Plan B and ella® morning after pills: How they work, common side effects and when each expires

Close up of a woman holding a pill

Although abortion remains legal in Nebraska, there is uncertainty surrounding the recent Supreme Court decision to overturn Roe v. Wade. In response, some women are purchasing extra doses of emergency contraceptive pills, also known as morning after pills, to keep on hand.  

There are two types of emergency contraceptive pills:

Plan B –

  • Available over the counter without a prescription. Some pharmacies have it behind the counter, others have it on the shelf in the "family planning" section 
  • Needs to be taken within 72 hours of unprotected sex
  • Works by blocking ovulation with a high dose of progesterone
  • Will only prevent pregnancy before ovulation has occurred 

Ella® –

  • Requires a prescription from a doctor
  • Needs to be taken within five days of unprotected sex
  • Works by blocking the production of progesterone, which either stops ovulation or prevents an egg from attaching in the uterus
  • Will prevent pregnancy both before ovulation has occurred and a little later in the cycle after the luteinizing hormone surge (the change in hormones that initiates ovulation)

Plan B and ella® side effects 

Both pills can delay your period, or make bleeding come a little sooner than you expected. They both can cause nausea.

If you experience heavier than normal bleeding, reach out to a doctor. 

Can emergency contraceptive pills cause infertility or ectopic pregnancies?

No, there's no evidence that emergency contraceptive pills like Plan B and ella® cause infertility. 

And no, they do not cause or increase the risk for an ectopic pregnancy. They actually decrease the risk for an ectopic pregnancy by preventing pregnancy in the first place.

When to get help from a doctor

Please contact your doctor, or call us to make an appointment with one of our OB-GYNs, if you are:

  • Experiencing bleeding that is soaking a pad every hour, lasting for two hours or longer
  • Having severe abdominal pain. This could be a sign of an ectopic pregnancy
  • Having trouble keeping the pills down or feeling nauseous. A doctor can prescribe anti-nausea medication to help 

If you have not had a period within three weeks of taking Plan B or ella®, take a pregnancy test. Contact your doctor if it is positive. 

Emergency contraceptive pills have no adverse effects on a pregnancy if the pills fail to prevent a pregnancy. 

When emergency contraceptives expire, and where to buy them 

Plan B has a four-year shelf life, and ella® has a three-year shelf life. 

Emergency contraceptive pills are sold at most pharmacies, including all our Nebraska Medicine pharmacies:

If you are having trouble finding emergency contraceptive pills at your local pharmacy, try bedsider.org. After typing in your ZIP code, the website lists online stores that will ship the pills to your door. 

Have questions for an OB-GYN?
If you would like to talk to a doctor about birth control or any other women's health topic, please call 800.922.0000 to schedule an appointment.