EC

Birth Control Bingo

Click through a series of detailed questions to narrow down your own best methods, become a pro on what method your partner is using, or windowshop in-depth info pages on each contraceptive option. With 25 integrated pages of teen and twentysomething-specific information, plenty of links, questions and answers, we've done our very best to help you protect yourself from unwanted pregnancy.

Ready for arguments about increasing your access to Plan B? We can help.

Submitted by Heather Corinna on Tue, 2011-12-06 15:45

You may have heard that the FDA may finally remove age restrictions for the morning-after emergency contraception pill in the United States. If you've heard that, you may have started to hear some panic or fear-factoring, not just gratitude and relief.

Currently, in the United States, someone must be over the age of 17 in order to get Plan B at a pharmacy without a prescription. Until two years ago, the age limit was 18. It's still kept behind the pharmacy counter for people of all ages, but those over 17 do not need a prescription from a doctor or a clinic to purchase it.

For a long time now, organizations like ours and many, many other reproductive choice, justice and health organizations, have been lobbying to remove that age restriction, something other nations -- like Canada, Australia, Denmark, Norway, Sweden, Israel and others -- do not apply; a restriction which has never been supported by sound health data. The restriction per age has long been about politics, not health.

In fact, a medical council formed expressly to inform the FDA about Plan B in 2003 recommended it be provided without prescription regardless of age then, a recommendation the FDA did not follow. More than one staff member at the FDA during the years this has been an issue, including the highly dedicated Susan Wood, resigned in protest of decisions about Plan B access and the political motives for those decisions, which stood counter to sound medical information, what the basis of FDA decisions are supposed to be about.

We feel, like so many other sexual health and adolescent health organizations feel, like you might yourself, that young people should have the same rights with their reproductive choices that those over the age of majority do, including the ability to access safe contraceptive methods the same way as those over the age of majority do. We feel that decisions for all citizens like this need to be centered on credible health information, not political or personal agendas or religious beliefs.

Given this possible sea change, you may find yourself, not unlike some former members of the FDA, having discussions or heated arguments about this with people who really do not get it for a while, and in those, you're probably going to face a serious lack of facts. In case you need them, here's a quick and dirty roundup of some typically uninformed statements with some factual information and context to counter them with.

But Plan B is so unsafe! It's like a GIANT dose of birth control pills!

A lot of over the counter medications, also without age restrictions are not only dangerous, but far more associated with serious health risks.

For instance, you can get all of the following over the counter here in the U.S., none of which have any age restrictions (links are to informational listings about them, including health risks): ibuprofen, acetaminophen, cough syrups or cold medications which contain dextromethorphan or pseudoephedrine, sleeping pills or energy drinks. Heck, you can get candy bars within reach even if you are still only crawling around in footie pajamas, but we don't hear people talking about putting them behind the counter for the safety of diabetic kids.

Plan B is a medication just as safe or safer than some of those things, especially when those things aren't used as directed, which happens a lot, no matter how young or old people are. No deaths have been linked to Plan B, and we can't say that about any of the other things I put on that list above.

It's also not quite right to say that it's a "giant dose of birth control pills."

Most people who use the pill use combined oral contraceptives: a combination of a synthetic estrogen and a synthetic progestin. And while both of those things carry potential health risks, especially for people who have health or lifestyle issues that heighten those risks, the larger risks tend to lie with the estrogens or the combination of estrogen and progestin. Plan B does not contain any estrogen, only levonorgestrel, a progestin. That matters and makes it tough to compare to the most common daily-use oral contraceptives. That's also some of why reputable medical organizations assert that emergency contraceptive pills are usually safe even for people for whom regular contraceptive pills are unsafe. The World Health Organization lists no medical condition for which the risks of emergency contraceptive pills outweigh the benefits.

Too, people who use either combined birth control pills or minipills tend to use them for longer than one or two days like with emergency contraceptive pills, but instead will take a pill every day for weeks, months, years or decades, depending on how long they use them for. Very few people will start using birth control pills and only take two out of a pack.

