Plan B - The New Morning After Pill For Emergency Contraception

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Plan B - The New Morning After Pill For Emergency Contraception

Plan B is an emergency contraceptive - morning after pill - that was approved by the FDA in July 1999. It is made up of two progestin-only pills containing levonorgestrel.

Emergency contraception is a method of preventing pregnancy to be used after a contraceptive fails or after unprotected sex. It is not for routine use. Drugs used for this purpose are called emergency contraceptive pills, post-coital pills, or morning after pills. Emergency contraceptives contain the hormones estrogen and progestin (levonorgestrel), either separately or in combination. FDA has approved two products for prescription use for emergency contraception – Preven (approved in 1998) and Plan B (approved in 1999).

What is Plan B Morning After Emergency Contraception Pill?

Plan B is emergency contraception, a backup method to birth control. It is in the form of two levonorgestrel pills (0.75 mg in each pill) that are taken by mouth after unprotected sex. Levonorgestrel is a synthetic hormone used in birth control pills for over 35 years. Plan B can reduce a woman’s risk of pregnancy when taken as directed if she has had unprotected sex. Plan B contains only progestin, levonorgestrel, a synthetic hormone used in birth control pills for over 35 years. It is currently available only by prescription.

How does Plan B Morning After Emergency Contraception Pill work?

Plan B works like other birth control pills to prevent pregnancy. Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation). If a fertilized egg is implanted prior to taking Plan B, Plan B will not work.

·	When a woman needs Plan B, she will have to get it very quickly. She can only start it within 72 hours (three days) after intercourse. But, sooner is better than later. On day one, 95% of pregnancies are prevented, compared with 85% on the second day, and 60% for those starting on the third day.

Plan B should not be used by anyone who is or suspects she is pregnant. It should also not be used if the woman has been experiencing abnormal vaginal bleeding for an undetermined reason. If a woman has had an allergic reaction to any part of the pill, they should not use it. A past reaction to Norplant, would be an example.

Plan B can be taken at any time during the menstrual cycle, and should be taken as soon after unprotected sex as is possible. It must be started within 72 hours (three days). A second dose is taken 12 hours after the first. If a woman vomits within an hour after taking either of the two doses of Plan B, she should talk to your doctor to find out if she should repeat the dose.

The Immediate Plan B Morning After Emergency Contraception Pill Experience

While the chance of nausea is dropped in half, it still afflicts about a fourth of its patients. This may cause a woman to take some time off of work or school in order to deal with this side effect. Some doctors suggest adding an anti-nausea medication to combat this. The woman may need to speak up and ask for it. Many anti-nausea medications cause drowsiness.

Other immediate common side effects reported by women taking Plan B include abdominal pain (17.6%), fatigue (16.9%), and headache (16.8%). Women will need to consider these factors in planning activities the two days after starting the medication.

Some women may find that they experience some spotting for a few days after taking Plan B. Wearing a pantyliner for two to three days is a good idea.

After Using Plan B Morning After Emergency Contraception Pill

Fertility returns within a cycle or two after a course of Plan B. A significant percentage notice differences in their next period. Some notice heavier (13.8% of all users) and some lighter (12.5%) menstrual bleeding.

Follow-up and If Pregnancy Occurs Anyway

Women do not need to go for a routine follow-up physical exam after using Plan B. A visit for birth control is appropriate in many cases. If a woman does become pregnant, it is more likely to be an ectopic pregnancy. Plan B doesn't cause ectopics per se. But since the uterus is not very receptive to the eggs that wind up there, by process of elimination, the tubal pregnancies become a higher percentage of the ones left. A woman should see a doctor right away if suspects she is pregnant, has pelvic pain, or any other concerns about her health.

The good news is that if a post-Plan B pregnancy goes to term, there hasn't been any adverse effects on the babies reported.

Progestins are the "pregnancy" hormone. Levonorgestrel is used in regular birth control methods, such as Norplant. Previous morning after pill formulations had used progestins in combination with estrogens, the "female" hormone. Plan B is the first progestin-only morning after emergency contraception pill that has been approved in the U.S. for emergency contraception after either unprotected sex or a contraceptive accident, such as a condom breaking.

A common side effect of the morning after pills is nausea. Plan B causes nausea much less often than the next best formulation, which is called the Yuzpe method. Plan B causes nausea in about 23 % of those who take emergency contraception compared to 50% of those on Yuzpe. Plan B is also more effective. Plan B's pregnancy rate was only 1% vs. about 3% for Yuzpe.

The combined Plan B benefits of decreased side effects and increased effectiveness may have a hidden advantage. More eligible women may decide take it because it is less life disrupting. Then the unwanted pregnancy rate for reproductive age women as a group could be improved beyond the extra 2% drop in pregnancies due to the drugs themselves.