After Plan B

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Medically reviewed by Drugs.com. Last updated on Mar 26, 2022.
Note: This document contains side effect information about levonorgestrel. Some of the dosage forms listed on this page may not apply to the brand name Plan B.
Applies to levonorgestrel : oral tablet
Along with its needed effects, levonorgestrel (the active ingredient contained in Plan B ) may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor immediately if any of the following side effects occur while taking levonorgestrel:
Some side effects of levonorgestrel may occur that usually do not need medical attention . These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.
Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Applies to levonorgestrel: intrauterine device, oral tablet, subcutaneous implant
The most commonly reported adverse effects are alterations of menstrual bleeding patterns, nausea, abdominal/pelvic pain, headache/ migraine , dizziness, fatigue, amenorrhea , ovarian cysts , genital discharge, acne /seborrhea, breast tenderness, and vulvovaginitis. [ Ref ]
Very common (10% or more): Irregular menstrual bleeding (67%), infrequent menstrual bleeding (up to 57%), ovarian cyst (31.2%), menstrual changes (up to 31.9%), decreased uterine bleeding (23.4%), prolonged menstrual bleeding (22%), vulvovaginitis (20.2%), amenorrhea (18.4%), genital discharge (up to 14.9%), heavier menstrual bleeding (13.8%),vaginal infections (13.6%), vulvovaginal infections (13.3%), lighter menstrual bleeding (12.5%), increased scheduled uterine bleeding (11.9%), breast tenderness (10.7%)
Common (1% to 10%): Dysmenorrhea, breast pain/discomfort, upper genital tract infection, genital tract bleeding, pelvic inflammatory disease , endometritis , dyspareunia, pelvic discomfort/pain, delay of menses more than 7 days, vaginal discharge, bleeding not related to menses
Uncommon (0.1% to 1%): Uterine spasm, cervicitis/Papanicolaou smear normal class II, change in vaginal secretion
Rare (less than 0.1%): Uterine perforation
Frequency not reported : Breast enlargement, vaginal candidiasis , changes in cervical erosion, changes in cervical secretion, ectopic pregnancy
Postmarketing reports : Oligomenorrhea, irregular menstruation [ Ref ]
Very common (10% or more): Nausea (up to 23.1%), abdominal/pelvic pain (up to 22.6%)
Common (1% to 10%): Diarrhea, vomiting
Uncommon (0.1% to 1%): Abdominal distension
Frequency not reported : Bloating, abdominal cramps [ Ref ]
Very common (10% or more): Fatigue (16.9%)
Common (1% to 10%): Partial/complete IUS expulsion, weight increased
Uncommon (0.1% to 1%): Edema , change in body weight
Very rare (less than 0.01%): Face edema
Frequency not reported : Decreased weight, sepsis , group A streptococcal sepsis
Postmarketing reports : IUS breakage, procedural bleeding [ Ref ]
Very common (10% or more): Headache (up to 16.8%), dizziness (11.2%)
Postmarketing reports : Stroke, syncope , IUS insertion related vasovagal reaction or seizure [ Ref ]
Common (1% to 10%): Depression/depressed mood, mood changes, mood swings, decreased libido, nervousness
Frequency not reported : Changes in libido [ Ref ]
Very common (10% or more): Acne/seborrhea (15%)
Common (1% to 10%): Alopecia , hirsutism
Uncommon (0.1% to 1%): Pruritus , eczema , pigmentation changes/hyperpigmentation
Rare (less than 0.1%): Rash, urticaria
Frequency not reported : Chloasma, melasma
Postmarketing reports : Angioedema [ Ref ]
Postmarketing reports : Increased blood pressure, arterial/venous thrombotic events, pulmonary emboli, deep vein thrombosis , stroke [ Ref ]
Common (1% to 10%): Back pain [ Ref ]
Frequency not reported : Benign/malignant liver tumors
Postmarketing reports : Breast cancer [ Ref ]
Frequency not reported : Contact lens intolerance [ Ref ]
Frequency not reported : Diabetes mellitus [ Ref ]
Frequency not reported : Allergic reaction
Postmarketing reports : Hypersensitivity reactions [ Ref ]
1. "Product Information. Mirena (levonorgestrel)." Berlex Laboratories (2003):
2. "Product Information. Plan B (levonorgestrel)." Women's Capital Corporation (2003):
3. Cerner Multum, Inc. "UK Summary of Product Characteristics." O 0
4. Cerner Multum, Inc. "Australian Product Information." O 0
5. "Product Information. Skyla (levonorgestrel)." Bayer Pharmaceutical Inc (2013):
6. "Product Information. Liletta (levonorgestrel)." Actavis Pharma, Inc. (2016):
7. "Product Information. Kyleena (levonorgestrel)." Bayer Pharmaceutical Inc (2018):
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
Some side effects may not be reported. You may report them to the FDA .
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Drugs.com provides accurate and independent information on more than 24,000 prescription drugs, over-the-counter medicines and natural products. This material is provided for educational purposes only and is not intended for medical advice, diagnosis or treatment. Data sources include IBM Watson Micromedex (updated 5 July 2022), Cerner Multum™ (updated 27 June 2022), ASHP (updated 16 May 2022) and others.
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How Plan B Works Before and After Ovulation

Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Ⓒ 2022 Dotdash Media, Inc. — All rights reserved

Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.

