How many times is it safe to take emergency contraception?

Emergency contraception, popularly known as the morning-after pill or plan B, prevents pregnancy after unprotected sex or when other birth control methods fail. But what happens if you take it more than once? There are many emergency contraception myths despite how common it is. In this article, we’ll discuss emergency contraception options, how frequently you can use them, and other safety precautions to consider.

If you want to keep emergency contraception on hand, Hey Jane offers two options: generic Plan B One-Step and prescription-strength Ella. You can fill out our intake form online and consult with a provider via text, chat, phone, or video call to get your prescription delivered to your home or local pharmacy for pick up. 

In this article, we’ll discuss emergency contraception options, how frequently you can use them, and other safety precautions to consider.

What is emergency contraception?

Emergency contraception is how we describe methods to prevent pregnancy after sex. They are typically used after unprotected sex, or when a contraception method fails (like when the condom breaks, you miss your pill, or you had sex on a fertile day). It’s often referred to as “Plan B” or “the morning-after pill,” but depending on the method, you may have up to 5 days after unprotected sex to use it. 

Emergency contraception works by delaying ovulation (the release of an egg from your ovaries). The sooner emergency contraception is used, the better. The bad news is that if you’ve already ovulated (released an egg), emergency contraception won’t work, and you’ll have to wait to take a pregnancy test before taking next steps. If you’re not sure if you have already ovulated, taking Plan B can’t hurt!

There are a few types of emergency contraception, including Plan B One-Step (also available as generic levonorgestrel), Ella (a prescription pill containing ulipristal acetate), copper IUDs, and taking multiple combination birth control pills (containing estrogen and progesterone) at once. You can get both generic Plan B and Ella through Hey Jane to keep on hand for future use, and take the “emergency” out of emergency contraception when you need it most. Get started here.

How many times can I take emergency contraception?

As many times as you need! There is no max number of times you can use emergency contraception, like Plan B or Ella, in your lifetime. Taking emergency contraception multiple times does not reduce its efficacy, nor does it impact future fertility. Although it’s labeled as for “emergencies,” for some people, it’s their preferred method to prevent pregnancy. Other folks may prefer to have it on hand if they don’t have unprotected sex very often, if they don’t want to use a daily or long term birth control method, if it’s not safe for them to take birth control, or a number of other valid reasons.

Can I take emergency contraception pills multiple times in a day?

Taking Plan B or Ella more than once a day isn't recommended as one dose is enough to work for 24 hours. Taking extra pills won't make it work better, and might make you feel sick. If you've already taken emergency contraception pills and have unprotected sex again that day, you don't need another dose.

Can I take emergency contraception pills multiple times in a week?

You can take emergency contraception pills more than once in a week if needed. It is safe to use emergency contraception each time you have unprotected sex. 

If you find yourself needing emergency contraception often, you might want to discuss ongoing birth control options with a trusted provider like Hey Jane, as they are more effective at preventing pregnancy when used correctly than Plan B. Our team of providers will partner with you to find the best birth control method for your body and lifestyle preferences. With 100+ options from pills and the ring to the patch and non-hormonal methods, we work together to find the right solution for you.

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Can I take emergency contraception multiple times in a month?

There's no set limit on how many times you can take emergency contraception pills in a month. It's safe to use as often as you need it, but some people find that using it as their main method to prevent pregnancy has these downsides:

1. It's less effective than daily or long-term birth control methods (e.g. pills, the patch, the ring).
2. It can make your periods irregular.
3. It's more expensive than many other birth control options.
4. Some insurance plans have a maximum number of times they will cover the cost of emergency contraception. 

What happens if you take Plan B multiple times?

It’s very safe to use emergency contraceptive pills no matter how frequently you need them, and there are no long-term health or safety risks. Most people tolerate the morning-after pill well, but like any medication, emergency contraception pills can cause side effects that vary person to person. Let’s break it down:

Side effects of emergency contraception

1. Irregular periods: Because emergency contraception delays ovulation, your cycle might be different. Your next period might come earlier or later than expected. It might also be heavier or lighter than usual. This is because emergency contraception temporarily impacts your hormone levels, and changes will vary depending on where you are in your cycle and when you take the pill. If taking emergency contraception frequently, these disruptions to your cycle may be even less predictable, but should return to your norm one to two cycles after your last dose. 
2. Nausea and vomiting: Many people feel sick to their stomach after taking Plan B or Ella as high doses of (or changes to) hormones can upset your stomach and alter digestion. This can start minutes or hours after taking the pill, but should go away within a day or two. If you’re taking emergency contraception frequently, this nausea may come and go if doses are close together.
3. Headaches: Headaches are another common side effect of Plan B and Ella, and you might get them more often when using emergency contraception frequently. Once again, changes in hormones are the culprit—they can really impact our bodies in multiple ways. Symptoms should go away with rest and ibuprofen after a few hours.
4. Breast tenderness: Your breasts might feel sore or sensitive for a few days after taking emergency contraception. Wearing loose, comfortable clothes can help in addition to pain relievers like ibuprofen.
5. Fatigue: You might feel more tired than usual after taking emergency contraceptive pills, similar to fatigue you might experience during your period. This fatigue may last more than a few days if you are taking pills close together. 

Long-term effects of emergency contraception

Emergency contraception pills do not cause long-term health risks when used as directed, according to research. That includes no long-term effects to fertility, or future effectiveness of emergency contraception if you need to use it again. However, frequent use of emergency contraception pills can lead to temporary menstrual changes including cycle length, spotting, or heavier periods. If you feel that your cycle hasn’t returned to its typical pattern within three months of using Ella or Plan B, it might be worth a conversation with your provider.

