Taking Plan B More Than Once

Taking Plan B More Than Once
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You're making out with your boyfriend, clothes begin to come off, and before you know it, you've had sex — unprotected. After the heat of the moment wears off, you rush to the pharmacy, grab over-the-counter Plan B One-Step, and swallow the pill to prevent pregnancy.
But what happens if you take Plan B more than once?
Plan B is the most common levonorgestrel-only pill that only contains progestin — a synthetic version of the naturally-occurring hormone progesterone found in some birth control pills. It is designed to prevent pregnancy. The special formulation of hormones should be taken within 3 days (72 hours) of unprotected sex or birth control failure to reduce the risk of pregnancy up to 89 percent, according to Plan B . However, the sooner you take it, the more effective it is. It works by either temporarily stopping the release of an egg from the ovary, preventing fertilization, or preventing a fertilized egg from attaching to the uterus.
Using emergency contraception, like Plan B, comes with short-term effects like painful menstruation and nausea. The pills might lead to unexpected bleeding (which is not dangerous, and should be resolved by your next period, according to Princeton University ).
It might also cause your next period to come early or late.
Some women may experience spotting a few days after taking Plan B One-Step. Menstrual bleeding patterns are often irregular among women using progestin only contraception.
A 2010 study comparing levonorgestrel and ulipristal acetate (ella) showed generally similar side effects for the two medications. Approximately 20 percent of women in each group experienced headaches following EC treat; up to 14 percent experienced painful menstruation; and up to 12 percent experienced nausea. Women who took ulipristal acetate had their next period on average 2.1 days later than expected, while women taking levonorgestrel began their next period 1.2 days earlier than expected, but the duration of periods was not affected.
So, what are its long-term effects?
A common misconception is that frequent use of Plan B can affect a woman's fertility. However, there are no health risks to using Plan B as much as you need.
"It's not necessarily bad to use as a regular form of birth control because it is simply a higher dose of a regular progestin-only birth control pill," said gynecologist Diana Hoppe to Shape Magazine .
Moreover, "oral emergency contraception may be used more than once, even within the same menstrual cycle" according to the American Congress of Obstetricians and Gynecologists (ACOG).
This is how taking Plan B more than once affects your risk for fertility and breast cancer. Photo courtesy of Pixabay, Public Domain
Simply put, there's no reason to believe it would have any effect on fertility, unless possibly if you begin trying to become pregnant immediately after taking the pill. There are no irreversible effects on fertility following exposures to levonorgestrel or progestins in general.
Moreover, the biggest risk of taking Plan B multiple times is an eventual unintended pregnancy. Plan B prevents pregnancy about 75 percent of the time if no other birth control pill was used, compared to the birth control pill or IUD that are around 98 or 99 percent effective, respectively.
There are two types of birth control pills available in the U.S. — oral contraceptives that contain man-made versions of estrogen and progesterone, and the mini pill, which only contains progestin. Naturally occurring estrogen and progesterone can influence the development and growth of some cancers, according to the National Cancer Institute .
Therefore, because some birth control pills contain female hormones, researchers are interested in establishing whether there is any link between these widely use contraceptives and cancer risk.
In 2005, the World Health Organization (WHO) officially classified oral contraceptives as a Class 1 carcinogen. Plan B is composed of levonorgestrel, which is a potent progestin found in some of today’s birth control pills.
A 2006 study published in the Mayo Clinic Proceedings noted that taking the birth control pill before pregnancy results in a 44 percent increased risk of developing breast cancer prior to age 50. The study analysis noted that 21 out of 23 retrospective studies have shown an increased risk of breast cancer in women who took oral contraceptives prior to pregnancy.
On the other hand, oral contraceptive use has consistently been found to be linked to a reduced risk of ovarian cancer. In a previous study , researchers found that the longer a woman used oral contraceptives, the more her risk of ovarian cancer decreased. The risk decreased by 10 to 12 percent after 1 year of use; approximately 50 percent after 5 years of use.
The research regarding oral contraceptives and cancer risks remains inconsistent and still warrants further research.
Plan B is an excellent alternative as an emergency contraception when preventing unwanted pregnancies. However, it’s not designed to be used as a regular form of contraception.Taking Plan B twice in a couple of months won’t do much harm.
Although docs agree there’s no clear danger from taking Plan B more than once or twice, it’s not recommended as a replacement for regular birth control.
"If someone is having sex even just three to four times a month, you're still talking about a couple hundred dollars a month," said Streicher.
Talk to your gynecologist for a healthier everyday alternative for safe sex.
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When your regular form of birth control fails—whether it's a broken condom or missed oral contraceptive—using emergency contraception can help prevent an unplanned pregnancy. While it's perfectly safe to take a morning-after pill, should you be concerned if you've taken it more than once, or even countless times? And could it affect your ability to get pregnant in the future? We asked experts to weigh in.

