The morning-after pill works by preventing or delaying ovulation, not by ending a pregnancy. It’s most effective within 72 hours after unprotected sex. It shares the same ingredient as Plan B (levonorgestrel) and is safe for anyone with a uterus, including trans men. Side effects are usually minor and mostly involve changes in your period. If you find yourself needing EC often, consider a regular birth control method.
Using the Julie Morning After Pill™ comes with some uncertainties. Not only does the efficacy of the morning-after pill vary from person to person, but the same applies to the pill’s potential side effects. There’s also other factors, like where you are in your cycle. Basically, you never totally know what you’re going to get. That being said, when it comes to emergency contraception (EC) we know what we know and we know what we don’t know.
How does the Julie Morning After Pill™ compare to other forms of emergency contraception?
Emergency contraception is the general category that encompasses a few different contraception forms. EC includes the morning-after pill (like the Julie Morning After Pill™), ulipristal acetate (sold under the brand name Ella®), and intrauterine devices (IUDs).
The Julie Morning After Pill™ has the exact same active ingredient in the exact same dose as other over-the-counter morning-after pills: levonorgestrel 1.5mg. This particular dose was initially approved by the FDA under the brand Plan B®, which is why it’s become synonymous with the brand, but the fact is that most over-the-counter morning-after pills made by different companies are essentially the same product. The main differences are price, availability, and company values. (For example, at Julie, we are committed to partnering with non-profit organizations and communities that promote access and acceptance of female sexual health and wellness.) Rest assured that if you go to your local pharmacy and they are out of Plan B®, most other morning-after pills on the shelf will do the same thing.
Compared to other forms of EC, the morning-after pill is the only one available without a prescription or ID in the United States. There is a prescription medication — sold as Ella® — that is more effective, with a 1.1% risk of pregnancy compared to 2.5% for someone with a BMI under 30. The gist is: Efficacy goes down as weight goes up, especially for those with a BMI over 30. (Both pills still reduce the risk of pregnancy, just not as well as they do for those with a BMI under 30.)
Far and away, the most effective form of EC is the IUD. Both copper and hormonal IUDs have a pregnancy risk of less than 1% if inserted within five days of unprotected sex. Efficacy is not impacted by weight, and they can stay inserted for ongoing contraception. The obvious hurdle is that an IUD needs to be inserted, so you’ll need to find a trained provider ASAP if you want to go this route.
What’s the difference between the Julie Morning After Pill™ and abortion?
Hmm, let’s see: Everything! The Julie Morning After Pill™ (and other OTC morning-after pills) do not end a developing or an existing pregnancy. The only way the Julie Morning After Pill™ prevents pregnancy is by delaying ovulation, aka when the ovary releases an egg. That’s literally it. If the egg isn’t released, there’s nothing for sperm to fertilize, which means there is no pregnancy.
Abortion — including abortion via medication — is the disruption of an existing pregnancy. If accidentally taken while pregnant, the Julie Morning After Pill™ will have no impact on the pregnancy.
What should I know before taking the Julie Morning After Pill™?
The most important thing to know is that timing is, famously, of the essence. We advise taking the morning-after pill within 72 hours of unprotected sex — but the sooner you take it the more effective it can be. The longer you wait (or if ovulation has started) the higher the chance that it might not work. And honestly, it’s important that you know that there is a chance it won’t work, especially if you have a BMI over 30. But something is better than nothing. If the morning-after pill is what you have access to, it’s definitely worth considering.
You should also know that the pill is basically a large dose of the hormone progesterone, which will likely have side effects. The most common and most confusing side effect is changes in menstrual bleeding. Spotting, an early period, and a later period are all possibilities. If your period is more than a week late, take a pregnancy test, but don’t panic — it may just be a side effect of the pill.
Finally, if you find yourself taking a morning-after pill regularly, please consider switching to a more effective form of contraception. The Julie Morning After Pill™ (and other morning-after pills) aren’t nearly as great at preventing pregnancy as other types of birth control.
What should I expect after taking The Julie Morning After Pill™?
Most people experience some type of interruption to their menstrual bleeding. It may look like unscheduled spotting, heavier bleeding, or an early period or a late period. These disruptions are expected as the goal of the morning-after pill is to temporarily disrupt your menstrual cycle — remember, we’re trying to pause ovulation. Other side effects like nausea, breast tenderness, mild abdominal cramping, fatigue, headache, and dizziness may also occur within 24-48 hours after taking the pill. However, these should resolve after a day or two.
Can transgender men taking testosterone take the morning-after pill?
Absolutely. The morning-after pill is designed for anyone with a uterus. A trans man can still take the morning-after pill following an act of unprotected penis-in-vagina sex, regardless of undergoing testosterone therapy.
Testosterone therapy provides the signaling to develop traditional male physical characteristics, like facial hair, a deeper voice, and an increase in muscle mass. It may also have the effect of reducing breast tissue and stopping menstrual bleeding. For the majority of individuals on therapeutic levels of testosterone, ovulation also stops. However, the effect is inconsistent, so the use of testosterone is not a reliable form of birth control alone.
How does the Julie Morning After Pill™ affect trans men taking testosterone?
All morning-after pills have the risk of causing bleeding, even if you are on testosterone therapy. These changes should be temporary, lasting only a month or two. If you are on testosterone therapy, your body should return to its baseline bleeding pattern — or lack thereof — after a couple of months.
While the morning-after pill causes a temporary jump-start to the menstrual cycle, it will not directly impact testosterone or its other effects on the body. Uninterrupted use of testosterone is safe and encouraged.
While we love to share useful and helpful information, the above shouldn’t replace the advice of your healthcare professional. For questions about contraception and other reproductive health issues, please talk to your doctor.
Julie wants to keep young women in the driver’s seat of their own stories and provide them with the tools necessary for a happy, healthy sex life.
We know (and have lived!) through the ups and downs of young adulthood firsthand, and we aim to normalize the events, conversations, and questions that come during this period to help destigmatize sexual health. We believe women should live life with total freedom — starting with their ability to choose how, when, and if they become pregnant.
We know that women can make the best choices for themselves when equipped with the right information. We don’t take sexual education lightly and are committed to sharing accurate and factual information through rigorous planning and QA processes. In fact, all Julie content is reviewed by at least two board-certified doctors on our medical board. Learn more about them here.
For more details on our editorial process, see here.
Tessa Commers, MD, FAAP, MS is a board-certified pediatrician based in the Seattle area with a particular interest in adolescent health and sexual education. In addition to clinical practice and serving as Head of Medical at Julie, Tessa also founded AskDoctorT — an education platform with over a million followers across Instagram, TikTok, and YouTube — aimed at improving adolescent health literacy and body confidence. She also hosted and wrote the puberty podcast “That’s Totally Normal!” and has contributed to peer-reviewed publications and educational initiatives focused on child and adolescent wellbeing.
Education: Children’s Mercy Hospital, Kansas City – Pediatric Residency; University of Nebraska Medical Center – Doctor of Medicine (MD); University of Nebraska Medical Center – Master of Science (MS, Genetics, Cell Biology and Anatomy); New York University – Bachelor of Arts (BA)