The copper IUD, which can also serve as emergency contraception, provides long-term protection against pregnancy for up to 10 years and does not affect future fertility once removed. While there are no severe long-term health risks associated with the use of emergency contraception, it is essential to use these methods as intended and consult with a health care provider for regular contraceptive options that suit your lifestyle and health needs.

Who shouldn’t use emergency contraception pills?

Emergency contraception is very safe and effective, but like any medication, certain options may not be right for you. You should not take emergency contraception pills if:

• You’re allergic to any of the pill’s ingredients
• You are taking barbiturates, which reduce the effectiveness of emergency contraception
• You are taking St. John’s wort, which reduces the effectiveness of emergency contraception

If you’re pregnant or breastfeeding, you should check with your primary care doctor or pediatrician before taking emergency contraception.

Other considerations if using emergency contraception frequently

You can use emergency contraception as frequently as you like, but there are factors other than health and safety you may want to consider if taking it often. Emergency contraception can be more complicated, expensive, or stressful to obtain regularly—especially if you are working against the clock. Some additional considerations include:

Efficacy of emergency contraception vs. birth control

Emergency contraception is very effective and does not get less effective each time you use it. However, emergency contraception pills are actually less effective than using regular contraceptive methods consistently and correctly! Plan B One Step is 87.5% effective when used as directed. If you have already ovulated, Plan B will not be effective at preventing pregnancy. On the other hand, many birth control options work by preventing ovulation all the time instead of once like Plan B.

Cost of emergency contraception vs. birth control

Emergency contraception can cost between $11-$50 on average for one dose without insurance, roughly the same price range as a 30 day supply of birth control pills. Emergency contraception is covered by insurance, but not all plans cover Ella (the most effective emergency contraception pill).  Generally, it’s more cost efficient to use another form of contraception regularly.

Availability of emergency contraception vs. birth control

Plan B (available over-the-counter) and Ella (a prescription option) should be available at most drug stores and pharmacies, but that doesn’t always mean they’re in stock. A 2021 study found that 32% of pharmacies in Western Pennsylvania didn’t have Plan B in stock—creating additional barriers to access when you’re in a time crunch. With daily or long term birth control methods, you can get a prescription for up to 12 months so you don’t have to keep requesting refills. You can also consult with a virtual provider, like Hey Jane, to have a consultation without leaving home.

Tips for using emergency contraception safely 

Emergency contraception can be a great backup when things don’t go as planned after sexual intercourse. But to ensure it actually works, keep the following tips in mind the next time you need to take Plan B:

1. Buy emergency contraception in advance

To avoid the stress of finding a pharmacy that stocks emergency contraception during an urgent situation, consider purchasing Plan B or Ella in advance. Having it readily available ensures you can take it as soon as needed, maximizing how effective it is at preventing pregnancy. Both pills are effective for several years before they expire as long as they are stored in a cool, dry place.

2. Check the expiration date

Always check the expiration date on your emergency contraception before using it—especially if you purchased it in advance. Expired emergency contraception isn’t a safe or effective option because the active ingredients in the pill have started to break down. Both Plan B and Ella are effective for several years until they expire as long as they are stored in a cool, dry place.

3. Check the weight limits

Emergency contraception pills may be less effective if you weigh over 165 pounds and take Plan B (levonorgestrel) or if you weigh over 195 pounds and take Ella. If you fall outside these weight ranges, a copper IUD, which is not affected by body weight, might be a more reliable option. If you don’t have another option, Plan B or Ella might still be worth a shot and won’t hurt you if you use them. You can always consult with a trusted healthcare provider who can help you choose the most effective emergency contraception based on your weight and preferences. 

4. Follow the instructions

It seems fairly simple, but it is crucial to follow directions to make sure you maximize the effectiveness of your emergency contraception pill. Don’t forget to review the list of medications that your emergency contraception pill can impact. For example, Ella works by blocking progesterone which is one of the main ingredients in birth control pills. If you use birth control pills regularly, Ella could reduce their efficacy and your birth control pills could reduce the efficacy of Ella. You should reach out to your provider to discuss how to best take Ella if you have any concerns about other medications you are taking. 

5. Explore your birth control options

Emergency contraception is a great, and very safe, tool to prevent pregnancy in a pinch, but there are many methods you can use before sex to reduce the need for emergency contraception. Depending on your preferences, there are many reliable options to choose from, including:

• Methods used only when having penetrative sex (e.g. condoms)
• Methods used daily (e.g. birth control pills, the patch, the ring, the shot aka Depo Provera)
• Long term methods (the arm implant, IUDs)
• Non-hormonal methods (natural family planning/ovulation tracking)

You can speak with your health care provider to discuss the best birth control methods for you, or connect with a compassionate provider at Hey Jane who can guide you through different options to try based on your medical history, lifestyle, and personal preferences.

If you missed the window to use emergency contraception and become pregnant, you can get fast, virtual abortion care from Hey Jane. Our licensed clinicians can prescribe FDA-approved abortion pills: mifepristone (which stops the pregnancy from growing) and misoprostol (which helps empty your uterus) and are with you through every step before, during, and after treatment. Treatment is mailed to your doorstep in unmarked packaging to maintain your privacy, and you can take the pills from the comfort of your own home.