Most oral contraceptives have 100 to 150 micrograms of levonorgestrel per pill; emergency contraceptive pills contain either two two 750 microgram levonorgestrel pills to be taken 12 hours apart (or together: taking them apart is mostly about reducing the chance of feeling nauseated) or one 1500 microgram pill, to be taken 12 hours apart. Almost everyone who uses a birth control pill for more than a week or two is taking in as much of the hormone in Plan B or, and most typically, far more. And these medications aren't like a sleeping pill or even an advil when it comes to overdose, if that concerns someone about the amount of hormone in Plan B. Not only do we know this is a safe amount to be used as directed, "overdosing" with oral contraceptives does not present the kinds of dangers we see with other kinds of medications. It might also help to take a look at the facts about frequent use of emergency contraception: in a word, we have no evidence so far, after more than decade of research, that has found any more or different risks than ongoing, proper use of other hormonal contraceptives.

Let's not forget that pregnancy can be one of the riskiest things there is when it comes to people's health. Preventing pregnancy with a safe medication like Plan B poses far less risk to someone's health, especially a young teen's health, than a pregnancy does.

But, but... it is SO DANGEROUS for TEENS!

But, but... it isn't. Not that anyone has discovered so far with many years of scientific study, anyhow. There has NEVER been broad medical or scientific support for the decision to require a prescription for minors, but not older people. It's been the other way around: most healthcare professionals and medical organizations, like the World Health Organization, the American Academy of Pediatrics, the American Medical Association and the American College of Obstetricians & Gynecologists, as well as, again, many doctors at the FDA, have objected to these age restrictions. The people who tend to oppose it most are people like this. (Note: that link is to an anti-choice site, the American Life League, which is hopefully obvious from the first sentence, but may become more so by the total lack of contextualization with the information given there, such as a lack of mention that all the risks they list for the MAP exist with a pregnancy. And maybe when reading their website.)

So much of what people know and have heard about emergency contraception has been informed and greatly influenced by people and organizations who are anti-choice, and who oppose Plan B and often other kinds of contraception, not because of concerns for anyone's health, but because of their political agendas to limit the control people -- most commonly women -- have over their bodies and reproduction.

Again, know what's dangerous, sometimes truly, earnestly dangerous? Pregnancy. Now, that doesn't mean people need to be afraid of pregnancy or that we're saying people who want to become pregnant shouldn't make that choice if it's a wanted choice. But there's a reason why maternal mortality rates are so high in places where pregnant people can't get sound, consistent care during pregnancy, labor and deliver from healthcare providers, including educated midwives. That's because pregnancy is dangerous. Preventing pregnancy with safe, studied contraceptives is always statistically safer than becoming pregnant. So, if someone wants to flip their lid about how dangerous contraceptives like Plan B are, they better at least be pulling out all the same stops and more about how potentially dangerous being pregnant and giving birth can be, too.

And even though legal abortion is also very safe, and in the first trimester, safer than a full-term pregnancy, emergency contraception is safer than abortion, too.

Some people have concerns that teens will not be able to understand how to use EC properly without getting a prescription from a doctor. While it doesn't make much sense to have that concern about EC and not all the other medications a young person can currently get over the counter, some studies have found that concern also is not sound. "Two studies were published in 2009 regarding emergency contraceptive label comprehension for teens. Raymond et al. found that 79% or more of adolescents aged 12-17 correctly understood six key concepts found in labeling: 1) EC prevents pregnancy after unprotected sex 2) it should be taken as soon as possible 3) it should be taken within 72 hours 4) it should not replace regular contraception 5) it does not protect against sexually transmitted infections (STIs) 6) it should not be used by women who are already pregnant." (The Reproductive Health Technologies Project, Tough Questions and Answers about Adolescents and Over-the-Counter Emergency Contraception, 2009) By all means, patient and consumer literacy is always something to be concerned with, but we have no reason to believe this is a greater concern with teens regarding Plan B than it is with people of all ages.

