Before the first time I took the morning-after pill, I was tremendously anxious. I was newly single after a long monogamous relationship, had experienced a questionably protected one-night stand the night before, and felt like I was treading completely uncharted waters. I had friends who’d taken Plan B, of course, but we’d never really discussed what it was like for them in depth. I didn’t remember learning anything about it in high school sex ed. And I didn’t bother looking up possible side effects on the internet, which I knew would be dramatic and terrify me. All these unknowns made my first Plan B experience about 10 times more stressful than it had to be.
As it turned out, I’d wind up having a perfectly uneventful and effective first go with Plan B (no side effects, no pregnancy), but I wished I’d been better educated about it and knew what to expect beforehand. That is what leads me to this story, and to Felice Gersh, an OB/GYN and the founder and director of the Integrative Medical Practice of Irvine in Irvine, California.
Let’s get the most basic question out of the way first: What is Plan B? According to Gersh, it’s the only form of the morning-after pill sold over-the-counter (so no prescription needed) and contains 1.5 mg of the hormone levonorgestrel. The pill’s mode of action may be “to prevent ovulation, fertilization, or implantation [of an egg],” she explains.
Thankfully I already had enough info about Plan B before taking it (thanks to my friends, by the way, not school, not the health care system) to know that it cannot get rid of an existing early pregnancy. Sadly not everyone is aware of this fact. “Morning after pills aren’t abortion pills,” Gersh confirms. “If you’ve already an implanted embryo in you, then it won’t work!” Plan B will not have any effect on the embryo whatsoever. The pill also can’t prevent the transmission of any kind of sexually transmitted infection. “Condoms should always be used when knowledge of the partner’s health status is unknown or questionable,” says Gersh.
Now that we’re all set up, let’s continue learning about what it’s really like to take Plan B. Here, five things I wish I’d known before my first morning-after pill experience.
#1. You don’t actually have to take it “the morning after” … but it will be less effective if you don’t
Just from the name, I thought you had to take the morning-after pill ASAP for it to work at all, but the truth is that you have 72 hours, the period it usually takes for an egg to be fertilized, before it’s too late. Still, it is not a prudent idea to have unprotected sex and figure, oh it’s fine, I’ll just take Plan B three days from now and it’ll be fine. “The reality is that it’s not full proof,” says Gersh. Here’s the breakdown: If you take Plan B within 24 hours, it is 95% effective at preventing pregnancy, but if you wait until 72 hours, that figure drops down to 89%. According to Gersh, Plan B is actually “less effective than using birth control properly” and ideally shouldn’t become your standard practice for preventing pregnancy (especially since the pill can run you $50 or more a pop).
#2. It could alter your period flow or make you spot
This doesn’t always happen, but after taking the morning-after pill, you could experience a heavier period, a lighter one, or irregular bleeding. And you will likely spot a little bit between the time you take the pill and the time you start your period.
Again though, because Plan B is not a 100% guarantee, if your bleeding is suspiciously abnormal and you’re feeling doubtful, Gersh recommends taking a pregnancy test just to make sure.
#3. You *might* experience side effects
The internet lists all kinds alarmist morning-after pill side effects, but according to Gersh, the most common ones include nausea, abdominal pain, fatigue, headaches, menstrual changes, breast changes, and dizziness. Whether or not you experience any of these side effects will depend on factors like your body’s particular hormone levels, sensitivity to hormones, and whether or not you’ve been pregnant or had an abortion before.
#4. But you also might not experience any side effects at all
I’d heard anecdotes and read information online leading me to believe that side effects from Plan B, like spotting and intense fatigue, were pretty much inevitable. This made me really nervous to take it. In fact, I even stalked up on Ibuprofen and canceled the dinner plans I had that night in anticipation of feeling like crap. But in reality, I experienced zero side effects from Plan B: no nausea, no dizziness, no weird period. Literally nothing. I’ve taken it about five times since that first go and have never felt so much as a little bit tired.
This is not to say that any warnings about Plan B’s side effects are exaggerated or untrue, it’s simply that everyone’s body is different. Your experience will likely be completely different from your friends or from what you read on the internet, so certainly prepare for the worst if you’re so compelled to, but also feel free to hope for the best, knowing that it’s a real possibility.
#5. Be prepared for some emotional fallout
I wasn’t expecting this at all, but after my first time taking Plan B, I felt a little weird, spiritually speaking. I felt embarrassed almost, like it was my fault and my fault alone for not having been more careful the night before. I'd love to say I was more of a badass than this, but as I was walking out of that pharmacy, I couldn't help but feel society’s slut-shaming eye watching me.
Luckily, I got over that emotional discomfort pretty fast. But no matter what you feel after your first Plan B (guilt, pride, ambivalence, a vague psychic ickiness), Gersh guarantees you’re not the only one. “Be sure to pamper yourself and deal with any emotions you may have,” she says. “Be open and honest if any mixed feelings should come out! Even the hormone changes from the morning after pill may affect one’s emotions.” Try talking to a friend who's taken the pill and can possibly relate, or just writing your thoughts out on paper.
Next up: The only birth control guide you'll ever need.