Emergency Contraception After Taking iPill
If you have unprotected sex after taking an emergency contraceptive pill (iPill/Plan B), you need to take another dose of emergency contraception as soon as possible, because the first pill only protects against pregnancy from intercourse that occurred before you took it—it does not provide ongoing contraception. 1
Understanding How Emergency Contraception Works
Emergency contraceptive pills work primarily by delaying or preventing ovulation for the specific act of intercourse that already occurred 2. They do not provide ongoing contraceptive protection for future acts of intercourse 1, 3.
- The iPill (levonorgestrel) is most effective when taken within 72 hours of unprotected intercourse, though it can work up to 120 hours 1, 4
- Effectiveness decreases significantly as time passes after unprotected intercourse 1
- Taking emergency contraception reduces pregnancy risk by approximately 75-80% for the intercourse it was intended to cover 1, 3
What to Do After Unprotected Sex Following iPill Use
You must take another dose of emergency contraception if you have unprotected sex after taking the first iPill 1. Your options include:
Levonorgestrel (Plan B/iPill)
- Take 1.5 mg as a single dose as soon as possible 2, 1
- Most effective within 72 hours but can be used up to 120 hours 1, 4
- Available over-the-counter in most locations 5
Ulipristal Acetate (Ella)
- This is the preferred option if more than 72 hours have passed since the new unprotected intercourse 2, 6
- Take 30 mg as a single dose 6
- More effective than levonorgestrel, especially after 72 hours (65% lower pregnancy risk in first 24 hours, 42% lower up to 72 hours) 5
- Effective up to 120 hours (5 days) after unprotected intercourse 6, 4
- Requires a prescription 5, 4
- More effective in women with higher body weight compared to levonorgestrel 2, 1
Copper IUD
- This is the single most effective emergency contraception method 2, 7
- Can be inserted within 5 days of unprotected intercourse 2, 4
- Provides ongoing contraception for up to 10 years 7
- Requires a trained provider for insertion 7
Starting Regular Contraception
You can and should start a regular contraceptive method immediately after taking emergency contraception 1. This is critical because:
- Emergency contraception should never be used as an ongoing contraceptive method 3, 7
- You remain at risk for pregnancy from any subsequent unprotected intercourse 1
- Regular contraceptive methods are far more effective than repeated emergency contraception 3
Timing for Regular Contraception Start
- Any regular contraceptive method can be started immediately after using Plan B 1
- Use backup contraception (condoms) for 7 consecutive days when starting combined hormonal methods 2
- Use backup contraception for 2 consecutive days when starting progestin-only pills 2
Common Pitfalls to Avoid
Do not assume emergency contraception provides ongoing protection—this is the most critical mistake 1, 3. Each act of unprotected intercourse requires its own emergency contraception if you are not using regular contraception.
Do not delay taking emergency contraception—effectiveness decreases dramatically with time 1, 4. If you're approaching or past 72 hours, strongly consider ulipristal acetate instead of levonorgestrel 2, 5.
Do not use emergency contraception as your regular birth control method—it is significantly less effective than ongoing contraceptive methods and is intended only for emergencies 3, 7.
Special Considerations
If Vomiting Occurs
Body Weight Concerns
- Levonorgestrel may be less effective in women with higher body weight, though it should still be offered 1
- Ulipristal acetate is more suitable for women with obesity 2, 7
- The copper IUD remains highly effective regardless of body weight 7