Back to the Questions

What is emergency contraception & the morning-after pill?

by Dr. Margo Harrison
Julie Medical Advisor
Morning After Pill

What is emergency contraception?

When unprotected sex happens, we’re sometimes left wondering: could I get pregnant? If this is you, emergency contraception is a safe and effective way to prevent a pregnancy from starting since it’s taken after you had sex with your partner. It’s intended to be used for emergencies only—not as a regular form of birth control like condoms, birth control pills, and IUDs.


The morning-after pill—like Julie— is one of the most common and convenient forms of emergency contraception since it’s an over-the-counter pill found at pharmacies and stores like Walmart, nationwide. Both Plan B and Julie have the same ingredient—levonorgestrel—which is FDA-approved and legal in all 50 states. When used correctly, it can significantly reduce your chance of getting pregnant. It doesn’t require a prescription, ID, or credit card, and can be purchased easily by anyone (you, your partner, your friend, or the nice guy from Instacart).


Other types of emergency contraception.

Because we deserve options. Beyond Julie, there are other types of emergency contraception available, like the copper IUD. The copper IUD is a small t-shaped piece of plastic with copper coils that’s inserted into the uterus by a healthcare professional. You might already know that it’s a very effective form of regular birth control, but it can also be used as emergency contraception if inserted within 5 days after unprotected sex. Studies have shown the pregnancy rate of people with an IUD is .1%. The one caveat is that you do need to get an appointment with a medical provider on the fly, which isn’t always easy. Since time is of the essence when you’re trying to protect yourself against pregnancy after unprotected sex, the morning-after pill (like Julie) is a much faster, convenient, and affordable option.


Speaking of time—it’s important to take the morning-after pill as soon as you’re able. The pill is most effective when taken within 72 hours (3 days), but the sooner you take it the better.


How the morning-after pill works

First of all, if you have unprotected sex, don’t panic—you are not automatically pregnant. In fact, pregnancy doesn’t happen nearly as fast as we think it does.


It actually takes up to 2-3 weeks to get pregnant. And three key things need to happen: an egg needs to be released from the ovary (ovulation), a sperm has to swim and link up with the egg in the fallopian tube (fertilization), and then that egg-sperm combo has to find a spot on your uterine lining to hang out and develop. Once it finds its landing spot, that’s when pregnancy officially starts.


The morning-after pill, like Julie and Plan B, uses a medicine called levonorgestrel to block this process in two different ways:


Prevent ovulation by stopping the egg from being released

  • Every month, the hormones that control your menstrual cycle get one of your eggs prepped and ready to leave your ovary. Once released, the egg floats through your fallopian tube, which takes about 12 to 24 hours. If you just had unprotected sex, it might meet up with the sperm. But if you haven’t ovulated yet, the morning-after pill temporarily puts the emergency brakes on your ovaries so an egg can’t be released.


Prevent fertilization by causing sperm to not reach the egg

  • Sperm are super tiny. Like microscopically tiny. When your partner ejaculates during unprotected sex, they release millions of sperm, and it only takes one to fertilize an egg. Those sperm can swim up through your cervix, uterus, and into your fallopian tubes. They’ll hang around for six days waiting to meet up with an egg. The morning-after pill may also work by preventing the sperm from ever meeting up with the egg— in other words, they get stood up. Sorry sperm.


How effective is the morning-after pill?

An over-the-counter FDA-approved pill, like Julie, is 89% effective when taken within within 72 hours (or 3 days) after unprotected sex and even more effective when taken within 24 hours. The golden rule is the sooner you take it, the better it will work.


If you just had sex and you’re not sure whether you were completely protected, we recommend taking the morning-after pill as soon as possible. Remember, you can easily find Julie at your local pharmacy or Walmart.


One thing to note: Weight does impact the effectiveness of the morning-after pill. If your BMI is over 25, levonorgestrel may not be the best option for you. 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 the most effective form of emergency contraceptive and 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.


When to use the morning-after pill aka Julie

As women, life happens and sex happens, and there are plenty of reasons why you might find yourself needing to take the morning-after pill. And none of them should ever make you feel shame. Whether a condom broke, or you forgot to take your birth control pills for a few days, Julie is here to help. Keep this checklist on hand to help you figure out whether taking the morning-after pill is the right decision for you.