Verywell Health articles are reviewed by board-certified physicians and healthcare professionals. These medical reviewers confirm the content is thorough and accurate, reflecting the latest evidence-based research. Content is reviewed before publication and upon substantial updates. Learn more .

Medically reviewed by
Monique Rainford, MD

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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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Verywell Health's content is for informational and educational purposes only. Our website is not intended to be a substitute for professional medical advice, diagnosis, or treatment.

Ⓒ 2022 Dotdash Media, Inc. — All rights reserved

Verywell Health is part of the Dotdash Meredith publishing family.

Monique Rainford, MD, is board-certified in obstetrics-gynecology, and currently serves as an Assistant Clinical Professor at Yale Medicine. She is the former chief of obstetrics-gynecology at Yale Health.

Plan B One-Step is an emergency contraceptive. Emergency contraceptives are used to prevent pregnancy after birth control failure or unprotected sex. Generic forms of Plan B include My Way , Take Action , and Next Choice One Dose .

Emergency contraception is safe and effective. Still, Plan B is controversial . Much of the debate is based on a misunderstanding about how Plan B works.

Some people believe Plan B prevents a fertilized egg from implanting in the lining of the uterus. This belief is based on the product's FDA labeling. Research, however, has not confirmed the information on the FDA label.

This article will discuss the controversy around the FDA labeling for Plan B. It will also look at what research says about how Plan B actually works.

According to the product label, Plan B prevents or delays ovulation, or the release of an egg. It may also prevent fertilization, when an egg and sperm combine.

The debate is based on another statement made on the label. Under "How does Plan B One-Step work?" the label says: “It is possible that Plan B One-Step may also work... by preventing attachment (implantation) to the uterus (womb).”

The medical community does not agree on the definition of pregnancy. 1 The legal definition of pregnancy "encompasses the period of time from implantation until delivery." 2

Some people, though, believe pregnancy begins when an egg is fertilized. People who hold this belief see Plan B as a form of abortion . This is because it is said to prevent implantation of a fertilized egg.

Research does not support this theory about how Plan B works, though. 3 In fact, studies have shown that Plan B does not decrease the rate of pregnancy when taken after ovulation. 4 This suggests it may not interfere with fertilization or implantation, just ovulation.

Most research suggests that Plan B does not cause changes in the endometrium , or lining of the uterus. 3 Because of this, researchers have concluded it cannot prevent implantation of a fertilized egg.

Plan B is not 100% effective at preventing an unintended pregnancy. It is also less effective the longer you wait to use it. Many researchers think this is because it does not prevent implantation.

Research shows Plan B does not cause any changes in the lining of the uterus. Therefore, it would not prevent implantation of a fertilized egg.

During Plan B's approval process, its manufacturer asked the FDA to remove the implantation piece from its label. It is not completely clear why the FDA chose to keep it there.

Most of the research done during the approval process focused on Plan B's active ingredient, the progestin hormone levonorgestrel . The research looked at the hormone's safety and its effectiveness at preventing pregnancy. These studies did not explore how Plan B works.

The FDA may have decided to include implantation on Plan B’s label because this is one of the ways birth control pills work . Birth control pills containing levonorgestrel or a different progestin change the lining of the uterus. The FDA may have decided that because the pill may do this, Plan B might, too.

But there are two things to keep in mind:

According to those involved in the Plan B approval process, the FDA thought it was important to include on the label the possibility that Plan B works "theoretically ... by interfering with a number of physiological processes." 6 This is why it included a list of all the possible ways that Plan B works.

Even though there was no scientific proof that Plan B works by preventing eggs from implanting, this claim was still included by the FDA on the drug’s label.

The FDA is has no plans to change the label. 7 But Erica Jefferson, an FDA spokesperson, did tell the New York Times that "the emerging data on Plan B suggest that it does not inhibit implantation." Research is clear that Plan B does not interfere with implantation. It works primarily by preventing ovulation. 8

Because of this, the research community and many in the medical field feel the language about implantation should be removed from Plan B labeling. 7

The FDA labeling for the Plan B emergency contraceptive says Plan B may work by preventing implantation of the fertilized egg. This has created controversy over its use. Research, however, shows that Plan B does not work this way. Instead, it works by preventing ovulation and fertilization of the egg.

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Chung GS, Lawrence RE, Rasinski KA, Yoon JD, Curlin FA. Obstetrician-gynecologists' beliefs about when pregnancy begins . Am J Obstet Gynecol. 2012;206(2):132.e1-7. doi:10.1016/j.ajog.2011.10.877
Gemzell-Danielsson K, Berger C, Lalitkumar PGL. Emergency contraception — mechanisms of action . Contraception . 2013;87(3):300-308. doi:10.1016/j.contraception.2012.08.021
Novikovaa N, Weisberg E, Stanczyk FZ, Croxattod HB, Fraser IS. Effectiveness of levonorgestrel emergency contraception given before or after ovulation — a pilot study . Contraception . 2007;75:112-118. doi:10.1016/j.contraception.2006.08.015
Gemzell-Danielsson K, Berger C, Lalitkumar PGL. Emergency contraception — mechanisms of action . Contraception . 2013;87(3):300-308. doi:10.1016/j.contraception.2012.08.021
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