It might also help to know that there are already some contraceptive methods as available to teens as to those over the age of majority which we know or suspect may pose different or greater risks for them, like Depo-Provera, which may present risks around bone density for younger teens. And young people should be informed by their doctors or pharmacists of any risks these or other medications or devices present to them based on age, when there are any, just like people should be informed when older age increases a risk, or when a given health condition or lifestyle issue may increase risks.

And if there were different or greater risks with Plan B for young people than those one, three or ten years older, those same standards should be applied and, you can be certain, would be applies. Thing is, based on all the study of these medications so far, we don't have any data to suggest the risks are different or greater for those under 17.

I am not okay with teenagers being able to give themselves an abortion by just walking all willy-nilly into a pharmacy.

Even as a strongly pro-choice person, I don't know if I'd feel comfortable with that, either. I am, however, a fan of walking willy-nilly. It's much more fun than just plain old walking, that's for sure.

But that's moot, since no one of any age can give themselves an abortion by just walking into a pharmacy and getting Plan B, including in places where people of every age can access emergency contraception without a prescription. That's because you can't use emergency contraception to terminate pregnancy.

A lot of people -- some out of ignorance, some who know better but know how easy it is to obscure the facts by just muttering the A-word -- have the odd idea that emergency contraceptive pills and a medical abortion, or "the abortion pill" are the same thing. They're not. Plan B and other emergency contraception not only is a very different medication, it does very different things. Even if someone wanted to terminate a pregnancy with Plan B, this medication can't do that: it lacks that capacity.

You can get information on the "abortion pill" -- a bit of a misnomer by itself, since medical abortion involves two medications, not just one -- here.

But more people will have sex without using birth control if they can just get EC easily.

Emergency contraception has the word contraception in it because that is what it is: it, like other methods, is contraception. Is it as effective as several other methods? Nope. It's also more expensive, too, especially if people are using it often.

I'm not sure why anyone is this concerned about people choosing this method of contraception rather than others by this token, but for those who are, so far, we also don't have any data that shows that when EC is made more available, including giving minors the same access those older have, that there's any basis for that concern. As reported by the Alan Guttmacher Institute years ago, providing adolescents with advance doses of emergency contraception neither increases their likelihood of having unprotected sex nor negatively affects their use of condoms or hormonal contraceptives.

Perhaps more to the point, if one is worried about people not using contraception, then it's tough to figure how it makes sense to limit their access to contraception.

Want more information about emergency contraception, including teen health concerns? Check out these links:

If and when you get tired or arguing with someone about this who just will not let go of the non-facts, do yourself a favor and just print them out, pass them on, and give yourself a breather. Bashing one's head into walls is something we know isn't healthy. :) If, on the other hand, like some of us (coughcough) you seem to have dedicated much of your life to arguments like this and you find what we gave you here isn't enough? Leave a comment with an aspect or issue you want more information about or help voicing. We're glad to help you out.


He says he doesn't like condoms, so should we use withdrawal instead?

Bam+Bam+ItsSam asks:

I am a 15 (almost 16) year old virgin. My boyfriend and I are thinking about having sex. We love each other, we are both mature and know everything, and we both ARE ready. He isn't a virgin, he had sex once before. While having a discussion on the phone he mentioned to me about this round-a-bout and that he doesn't like using condoms. I am completely 100% for condoms and would never risk myself getting pregnant or getting something (even though I know he doesn't have anything). But he insists that he barely pre-cums and when he does "finish" he knows beforehand. I know guys just say that. I've thought about it and maybe after were used to intercourse I'll think about the pull out method. But ONLY if we use another type of protection.

What do you think about the pull out method? For the other question I have, what is safer to use, in a girl's point of view? Morning after pill? The Ring? Birth control? How can I get my hands on a Morning after pill? Thanks ever so much.

P.S. your site rocks =]

The Buddy System: Effectiveness Rates for Backing Up Your Birth Control With a Second Method

You already know that no method of contraception is 100% effective to prevent pregnancy. You probably also know, however, that there are reliable methods which are very effective when used properly, and that if you use contraception correctly and consistently, pregnancy becomes a whole lot less likely. But did you know that by doubling up and using two methods, with almost any combination you use, you can get mighty close to that 100% with most combos?

