Can Your Birth Control Double as Emergency Contraception?

When you’re in need of emergency contraception, it can be hard to think straight. What should you do? Do you have to go buy the morning-after pill? Or could you just “double up” on your birth control pills instead?

Ob/Gyn Diedre McIntosh, MD, explains your options.

Using birth control pills as emergency contraception

“Emergency contraception” is the term for medication you can take after sexual intercourse to help prevent pregnancy. It’s not a regular form of birth control. It’s used in situations where you weren’t able to use protection or your regular birth control method failed (like if the condom broke).

But Dr. McIntosh says you shouldn’t turn to a double dose of your birth control pills as an emergency measure. She explains why — and what to do instead.

What is the Yuzpe method?

The Yuzpe regimen is a method of emergency contraception that involves taking a higher-than-usual dose of birth control pills containing both progestin and estrogen. This method was named after Canadian Ob/Gyn A. Albert Yuzpe, who published the first studies about it in 1974.

The Yuzpe regimen calls for 200 micrograms of ethinyl estradiol, which is the estrogen component of a birth control pill, and 1 milligram of progesterone. You divide that dosage over two separate sittings, taking the first half ASAP after unprotected sex (up to five days afterward) and the other half 12 hours after that.

All that math can be tough to figure out on your own. So, exactly how many pills does that add up to? It depends.

“The number of pills you would take under the Yuzpe method depends on the specific brand of birth control that you’re on,” Dr. McIntosh explains. “There are charts online that list the specific number of pills that make up the correct dosage for a variety of different birth control brands. But it’s risky to try to do yourself.”

That’s one of the few reasons the Yuzpe regimen isn’t generally recommended as a form of emergency contraception.

Why doubling up isn’t recommended

“The Yuzpe regimen is less effective than other types of emergency contraception and is known to cause more side effects,” Dr. McIntosh cautions.

Studies show that the Yuzpe regimen is about 74% effective at preventing pregnancy. Compare that to morning-after pills, like Plan B One-Step®, which can be up to 94% effective if taken in the first 24 hours after sex. (It’s worth noting that most of the research into the Yuzpe regimen’s effectiveness was done in the late 1990s and early 2000s. But that data is still considered the most accurate.)

The Yuzpe regimen also delivers a much higher dose of estrogen than other emergency contraceptives. That means it can cause more significant side effects than other types.

“In particular, it’s known to cause extreme nausea because of the amount of estrogen being taken,” Dr. McIntosh warns.

One study reported that 50% of people had severe nausea and 19% experienced vomiting after the Yuzpe regimen. Taking anti-nausea medication half an hour before each dosage and taking each dose with food may help minimize these concerns.

Other possible side effects include:

• Abdominal pain
• Breast tenderness
• Dizziness
• Fatigue
• Headaches
• Irregular vaginal bleeding

Exceptions

In some places, the Yuzpe regimen is the only emergency contraceptive available to those who need it.

“This method should be used only when you can’t access a more effective form of emergency contraception,” Dr. McIntosh emphasizes. “And even then, it should only be done under the supervision of a physician.”

In these cases, it’s best to follow the Yuzpe regimen within three days of having unprotected sex for the best chances at avoiding pregnancy.

Emergency contraceptives to consider instead

Emergency contraception shouldn’t be your primary form of birth control. But in an unexpected situation, these forms of emergency contraception are more effective than the Yuzpe regimen:

• Levonorgestrel (Plan B and generics): These over-the-counter pills contain the synthetic hormone progestin. They prevent pregnancy by delaying the release of the egg from the ovary (ovulation) to prevent fertilization.
• Ulipristal acetate (ella^®): This prescription medication also suppresses or delays ovulation.
• Some types of IUDs: A healthcare provider can place a copper-releasing IUD or a Mirena® IUD in your uterus up to five days after unprotected sex or contraceptive failure. From there, it offers longer-term pregnancy protection for as long as you keep it in.

“As a reminder, none of these emergency contraceptive methods will work if you’re already pregnant,” Dr. McIntosh clarifies. “Talk to your Ob/Gyn to find the most appropriate contraceptive option for you.”