Plan B, the most common ‘morning after pill’ has made the news recently with the ongoing debate about availability in pharmacies however a lot of people are still misinformed about the purpose and action of this medication. To begin, this article is intended as informational only in order to explain what it is, how it works, side effects and the current arguments surrounding its use. Plan B is not the abortion pill, RU-486, as many commonly believe they are similar.
What is Plan B?
Plan B is a pill that contains levonorgestrel which is a synthetic progesterone otherwise known as a progestogen. Please do not confuse it with the actual progesterone your body creates. Levonorgestrel is a common ingredient in many birth control pills and has been used for many years -- it is not new to the market – however compared to the pill, the amount in Plan B is much higher at 1.5mg in a single pill.
When to take it?
Plan B must be taken within 72 hours (or three days) of intercourse -- the sooner the better. It is not meant to replace the birth control pill and is strongly advised against taking it routinely as it is a powerful hormone and may have side effects. Do not take it if you are already pregnant.
How does it work?
It is thought to work in a few ways. The high dose of hormone can prevent ovulation, it can change the way the egg or sperm move through the tube such that they don’t meet, and it can change the lining of the uterus in order to discourage implantation. Many birth control options work this way as well such as the pill, ring, injection and IUD however they provide protection through the entire month. Much like those same birth control options, Plan B does not protect you from sexually transmitted infections such as chlamydia, gonorrhea, herpes, HPV, or HIV.
What to expect?
Many women report a change in their menstrual cycle -- either it starts much sooner or is delayed (take a pregnancy test just in case!) and can either be a heavier or lighter flow. As it is a high dose of progestogen, other side effects include dizziness, nausea, stomach upset, headaches, and breast tenderness.
Where is it sold?
Plan B is sold at most pharmacies without a prescription however it is kept behind the counter therefore you will need to talk with a pharmacist and prove that you are least 17 years of age. Those girls under 17 years old will need a prescription.
The debate?
The current debate is whether it should be put out on the shelves, next to the condoms and other family planning supplies. Research submitted to the Food and Drug Administration (FDA) showed that 79 percent of girls between the ages of 12 and 17 could understand the instructions for Plan B and use it effectively and should therefore be available over the counter.
The FDA commissioner agreed however the U.S. Department of Health and Human Services (HHS) disagreed and has decided Plan B is to remain behind the counter. The FDA and several groups in support of Plan B are arguing that girls are becoming sexually active and are able to become pregnant at very young ages and may not see their healthcare provider or want to talk with their parents about it until it is too late. They have also brought up young rape victims who may want to utilize Plan B without seeking medical care.
Those that oppose Plan B, including the HHS Commissioner, believe there is not enough documented evidence that it should be available for girls under 16 years of age. Others believe its widespread availability could lead to promiscuity, sexual abuse, and less visits to the doctor for sexual health concerns.
References:
1. Plan B: Sebelius Overrules FDA, Nixes Sale Without ID. Web. December 14, 2011.
http://www.medscape.com/viewarticle/754950
2. Barriers to Emergency Contraception (EC): Does Promoting EC Increase Risk For Contacting Sexually Transmitted Infections, HIV/AIDS? Web. December 14, 2011.
http://www.medscape.com/viewarticle/583741
3. Mechanisms of Action of Hormonal Emergency Contraceptives. Web. December 14, 2011.
http://www.medscape.com/viewarticle/719473
Reviewed December 14, 2011
by Michele Blacksberg RN
Edited by Jody Smith