Does Plan B Cause Abortion
On August 24, I wrote a piece about Plan B, which the FDA had just approved. Afterward, someone left this comment:
How do they not know whether or not Plan B sheds or doesnt shed the uterine wall? That seems like it would be simple to find out. If Plan B did in fact do thiswould this change some of your opinions?
In my original entry, I quoted William Cutrer, M.D. He was a graduate of Dallas Theological Seminary, had been an ob-gyn for about two decades, and had been on the front lines of the pro-life movement offering free obstetrical care to thousands of women at risk for abortion. He taught at The Southern Baptist Theological Seminary in Louisville, Kentucky until the time of his death in 2013. I asked him to respond to this readers question because its so important that we understand the medicine. Here is what he had to say:
Before we can talk about the ethics, we have to be on the same page about how Plan B works. That requires an understanding of some of the events in a womans menstrual cycle required for an embryo to implant. This is a complex synchrony, and many factors can alter the process. But we begin with some basics:
Now, Plan B = progesterone. Thats all it isjust progesterone. Unlike combination oral contraceptive pills, which contain both estrogen and progesterone, Plan B contains only progesterone in a synthetic form.
Who Can Take Plan B Morning
Any sexually active woman can take Plan B One-Step for the prevention of pregnancy after unprotected sexual intercourse or potential contraceptive failure. You should not use emergency contraception if you are pregnant or suspecting a chance of pregnancy. Similar to other medications, the morning-after pill carry risks, therefore, it isnt appropriate for everyone. For instance, this type of medication is not intended to be used by postmenopausal women and younger gilrs who havent had their menstrual cycle. In addition to that, certain medications and dietary supplements can interact with the active ingredient of the morning-after pill. If you have questions, dont hesiate to talk to your doctor or local pharmacist to make sure this type of emergency contraception is safe and effective for you.
Side Effects Of Using Plan B
As mentioned, discharge is not a side effect of Plan B. But surely there are some adverse effects of this as well.
The usage of Plan B can cause:
- Alteration in your menstrual cycle. It changes the timing as well as the intensity of menstruation.
- Headache is like a migraine.
- Hormonal changes that may cause depression, stress, and anxiety
Less commonly, it can cause acne, spots on the skin, hair damage, restlessness, difficulty while sleeping and very rarely blood clotting can occur in blood vessels. It can be a very severe condition and occurs very rarely.
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This Is How Levonorgestrel
According to the American College of Obstetricians and Gynecologists , the most commonly used emergency contraception in the United States is levonorgestrel, a synthetic form of the hormone progesterone. You probably know this by the brand name Plan B, though its technically called Plan B One-Step as its just one pill . Plan B One-Step and its generics are made up of a single pill containing the full 1.5-milligram dose. Levonorgestrel is available over the counter without age restrictions, according to ACOG, and is advised for use up to 72 hours after unprotected sex.
Interestingly, levonorgestrel is the same ingredient thats in a few other methods of birth control, like certain birth control pills and the hormonal IUD. The difference, of course, is the dose.
This medication works by delaying or preventing ovulation. So, lets say you have sex on Saturday and you have no idea if or when youre ovulating, but you do know that you dont want to risk an unintended pregnancy. If you ovulate around the time that you had sex, your body will release an egg, and that egg might get fertilized by the sperm thats hanging out in your body from the sex. But what if you could delay ovulation so that theres no egg around for the sperm to fertilize?
What If You Take It After 72 Hours
Research has found that Plan B is moderately effective when taken between 72 and 120 hours after sex.
But remember that its effectiveness decreases the longer you wait.
Theres no officialweight limit for Plan B.
But the pill may not be as effective for people who have a
After conflicting results, some researchers have recommended a greater level of counseling for people who fall into those two categories.
But they point out that theres no reason to restrict Plan B.
More research is needed into whether a higher weight and BMI decreases the effictiveness of Plan B. For now, youre free to take it, no matter how much you weigh.
However, other forms of EC may be more effective.
Plan B only works to prevent a pregnancy it cant end one.
It helps prevent pregnancy by using a bigger dose of levonorgestrel, the synthetic hormone found in birth control pills.
This mimics the natural hormone, progesterone, delaying the release of an egg from the ovary, thereby preventing ovulation.
If no egg has been released, theres nothing for sperm to meet, and therefore no fertilization. Plan B also prevents fertilization by making it more difficult for the sperm and egg to meet. Additionally, Plan B may prevent the fertilized egg from sticking to the uterus.
Theres been talk of Plan B also working to prevent a pregnancy
- breast tenderness
Your menstrual cycle may also temporarily change.
This means your period could come earlier or later, and it could be heavier or lighter.