Use the morning-after pill if:

  • You didn’t use birth control.
  • You missed 2-3 active birth control pills in a row.
  • You and your partner only used the pull out method
  • You had unprotected sex.
  • The condom broke or came off.

The morning-after pill is not the abortion pill

The morning-after pill—like Julie and Plan B— is very different from the abortion pill. The morning-after pill prevents pregnancy from starting by stopping the egg from being released, potentially halting fertilization, and preventing implantation. Plus, it’s FDA-approved and legal in all 50 states.


On the other hand, the abortion pill ends an existing pregnancy, which is something that the morning-after pill cannot do. If you’re already pregnant, the morning-after pill and the medicine within it, levonorgestrel, cannot end the pregnancy or impact it in any way. Remember, emergency contraception is a backup form of birth control and should not be used as regular birth control. It is not an abortion pill and cannot end a pregnancy that has already started.


The morning-after pill will not affect your fertility

The morning-after pill, aka Julie, only stops ovulation short-term. When you take it after unprotected sex, it reduces your chance of getting pregnant now. 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.


Is the morning-after pill like Julie safe?

Yes! The morning-after pill aka levonorgestrel is safe and effective when taken as directed. Millions of women have used these pills to prevent pregnancy for decades. Julie does not affect your fertility, but there are a few different side effects that are common, like changes in your period, nausea, lower stomach pain, fatigue, headaches, dizziness, and breast tenderness (David Turok, MD (2022). Emergency contraception. In UpToDate.).Plus, they’ve been tested and approved by the FDA, and are legal and available in all 50 states. While the morning-after pill is safe, it’s important to remember that it does not protect against sexually transmitted diseases. You’d have to use proper STD and HIV protection—like a condom—when having sex.

FAQ

Where can I buy the morning-after pill?

  • You can buy Julie, Plan B, and other popular morning-after pill options as soon as you need it at Walmart, online, through a delivery service, or at your local pharmacy. And no, you don’t need an ID, prescription, or credit card to purchase it.

Who can use the morning-after pill?

  • Anyone with female reproductive organs who has had unprotected sex. Unprotected sex can happen for many reasons like the condom broke, your partner didn’t pull out, you forgot to take the pill, or the thought of birth control just didn’t occur. If you find yourself in that situation, use Julie, or any morning-after pill, as a backup.


What are the side effects of Julie (the morning-after pill)?

As with any medication, there are some common side effects to keep in mind. None of these are long-term and should resolve themselves on their own. Reported side effects of the morning-after pill include:

  • Changes in your period- heavier or lighter, early or late
  • Nausea
  • Lower abdominal cramps
  • Tiredness
  • Headache
  • Dizziness
  • Breast tenderness
  • Bleeding between periods


Are there any interactions with this medication?

If you’re taking certain medications, they could interact with levonorgestrel—aka Julie and Plan B—which can make the pill less effective. So it’s always a good idea to check your medicine cabinet and talk to your doctor or pharmacist first. Known medications that can interact and reduce the effectiveness of Julie are:

  • Efavirenz (HIV medication)
  • Rifampin (tuberculosis treatment)
  • Griseofulvin
  • St. John’s Wart
  • Certain anti-seizure meds (epilepsy)

How long after sex can I take the morning-after pill?

  • The sooner, the better! Pills with levonorgestrel–like Plan B and Julie—are most effective within 72 hours (3 days) of unprotected sex.

Does the morning-after pill disrupt my cycle? Or cause my period to be late?

  • It depends. Everyone’s body is different. Your period could come earlier or later. If it’s been three weeks since you’ve taken the morning-after pill and you still have no period—take a pregnancy test.
  • Not pregnant? Then your cycle might just be a little out of sync; it should return to normal the following month.


Can I use the morning-after pill as regular birth control?

  • No, Julie is not intended to act as your go-to birth control method. Standard birth control options like the birth control pill, the shot, implant, ring, and IUDs are better at protecting you in the long-term and are less expensive.


I’m not sure if I had unprotected sex. Should I take the morning-after pill?

  • Peace of mind is everything. If you think you might’ve had unprotected sex or if your birth control might’ve failed, be kind to yourself and take Julie. You can easily find it and other emergency contraceptive options at Walmart, online, or at your local pharmacy.


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. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any medication.