6 Things You Should Know About The Morning-After Pill, As Told By A Gyno

by Dr. Pari

You stand there. You feel timid. You're either staring at the drug store floor or texting fervently in an effort to avoid eye contact with the pharmacist. You lift up the box and place it on the counter.

All of a sudden, you feel like you're in an '80s sitcom. Your mother is dressed as an angel, sitting on your right shoulder and judging you.

"What are you doing?” she asks.

A mini you stands on your left shoulder. She's dressed in a tight dress, and is wearing 6-inch Louboutins. She has devil horns, a pitchfork and a ridiculous amount of cleavage.

She's shouting, “Don't worry, girl. It was worth it."

Buying emergency contraception can be one of the most embarrassing experiences for a woman, especially for a single woman. No matter how old you are, there is something embarrassing about publicly admitting you have sex. Having a complete stranger acknowledge that fact (while exchanging currency) can ignite a spiral of shame.

It is similar to the feeling a woman experiences when she buys condoms. But this is 10 times worse, since this purchase occurs after the fact.

As an OB-GYN, I can attest that emergency contraceptive use is extremely underreported and rarely discussed with a physician. Even still, it is highly used. Last week, I went into my local CVS in Los Angeles, near UCLA. There were no Plan B boxes on the shelf; the store was sold out.

So, I must ask: If it's clearly so frequently used, why do we never discuss it? My patients rarely ask about emergency contraception, even though I'm sure there are many questions and concerns about its use.

Here are a few facts about emergency contraception, also known as the morning-after pill:

1. The morning-after pill is made of progesterone.

This is one of the hormones found in birth control pills. But, it's in a much higher dose in the morning-after pill. The progestin-only pills are available as a single pill (Plan B One-Step) or two pills that have to be taken 12 to 24 hours apart (Plan B and Next Choice).

2. Take it as soon as possible.

You should take the morning-after pill as soon as possible after unprotected sex. It can be protective for up to five days after intercourse. However, it is recommended that it be taken within 72 hours. If you can, don't even wait that long.

The morning-after pill is about 75  percent effective for preventing pregnancy, but its effectiveness decreases with time. So, as much as you want to first go to brunch with your BFF and drown your guilt and anxiety in a bucket of cheese fries, go straight to the pharmacy.

3. Emergency contraception is designed for emergencies.

That's why it has such a name. As it will fail one out of eight times, it's not an effective form of primary birth control.

4. It is not an abortion pill.

There is this awful misconception that Plan B is an abortifactant. Some people believe the pill interrupts already-existing pregnancies. This is completely false.

It works mainly by preventing ovulation, in the same way birth control pills work. It will not work if you happen to already be pregnant, and it will not affect a pregnancy that has already started.

So, please don't add the "Am I having an abortion?" question to your already anxiety-ridden mind. You are not.

5. Side effects usually only last a few days.

The most common side effects include abdominal pain, nausea, breast tenderness, dizziness and fatigue. I can also personally attest to the additional side effects of increased hunger and emotional liability. (Although, I'm not positive that this effect isn't just the anxiety associated with taking emergency contraception. Or maybe, I'm just always ready for an excuse to eat a bunch of chocolate.)

Another side effect is spotting. You should expect your period to be off that month. In fact, many times, you won't get your period that month at all.

Of course, you should take a pregnancy test just in case the morning-after pill doesn't work. Just know that if the test is negative, you will probably miss your period.

6. Follow up with your OB-GYN.

If you're using emergency contraception because you've had unprotected sex, make a follow-up appointment with your OB-GYN within the week for STD testing.

Overall, it is important to know that it is normal to have sex, even if you don't have a ring on your finger. If you're going to have sex, it is crucial you be smart and cautious enough to protect yourself from an STD or unwanted pregnancy.

Don't be embarrassed. Brush your shoulders off and purchase that pill with confidence.