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Is Plan B One
No. RU-486, sold as Mifeprex, is a prescription drug for medical abortion. Mifeprex is used after a woman is already pregnant. Plan B One-Step is an emergency contraceptive. It is used to prevent pregnancy. While some people do feel that pregnancy begins at the time of conception, many doctors and the FDA do not describe Plan B One-Step as an abortion pill but as emergency contraception.
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How To Prescribe Emergency Contraception
Paediatricians, family physicians and others who care for teens should consider having ECPs available in the office. Some teens will have difficulty getting a prescription filled, and may not be able to manage a visit to both the physicians office and the drugstore. A prescription can be written for Plan B, as directed or levonorgestrel 0.75 mg PO now and again in twelve hours.
Although nausea is much less common with levonorgestrel only, almost one quarter of women taking it report some nausea. The drug company does not make a recommendation regarding concurrent administration of 50 mg dimenhydrinate, but there is no reason to believe that it will interfere with the efficacy of ECPs and can be given with either or both doses .
For either regimen, the timing of the second dose is important. For practical reasons, the first pill can be delayed so that both doses are given during the teens normal waking hours. If the second set is missed, the entire course must be repeated.
If Plan B is not yet available in your province, two high dose norgestrel-ethinyl estradiol tablets can be given with 50 mg dimenhydrinate initially the entire dose is repeated 12 h later.
It has been suggested that if norgestrel-ethinyl estradiol is not available, use four lower dose oral contraceptive pills. But if using cycled pills, use only four pills of the highest dose and repeat 12 h later. However, these have not been evaluated in clinical trials.
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How Can Plan B Be Taken
Plan B does not work like other birth control pills. It cannot be taken regularly to prevent pregnancy. Plan B drug is actually morning-after pills, refers as emergency contraceptives.
It contains more doses of levonorgestrel hormone. An effective amount of estrogen is present with levonorgestrel hormone in the plan B drug.
It is effective if somebody uses it 2 to 3 days after unprotected sexual activity. As time passes, its effectiveness goes on decreasing. Therefore, it is strictly mentioned that plan B can be used within 2-5 days after sexual exploitation.
How Many Times Can You Take Emergency Contraception Medications
Even though there isnt a set restriction on how many times you can take the morning-after pill, you shouldn’t use it as routine birth control. This type of birth control is meant to be used in emergency situations when your birth control has failed, wasn’t used or in cases of non-consensual intercourse.
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This Is How Ulipristal Acetate Works To Prevent Pregnancy
The other main type of morning-after pill is ulipristal acetate , which is taken as a single 30-milligram pill. It also works by hampering ovulation, but in a different way than levonorgestrel.
The mechanism isnt entirely understood, but it appears that ulipristal acetate modifies progesterone receptors in the follicle that surrounds the developing egg in the ovary, ultimately barring the release of the egg into the fallopian tubes, meaning ovulation is delayed or prevented.
Ulipristal acetate is designed to be taken within 120 hours of unprotected sex. Unlike levonorgestrel, its efficacy does not decrease significantly over that time period. Ulipristal acetate … continues to delay follicular rupture closer to the time of ovulation, Dr. Raine-Bennett explains. Its apparent mechanism is capable of working even after LH has begun to rise, so it can be effective closer to the time of ovulation than levonorgestrel.
The most common side effects of ulipristal acetate are generally the same as levonorgestrel, including headache, stomach pain, wonky bleeding, and nausea. Vomiting within three hours of taking ulipristal acetate warrants a call to the doctor for the next steps.
What Should You Do If You Dont Think It Worked
Its difficult to know whether EC hasnt worked. In fact, the only foolproof way is to wait for your next period.
If you know when your period is due and it appears to be more than 7 days late, take a home pregnancy test.
If youre not sure when your periods due, wait at least 21 days after sex to take a test.
The hormone that pregnancy tests detect is only produced 6 days after fertilization, so theres no point in taking one early.
If a pregnancy test comes back positive, book a doctors appointment for advice on all your options, including maintaining or ending the pregnancy.
Be aware, too, that vomiting within a couple of hours of taking any form of pill can result in it not working.
If thats the case, you may need to take another dose. Just make sure you talk with a healthcare provider beforehand.
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How Often Can You Take Plan B For Birth Control
There is no limit on how often you can use Plan B as emergency contraception to prevent an unwanted pregnancy. Emergency contraception pills like Plan B are generally safe for most people and do not pose any significant health risks.Taking Plan B multiple times does not make it less effective or cause any long-term side effects. Be mindful that multiple use of Plan B is acceptable, and this is different than taking it regularly as a form of birth control which well discuss below.
How Supplied/storage And Handling
Plan B tablets, 0.75 mg, are available for a single course of treatment in PVC/aluminum foil blister packages of two tablets each. The tablet is white, round and marked INOR on one side.
