How To Prevent Pregnancy After Unprotected Sex

Unplanned pregnancies are not uncommon. In fact, almost half of pregnancies in the United States are unplanned, with the highest rate among people between the ages of 18 to 24 years.

If you dread having to make the difficult, life-altering decisions that come with an unplanned pregnancy, know there are options for emergency contraceptives. Emergency contraceptives can be effective if you use them within days after unprotected sex.

Here's what to know about emergency contraception options and some other considerations.

What To Do After Having Unprotected Sex

After having unprotected sex (or having sex where the condom breaks), you'll want to first use the bathroom and clean up any fluids from your genital and anal regions.

Peeing after sexual activity also helps. While it won't reduce your chance of pregnancy, it could reduce your chance of getting a urinary tract infection (UTI).

UTIs occur when bacteria enter and colonize inside the urethra, the tube that carries urine from your bladder to the exterior of the body. UTIs can also spread to the bladder and kidneys. Some resolve themselves, but sometimes, you will need to take a course of antibiotics.

The one thing you shouldn't do after unprotected sex? Douching.

Douching in general is not recommended. It alters the normal balance of yeast and bacteria in the reproductive tract. When that balance is out of whack, you're more likely to get a UTI.

Douching can also increase your chances of getting other infections of the reproductive system, sexually transmitted infections (STIs), and vaginal irrigation or dryness. Plus, douching could make it harder to get pregnant if you are trying or want to try later, and it could create complications during pregnancy.

Get Tested for Sexually Transmitted Infections

One of the best ways to prevent STIs while engaging in vaginal, anal, or oral sex is to use condoms.

If you are sexually active, you should receive regular tests for STIs—including gonorrhea, chlamydia, syphilis, human immunodeficiency virus (HIV), and hepatitis B and C virus. 

It's a good idea to receive a test within a couple of weeks of unprotected sex. However, if your HIV and hepatitis test results are negative, you'll need to get retested in another six months to be absolutely sure. Some tests for those viruses take anywhere between a couple of weeks to six months to detect the viruses in your body.

If you think you've been exposed to HIV, you can take a course of post-exposure prophylaxis (PEP) within 72 hours of exposure. However, PEP is generally reserved for high-risk scenarios.

How Effective is Emergency Contraception?

Emergency contraception doesn't guarantee you will not become pregnant, but it can reduce your risk. According to the World Health Organization, emergency contraception taken within five days after sex can prevent more than 95% of pregnancies. That means about 5% or less of the time, you still have a chance of getting pregnant.

So, you'll want to keep an eye on your menstrual cycle after having unprotected sex. Also, bear in mind that a morning-after pill can cause spotting and may alter the flow of your period. That can make it hard to tell whether you are pregnant, so if your period is over a week late, take a pregnancy test.

You can also become pregnant after having unprotected sex during menstrual bleeding, though it's less likely. The menstrual cycle starts with bleeding on Day 1. Sperm can live inside the female reproductive tract for as long as five days. Ovulation, the time when you are most likely to become pregnant, is typically from Day 11 to 14 of the cycle.

Still, using emergency contraception can lower your risk of becoming pregnant after having unprotected sex.

Emergency Contraception

There are two types of emergency contraception to consider: emergency contraceptive pills and intrauterine devices (IUDs) that contain copper. Here's a breakdown of three different options—Plan B, ella, and Paragard.

Plan B

Also known as a morning-after pill, Plan B is one of the first hormonal products approved by the Food and Drug Administration (FDA) for emergency contraception. 

A progestin-only pill, Plan B can prevent ovulation and fertilization if you take the pill within three days of having unprotected sex. It can also prevent an embryo from implanting in the uterus by changing the endometrium—the tissue that lines the inside of the uterus.

The sooner you take Plan B, the better.

Anyone can buy Plan B and its generic counterparts over the counter, meaning you don't need a prescription (although you may have to ask the pharmacist). Plan B costs between $20 and $50.

You should keep it on hand for emergency cases, Christopher Estes, MD, a healthcare provider specializing in functional medicine at the Miami Beach Comprehensive Wellness Center in Florida, told Health.

However, there can be side effects of Plan B, which include:

• Changes to your next menstrual cycle
• Nausea or vomiting
• Abdominal pain
• Fatigue
• Tender breasts
• Dizziness or headaches

If you vomit within two hours of taking Plan B, you'll need to take another pill to ensure its effectiveness.

Ella

Like Plan B, ella (or ellaOne) is an emergency contraceptive approved by the FDA. Generally, it works the same way as Plan B, except it's effective if you take it as many as five days after having unprotected sex.

Additionally, while Plan B is progestin-only, ella is ulipristal acetate. According to one study published in 2011, ulipristal acetate works by attaching to receptors on progesterone molecules and creating an anti-progesterone effect inside the body.

That effect suppresses ovulation and prevents the endometrium from becoming thick. Ovulation and a receptive endometrium are necessary for pregnancy to occur.  

Similar to Plan B, the side effects of ella include nausea, tiredness, headache, and dizziness.

Paragard

Another type of emergency contraception is Paragard, a hormone-free, copper IUD. Copper-bearing IUDs are the most effective type of emergency contraception. ParaGard needs to be inserted by a healthcare provider within five days after having unprotected sex.

Paragard works because of one key component: copper. This IUD prevents the sperm from reaching and fertilizing the egg, and it may also prevent an embryo from implanting in the uterus.

Unlike the two emergency contraceptive pills, Paragard is effective at preventing pregnancy for up to 10 years if it remains in the proper place.

It could be costly, however, if your insurance doesn't cover it. According to Planned Parenthood. Paragard costs anywhere between $500 and $1,300 without insurance.

Side effects include cramping and bleeding between periods. However, those side effects usually go away after the first few months.

A Quick Review

If you have unprotected sex, find a method of emergency contraception immediately. In addition, this is a good time to consider your future birth control options. Make an appointment to speak to a healthcare provider to figure out the safest and most effective choices for you.

Emergency contraception can have side effects and may or may not prevent pregnancy. So while it is helpful if other methods fail, do not rely on this method as your only birth control.

Instead, invest in a more reliable form of birth control, like the birth control pill, patches, shots, vaginal rings, or IUDS, among others. And to prevent STIs, make sure you are correctly using condoms.