The most common morning-after pills are over-the-counter tablets containing higher doses of levonorgestrel, a synthetic progestin hormone that is also in oral contraceptives. These pills work by preventing the ovary from releasing an egg or delaying the release of an egg, which in turn lowers the risk of male sperm fertilizing an egg. You might know them by brand names such as Plan B One-Step.

You don't have to wait until the actual morning after to get or take the pill. You do have the option to get emergency contraception in advance; additionally, if you have unprotected sex, you should take emergency contraception as soon as possible. Morning-after pills aren't 100% effective at preventing pregnancy, but they "can prevent up to over 95% of pregnancies when taken within five days after intercourse," according to the World Health Organization (WHO) .

Of note, morning-after pills are not intended to be used as routine birth control, per the Office on Women's Health (OWH) , as using them for that reason has not received FDA approval. The OWH added that the correct use of regular birth control (so, taking it daily and on time) is much more effective than emergency contraception for pregnancy prevention.

While morning-after pills won't have harmful long-term effects on your body, taking it multiple times can turn your hormones upside-down, said Sherry A. Ross, MD , a Los Angeles-based ob-gyn and author of She-ology ($26; amazon.com ). "It's temporarily harmful in that you will have irregular bleeding and may feel emotionally unraveled," Dr. Ross told Health . "But once you stop taking it, your body will have the opportunity to reset."

Orlando-based ob-gyn Christine Greves, MD , a fellow of the American Association of Obstetrics and Gynecology, agreed with Dr. Ross. You might experience unpleasant side effects after taking Plan B, Dr. Greves explained, including nausea and lower abdominal cramps in addition to irregular bleeding. Other short-term effects might include headaches, dizziness, fatigue, or breast pain, per the OWH.

Although taken less often, Ella, another type of morning-after pill available with a prescription, also won't have long-term effects on your health, Dr. Greves said. But she did note that you shouldn't take other forms of birth control pills that contain progesterone for at least five days after using Ella, because it could interfere with the pill's effectiveness.

However, if you've taken the morning-after pill countless times, you might want to speak to your gynecologist about alternate contraceptive options, said Bat-Sheva Lerner Maslow, MD, a reproductive endocrinologist at Extend Fertility .

Dr. Maslow pointed out that it's better to have a reliable form of contraception than constantly turning to emergency ones. If you struggle to remember to take birth control pills, for example, long-term contraception such as an intrauterine device (IUD) can make forgetfulness a non-issue. Even if you don't already have an IUD, you also have the option to have a "copper T IUD inserted within five days of unprotected sex," according to the Centers for Disease Control and Prevention (CDC) .

So, say you had unprotected sex and took the morning-after pill. Would that same pill prevent pregnancy if you then had unprotected sex again a few days after taking it? To play it safe, it's best to take Plan B after every unprotected sexual encounter, experts said.

"In theory, it should cover you until your next period because of the changes it causes in the uterine lining," Dr. Maslow explained, "but I wouldn't necessarily recommend relying on it as a proactive form of birth control."

And can taking Plan B make it difficult to get pregnant when you do want to down the road? Fortunately, all experts we polled were in agreement on this: The morning-after pill won't have any long-term effects on future fertility.

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