraindications to its use 7
  • The copper intrauterine device is the most effective method of emergency contraception 6
  • Ulipristal acetate tends to be more efficacious in pregnancy prevention than is levonorgestrel, especially when taken later than 72 hours postcoitus 6
  • Women who weigh more than 75 kg or have a body mass index greater than 25 kg/m(2) may have a higher risk of unintended pregnancy when using oral levonorgestrel emergency contraception 6

Access and Use

Access to and use of emergency contraception can be improved by:

  • Educating women about the options available 3, 7
  • Providing advance provision of emergency contraception 5
  • Ensuring that healthcare providers are aware of the range of emergency contraception options and can counsel patients appropriately 6

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Emergency contraception.

Seminars in reproductive medicine, 2001

Research

Emergency Contraception.

Mayo Clinic proceedings, 2016

Research

Emergency contraception: a review.

Minerva ginecologica, 2014

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.