Alice,

My boyfriend and I had sex last night and we saw that the condom had broke. We don't know when it happened and I've been looking all over for the 72 hour correction thing that the commercials say — just in case. Can you help me?

K

Dear K,

It sounds like you're searching for emergency contraception (EC), which can help to prevent a pregnancy if taken after sex that occurred when a birth control method failed or wasn’t used. You actually have a few options when it comes to EC (keep reading for more on). It's most effective at preventing pregnancy if taken within 72 hours after sex (for several types of EC), though for others, it can be effective if taken up to 120 hours after sex. There are a few considerations to make when choosing which type of EC is best for you, but in any case, your best bet is to take it as soon as possible for greatest effectiveness.

In the United States, brand-name and generic versions of the EC pill containing levonorgestrel (a synthetic hormone also used in some forms of birth control) are available on-the-shelf. This means that you don't have to ask a pharmacist for it and it can be sold to you without proof of age or a prescription. Just walk into a drugstore and check the family planning aisle. The cost is usually between $35 and $50, but differs depending on location and brand. Before you head out to the pharmacy or drugstore though, it’s a good idea to call to see which types of EC are available.

A few other methods are also available that have a longer window of effectiveness (up to 120 hours after sex). These options typically require a prescription or a visit to health care provider. ella®, an EC pill option that contains ulipristal acetate, requires a prescription and the price for ella® can be around $50 to $70. One specific issue with ella® is that if you’re currently using hormonal birth control (BC) methods (such as the pill, patch, ring, or shot), it may impact the effectiveness of this EC method. If you’ve been looking for regular birth control method though, you could consider the non-hormonal intra-uterine device (IUD). It must be inserted into the uterus by a health care provider within 120 hours after sex to be effective as EC, but can remain in the uterus for up to 12 years as a long-acting, reversible birth control method. If you decide to go this route, it’s good to call your provider in the short-term and request an appointment for an IUD insertion so that you can get seen within that 120 hour window.

Another consideration as you decide on the type of EC you might like to use: a person’s weight can impact the effectiveness of some EC methods. Research has found that for people with a body mass index (BMI) of 26 or more, the levonogestrel versions of EC pills may be less effective. Reduced effectiveness may also occur for those with a BMI of 35 or more if using ella® (the ulipristal acetate EC method). That said, the non-hormonal IUD’s effectiveness as an EC method is not impacted by weight, so it’s a suitable option for anyone.

Lastly, if EC is too expensive, you may want to find a family planning clinic, like Planned Parenthood, that may be able to offer it at a reduced rate. In some cities, EC pills are available for free, 24 hours a day at public hospitals. If you have health insurance, you may also see whether your plan covers these methods — there may be no out-of-pocket cost involved under certain circumstances. While you’re at it, you might also consider getting another dose of EC to have on-hand, that way you can have it when you need it and be able to take it as soon as possible in the future.

Best of luck!

Alice!

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