Julie Medical Advisor
Morning-after pill effectiveness
How effective is the morning-after pill?
Levonorgestrel, most commonly referred to as the morning-after pill, is an emergency contraception pill that can reduce the risk of pregnancy by up to 89% if taken within 72 hours after unprotected sex. It’s proven to be even *more* effective if taken within 24 hours, so it’s always best to take it ASAP.
Levonorgestrel is the active ingredient in Julie and was initially approved by the FDA in 1999. It’s been used by millions of women for decades and is an effective emergency contraception option for stopping a pregnancy before it starts.
Fun fact: levonorgestrel is the most used form of emergency contraception around the world.
If you just had sex and you’re unsure whether you were fully protected, take the morning-after pill, like Julie, as soon as possible. Remember, you can easily find Julie at your local Walmart or purchase it online. Julie’s packaging is discrete and designed to look nothing like other morning-after pills, so you don’t have to worry if you run into someone you know.
Weight does impact the effectiveness of the morning-after pill
If you’re over 165 lbs, the morning-after pill may not be the best option for you. In 2009, a study found that women taking emergency contraception with a higher BMI had a 3x greater risk of pregnancy than women with lower BMIs. Research, unfortunately, doesn’t know why. But you still have options. Ella® is another type of emergency contraception pill that works for women up to 195 lbs. Like Julie, it’s a one-time pill, but it does require a prescription. The copper IUD is not affected by weight at all, but it does need to be inserted by a healthcare professional up to 5 days after having unprotected sex.
What you need to know about levonorgestrel
Levonorgestrel is a progestin (a synthetic form of your body’s natural hormone progesterone), found in most oral and IUD contraceptives. However, the morning-after pill, like Julie, contains a much higher dose of progestin than daily birth control. Julie should not be used as a regular birth control method, because it's not as effective as regular birth control. It works by attaching to the progesterone and androgen receptors, which slows the release of gonadotropin-releasing hormone (GnRH) from the hypothalamus. This process suppresses the normal luteinizing hormone (LH) surge that precedes ovulation, which stops your ovaries from releasing an egg.
Depending on where you are in your cycle, the morning-after pill helps to prevent or delay ovulation, and prohibit sperm from fertilizing an egg. It’s important to remember that levonorgestrel is *not* the abortion pill; it will not induce an abortion or miscarriage, and won’t work if you are already pregnant—nor will it harm a fetus. Levonorgestrel helps to prevent pregnancy. It does not reverse it. The morning-after pill like Julie is legal without a prescription in all 50 states.
How effective is the morning-after pill when ovulating?
Julie (levonorgestrel) is most effective when taken before ovulation (about mid-way through your cycle) because it will stop the ovaries from releasing an egg, making it unavailable for a sperm to fertilize after unprotected sex. The ovulation window only lasts about 12-24 hours, and if taken during this time, some evidence suggests that the morning-after pill might be less effective. However, if you’ve already ovulated, it is possible that Julie can prevent sperm from fertilizing an egg or attaching to the uterus. It’s recommended to take a pregnancy test 2 weeks after you take the morning-after pill just in case.
How to know if you’re ovulating
Tracking your cycle is an easy, helpful way to know what stage of your menstrual cycle you’re in, like when you’re ovulating and what days you’re most fertile. On the days that you’re ovulating, it’s especially important to be very cautious with contraception. Ovulation usually begins mid-way through your cycle, about 10-16 days before your period starts.
Some ways to tell that you’re ovulating:
-Basal body temperature falls slightly, then rises again
-Cervical mucus or discharge becomes clearer, thinner, and more slippery
-Sex drive increases
-Light spotting
-Vulva or vagina might appear swollen
-Mild cramps in lower abdomen
There are a number of tools to help you track your cycle from period tracking apps to taking your basal body temperature every morning. If you prefer to go old school, tracking your period with a calendar works just as well.
How long are you protected against pregnancy?
Morning-after pills, like Julie, work retroactively—meaning they can protect you from pregnancy if taken within 3 days after having unprotected sex (they can work up to 5 days after unprotected sex, but it’s most effective the sooner you take it). Once you’ve taken the pill, the hormones will be active in your body for around 5 days, protecting you from sperm cells that can survive inside you for roughly the same amount of time.
The morning-after pill does not protect you against future unprotected sex, so you’ll want to continue using your regular form of birth control immediately after taking Julie.
Julie won’t affect your fertility
Julie is not a permanent form of birth control—it only stops ovulation in the short term. When you start a new cycle next month, you’ll go through a brand new ovulation phase, which is a new opportunity to get pregnant. So if you’re planning on having babies in the future, rest assured your chances of getting pregnant won’t be affected by Julie, even if you take it multiple times.
Need Julie now? Find a Walmart near you or buy a pack online to have on hand.
When used as directed, Julie is safe and effective. Common side effects may include changes in your period, nausea, lower stomach pain, tiredness, headache, dizziness and breast tenderness. Julie will not protect you from HIV and other sexually transmitted diseases.