It's complicated, but I can't bear to see a doctor to get EC. What do I do?

Anonymous asks:

I am in my early 20s and recently had to stop taking the contraceptive pill because of a medical reason. Now that I am medically ok again, I planned to re-start the pill at some point this week. However, me and my BF of 2 yrs got drunk last night at a party and stupidly had unprotected sex. I am too embarrassed to go to a doctor and ask for a Plan B pill I have heard that if I take two contraceptive pills now (or asap) then it acts in the same way a morning after pill does...is this true?

What's this stuff coming out of my vagina after unprotected sex?

CURIOUS asks:

I had sex last night without a condom and now I have mucus coming out my vagina. Not sure what that can mean?? PLEASE HELP!

He was going to pull out...but he didn't, and I feel bad taking Plan B.

Stacey asks:

My boyfriend and I have been together for about 2 months and we just started having sex. He was my first and I am completely in love with him. We've been protected for 4 of the times with a condom, but tonight we didn't use one. He was about to pull out right before, but he came. I'm really scared that I could become pregnant and I know that one of my friends has the "morning after" pill, but I feel bad taking it. I am so worried and confused. HELP ME!

Can I just use EC instead of other birth control?

LizzyUK2002 asks:

I am going to have sex with my boyfriend soon, but I am really scared about getting pregnant. We are going to use a condom but I'm paranoid that I'm going to get pregnant. I could go on the pill but my mum wont let me.. so I'm going to ask my friend's mum, also. If I could get the morning after pill and take it just in case it won't harm me will it?

She took Plan B and now she has her period. Can she still be pregnant?

JustAnOrdinaryPerson asks:

First thank you for taking the time to read my question.
Anyways... my girlfriend (19) and I (also 19) recently became sexually active. We are both virgins and have no diseases. I got tested just in case just to make sure. Well we have had sex a few times with protection. Then this passed Wednesday (the 2nd of January) about 2pm, we had sex but I'm not sure I believe the condom broke because once I pulled out I noticed she had white liquid on her which I believed to be sperm. She said she had an orgasm and thinks maybe thats what it was. But any who, just to play it safe around 6pm the same day we went end got the Plan B pill and she took it, and took the 2nd pill around 5am the next morning. The thing is she was supposed to start her period soon and the very next day (Thursday) night she did (which was the same day of the month as the previous period). Well we were wondering if she could be pregnant? Today is the 5th and all of that happened within a short amount of time.

Sex (on the 2nd)- Plan B (on the 2nd)- period (on the 3rd)

So what im asking really is...
1) Is her period to early to actually know if she got pregnant? Or is it a sign she isn't?
2) If it isn't a sign of anything since its too early, could it increase the chance of her not being pregnant?
3) Can we get a pregnancy test 20 days from intercourse or do we have to wait until the next period?

p.s thanks again this will be a huge help

I took EC one day, and then the condom broke the next. Am I at risk?

Anonymous asks:

Okay, I am really frustrated. My boyfriend and I had unprotected sex 2 days ago. He pulled out, but I was still worried so I went ahead and got EC the next day and took it. I felt a lot better about the whole scenario. Then, the day after THAT, my boyfriend and I had sex again, this time with a condom. He literally JUST went in when he said he felt something funny and pulled out right away and noticed it ripped a little. I FREAKED OUT. He probably had it on wrong or something. I don't know what to do now. He didn't ejaculate inside of me but the chance of pre-cum scares me to death. He did go pee before, so does that mean there was probably not any pre-cum? I can't get EC AGAIN. I just took it the day before and I don't have another $45 on me. Plus, I'm only 17 so I got a friend of mine who is 18 to get it for me and I don't wanna ask him again. Am I freaking out too much? Are my chances of pregnancy pretty low? Oh, and don't worry we both don't have any STI's (he got tested and I was a virgin before him). That's at least one less thing to worry about.


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