Under my Um-brella . . . Ella . . . Ella. What is Ella?

Dr. Sharon Orrange
Dr. Orrange is an Associate Professor of Clinical Medicine in the Division of Geriatric, Hospitalist and General Internal Medicine at the Keck School of Medicine of USC.
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What is Ella?  The latest in emergency contraception:

Whoops! Emergency contraception (EC) can prevent pregnancy soon after unprotected intercourse, sexual assault, or failure or improper use of a birth control method. EC reduces the risk of pregnancy when used up to 120 hours (5 days) after unprotected intercourse.

Almost 50% of all pregnancies and more than 82% of teen pregnancies in the U.S. are unintended. Emergency contraception exists because it is estimated that 1.7 million unintended pregnancies could be prevented annually if emergency contraception were used.

The newest EC available is Ella (ulipristal acetate) which is a single pill, making it more convenient than some of the other EC options. Here is what you need to know about Ella and other “morning-after” options for emergency contraception:

Ella is as effective as Plan B (levonorgestrel) up to 72 hours after unprotected sex, yet more effective than levonorgestrel from 72 to 120 hours.

• A pregnancy test is not necessary before administering EC pills because the medicines will not harm an existing pregnancy.

Ella, Plan B, Next Choice, and Plan B One-Step are the options for EC.

Ella is a single-dose pill that is a progesterone-receptor modulator and it’s usually more expensive than Plan B.

• Men and women over the age of 17 can purchase Plan B, Next Choice and Plan B One-Step without a prescription, but Ella requires a prescription.

Ella and the other EC pills work best when used up to 120 hours (5 days) after unprotected intercourse but are more effective if used earlier.

• Nausea occurs in half of the women who take EC pills and vomiting in one fifth but this is lower after taking Ella.

• After using EC, you should have your menses within 3 days of the expected onset date so if you don’t, see a doctor or take a pregnancy test.

Dr O.

The two-tablet packages of generic levonorgestrel and Next Choice should each cost around $25 – $35. The brand name Plan B runs closer to $40. Ella is slightly higher, closer to $45 at most pharmacies, though the manufacturer does offer it for $40 with an online prescription. Some insurance plans will cover some EC options, but may require a prescription even for the over-the-counter meds.

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