This article is for informational purposes only and does not constitute medical advice. Always talk to your doctor about the risks and benefits of any medication.
Emergency contraceptives like Julie work when you take them after sex. That’s because emergency contraception prevents pregnancy by delaying when you ovulate. By taking emergency contraception before sex, you may not be delaying ovulation long enough.
No. Julie is not what is commonly called “the abortion pill” or “medication abortion”. The active ingredient in the abortion pill is mifepristone. Pregnancy needs a hormone called progesterone to grow normally. Mifepristone blocks your body’s own progesterone, stopping the pregnancy from growing. Julie does not and will not impact an existing pregnancy, and works by delaying ovulation before there is a pregnancy.
The FDA recently made an update in December 2022 to remove any language suggesting that Julie may prevent implantation of a fertilized egg. We are currently working on removing this outdated disclaimer but you may still see it present on some of our packaging in the meantime. Please disregard these statements because they are out of date. Julie will not impact an existing pregnancy.
Julie is an emergency contraception you can take after:
- You didn’t use any form of birth control or had unprotected sex
- There was an issue with your regular birth control method (eg, the condom broke or slipped)
- You missed a dose (or more) of your regular birth control pill
Taking Julie will not impact your ability to get pregnant.
After taking Julie you can continue on with your regular birth control method if you have one (for example, continue taking birth control pills).
You will know Julie has been effective when you get your next period, which should come at the expected time, or within a week of the expected time. If your period is delayed beyond 1 week, it is possible you may be pregnant. You should get a pregnancy test and follow up with your healthcare professional.
Julie is a backup or emergency method and should not be used as a regular birth control method. Consult with your doctor about a birth control method that makes sense for you.
Please know that taking a dose of Julie will only protect you from one instance of unprotected sex, it will not prevent pregnancy from unprotected sex over the coming days or weeks. If you have unprotected sex in the future and want to prevent pregnancy, be sure to take a new dose of Julie and talk to your doctor about the best birth control options for you.
Your menstrual bleeding patterns may change temporarily after using levonorgestrel. If you find that your period is more than a week late, take a pregnancy test to confirm whether the contraceptive has worked.
Julie can be used by all women, regardless of weight but women with BMIs above 29.9 have a pregnancy risk of 5.8% - meaning that out of every 100 women who take Julie, 6 may become pregnant. We advise that you speak with your doctor for further information on how this may affect you personally.
Take Julie tablets orally (swallow it). It is preferable to take it with water, and you can take it with or without food. Do not insert Julie vaginally.
Julie is not an abortion pill and will not harm an existing pregnancy nor will it be effective if a woman is already pregnant.
Julie is a progestin‑only emergency contraception product that helps prevent pregnancy before it starts when taken within 72 hours after unprotected sex.
Julie is a backup method of preventing pregnancy and should not be used as regular birth control. Use as directed.
Julie is effective up to 72 hours (3 days) after unprotected sex. The sooner it’s taken after unprotected sex, the better it works.
Julie can significantly decrease your chances of getting pregnant. When used as directed, about 7 out of every 8 women who could have gotten pregnant will not become pregnant after taking Julie. The most important factor affecting how well Julie works is how quickly it is taken. When taken as directed within 72 hours after unprotected sex or birth control failure, Julie can significantly decrease the chance that a woman will get pregnant. In fact, the earlier Julie is taken after unprotected intercourse, the better it works.
Emergency contraception is not 100% effective, which is why it is critical that women have a regular birth control method. If you have any further questions, we encourage you to talk to your healthcare provider.
Since emergency contraception can affect the length of your menstrual cycle, your period might come about a week later or earlier than usual after taking Julie. If your period is more than one week late, consider the possibility of pregnancy.
No. No one needs a prescription to purchase Julie or EC. However, some insurances require a prescription for reimbursement. Some pharmacies and places where EC is sold may tell you that you need a prescription. You do not.
You do not need to see a doctor before or after taking Julie. You do not need a prescription from a doctor. We do encourage you to speak to a doctor you feel comfortable with about sex, reproductive health, and contraception.
No. We know this is a common misconception so let’s break it down. Using Julie (no matter how many times you take it) does not affect your fertility — and it will not prevent you from becoming pregnant in the future. You should feel free to use Julie whenever you think it’s necessary. Julie (and all EC) is not recommended as an ongoing form of birth control because it’s not as effective at preventing pregnancy as birth control methods like the IUD, patch, pill, ring, or shot. Also, frequent use of EC may cause periods to become irregular and unpredictable. That’s it!
Yes. You are not alone. Often times, people who buy EC are feeling stressed out, concerned, embarrassed, confused or ashamed. The important thing to remember is that you are not alone, you have nothing to be ashamed about, and the Julie community is here to support you. By taking Julie after unprotected sex, you are taking control of your future and taking a safe, effective, approved method of preventing pregnancy.