Available as: Unit-of-use NDC 51285-769-93
Store Plan B tablets at controlled room temperature, 20° to 25°C excursions permitted between 15° to 30°C .
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Does Plan B Have A Weight Limit
Yes. Plan B may be less effective for those who weigh over 155 pounds. Or for those who have a BMI over 25, said Dr. Demosthenes. Because some researchers have found that people who weigh more may metabolize drugs differently.
Worth noting: The average American woman weighs about 170 pounds, and some research shows that BMI is a problematic tool for measuring a persons overall health and weight status.
Possible Risks And Side Effects
Plan B and other forms of emergency contraception are relatively low-risk. They have been in use for over 30 years.
Emergency contraceptive pills do not carry the same risks as taking other forms of hormonal birth control on a continuous basis.
This is because the hormones remain in a persons system for a much shorter period than they do when taking ongoing birth control.
The primary risk associated with using Plan B is an unplanned pregnancy since it is less effective than other forms of birth control. Another risk is the risk of irregular periods, especially if a person takes plan B regularly.
It is also an expensive form of birth control. Other methods are likely more cost-effective.
Short-term side effects that may result from emergency contraceptive pill usage include:
These side effects should only last a few days, although a persons period may be up to 7 days late. If the period does not arrive after a week, it is best to take a pregnancy test.
There are no long-term risks of morning-after pill use. The pills also do not affect a persons future fertility.
Other forms of contraception are more reliable than Plan B at preventing pregnancy. People should speak to their doctor about the best form for their needs.
Options include:
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What To Do If Plan B Didnt Work
The sooner you take Plan B, the more likely it is to be effective. Ideally, it should be taken within a 72-hour window. Thats 3 days from the time you had unprotected sex. You should also continue to use your regular birth control.
In any case, its not 100 percent effective. Its estimated that about 7 of every 8 women who would have gotten pregnant will not get pregnant after taking the medication. It may not work if you vomit within 2 hours of taking it.
Is Plan B Available Everywhere
Plan B is available at local drug stores, pharmacies, and online. It can cost up to $50 without insurance, and $11 for a generic brand. But after Roe v. Wade was overturned, stores like Amazon and CVS initially limited purchases as customers rushed to stock up, and depleted inventory. If youre looking to buy Plan B, check in with your local pharmacy or drug store about availability.
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What Are The Signs That Emergency Contraception Hasn’t Worked
If you take the morning-after pill in the immediate time window after having unprotected sex, it can be very effective. But it doesnt always work. Emergency contraception medications become less effective the longer you wait before taking them. One of the main signs that a morning-after pill hasnt worked is a missed menstrual period. If your period is more than seven days later than you expected, take a pregnancy test.
Estrogens/progestogens Thyroid Function Tests
Moderate Potential Hazard, Moderate plausibility. Applicable conditions: Thyroid Disease
When administering estrogen and/or progestogen therapy in patients with thyroid disorders, clinicians should be aware that these hormones may affect thyroid function tests. Changes have mostly been reported with the use of combination oral contraceptives. Specifically, thyroid-binding globulin may be increased, resulting in elevated circulating total thyroid hormone, as measured by PBI , T4 by column or radioimmunoassay, or T3 by radioimmunoassay. Free T3 resin uptake may be decreased. On the contrary, a decrease in TBG and, consequently, thyroxine concentration, has been reported by the manufacturers of the progestin-only oral contraceptives.
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How Often Can You Take Ec
You can take Plan B and other levonorgestrel pills as often as you need them.
There are no long-term side effects.
But ella does have a limitation: The label says you should only take it once during a single menstrual cycle.
Its also advised not to take two different kinds of EC pills within 5 days of each other, as theres a risk that they may not work.
Are There Alternatives To Plan B
Ella is another type of emergency contraception that can delay or prevent ovulation, said Dr. Demosthenes. . Its more effective for people who exceed the weight limit for Plan B. But it still might not be effective for people who weigh more than 195 pounds. And it requires a prescription.
The Yuzpe method is another emergency contraceptive option. Aka taking multiple birth control pills that contain both estrogen and progestin, in two doses, 12 hours apart. Its about 56 to 86 percent effective.
Copper and hormonal IUDs can be used as EC too, and are also long-term contraceptive options. Copper is toxic to sperm, and the hormonal IUDs release levonorgestrel . They work by inhibiting the sperms movement, thickening the mucus in the cervix to stop the sperm, thinning the lining of the uterus, and sometimes suppressing ovulation. But youd need to see a medical provider to have it inserted into the uterus . Dr. Demosthenes said they should be inserted within five days after having unprotected sex. And they can be left in for three to 10 years.
Before you pick a method, check with your doctor to discuss which option would work best for you.
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