Plan B alternatives include Ella (ulipristal acetate), a copper intrauterine device (IUD), and combined hormonal birth control pills. Plan B, also known as “the morning after pill”. It uses a hormone called levonorgestrel to inhibit ovulation and prevent pregnancy after unprotected sex.
Drug dealers saw a dramatic increase in demand for emergency contraceptives like Plan B after the Supreme Court overturned Roe v. Wade in 2022. This well-known drug is not the only form of emergency contraception. Other levonorgestrel pills, such as Aftera, Next Choice, Take Action, and AfterPill, are also alternatives to Plan B.
Ella is available as a single tablet that you take by mouth. This pill prevents pregnancy by delaying ovulation. Ella also affects the endometrium, or inner lining of the uterus. This makes the endometrium hostile to sperm.
Note that Ella may interact with several medications. Talk to your healthcare provider if you are taking medicines to treat epilepsy, yeast infections or tuberculosis.
Factors to consider
Efficiency: Ella can prevent pregnancy up to five days after unprotected sex. It reduces the pregnancy rate to 9 in 1,000 (or 0.9%) when taken within 24 hours of unprotected sex. Ella may be less effective in people with a body mass index (BMI) greater than 30.
What it costs: It depends on your health insurance (if you have it), but Ella usually costs about $67 out of pocket. The pill is free with health insurance.
Where to buy: You will need to see a doctor for this type of emergency contraception. Ella is only available with a prescription.
Plan B One-Step, Aftera, Next Choice, Take Action and AfterPill are available in oral tablet form. They contain levonorgestrel, a type of progestin. Progestin is a hormone that prevents the release of an egg from the ovary and fertilization of the egg by sperm.
Directions for each drug vary by brand. You will usually take the tablet by mouth as soon as possible after unprotected sex.
Factors to consider
Efficiency: These drugs can reduce the risk of pregnancy by 89% if taken within three days of unprotected sex. Levonorgestrel tablets are “moderately effective” when taken within five days. These options, like Ella, may be less effective in people with a BMI greater than 30.
What it costs: Prices vary by brand. The retail cost of Plan B One-Step and similar levonorgestrel pills is about $20 to $50 out of pocket.
Where to buy: These drugs do not require a prescription and are usually available over the counter. You can usually find them on the shelves at your local drugstore or big box chain.
Paragard is a copper IUD, which is a T-shaped device that is inserted into the vagina. It does not contain hormones and prevents pregnancy for up to 10 years. The copper IUD prevents pregnancy by making the sperm less able to fertilize the egg.
A healthcare professional must insert the copper IUD within five days of unprotected sex. You can use the IUD for long-term birth control and remove it every time you want to get pregnant.
Paragard has no weight limit, so it works the same in every body.Note that it is not the most comfortable method of emergency contraception. Insertion can be painful, especially if you have never given birth.
Factors to consider
Efficiency: Paragard is one of the most effective forms of emergency contraception. It has been shown to prevent pregnancy 99.9% of the time.
What it costs: The copper IUD is free if you have health insurance and are in the network. It costs up to $1,300 out of pocket.
Where to buy: You must see a healthcare professional to receive and remove the IUD. It’s one of the most difficult forms of emergency contraception to access: getting in quickly to see someone can be difficult.
Combined hormonal birth control pills contain both estrogen and progestin. People often use them as a daily form of birth control. You can also use them as emergency contraception if your healthcare provider prescribes them in larger quantities.
You will need to take combined hormonal birth control pills as soon as possible, up to five days after unprotected sex. The number of tablets you will need to take depends on the dose. You may need to consult a healthcare professional to know how many tablets to take.
Factors to consider
Efficiency: Combined hormonal birth control pills are the least effective form of emergency contraception. Some evidence suggests that the failure rate is around 2% to 3.5%.
What it costs: It won’t cost you anything if you have health insurance. The cost depends on the brand you use if you have coverage.
Where to buy: This can be an easy option to use if you already have a pack of combined hormonal birth control pills at home.
| Plan B Alternative | Form | Who is it for? | Price | Prescription |
|---|---|---|---|---|
| Ella | The pill | People with a BMI of less than 30 | $67 without insurance | Yes |
| Levonorgestrel pills | The pill | People with a BMI of less than 30 | $20 to $50 without insurance | no |
| Paraguard | IUD | Any BMI | Up to $1,300 without insurance | Yes |
| Hormonal birth control pills | The pill | Any BMI | Depends on the brand without insurance | Yes |
Call a health care professional if you need emergency contraception and are not sure what to do. They can offer personalized guidance. The sooner you act, the more effective emergency contraception is.
Here are some factors to consider before choosing the Plan B alternative:
- Convenience: It may be more convenient to buy levonorgestrel pills, which are available over the counter. Other types of emergency contraception require a prescription. It may be more difficult to make an appointment with a healthcare provider.
- Sexual activity: Emergency contraception generally works if you take it within five days of having unprotected sex. Having unprotected sex within 24 hours of using emergency contraception can make it less effective.
- Weight: Some evidence suggests that certain types of emergency contraception are less effective in people who are obese. Paragard may work best in people with a higher BMI.
The Office on Women’s Health (OHW) advises a more regular form of birth control if you are sexually active. Birth control includes condoms, hormonal birth control pills, patches, implants, rings or IUDs. These options are generally more reliable and less expensive than emergency contraception.
A health care provider can help you decide which form of birth control might be best for you. Note that you will need to wait five days to resume regular birth control if you are taking Ella. You can use birth control as normal if you use other types of emergency contraception.
Plan B or the “morning after pill” is a type of emergency contraception that prevents pregnancy after unprotected sex. Alternatives to Plan B include Ella, the copper IUD, and combined hormonal birth control pills. Other levonorgestrel pills are available, such as Plan B.
The effectiveness, cost, and side effects of these options vary. Health insurance largely covers the cost of birth control and emergency contraception. You can talk to your healthcare provider or pharmacist about the best option for you.