How to Take Emergency Contraception

Taking emergency contraception (EC) after unprotected sex is the best way to prevent unplanned pregnancy. EC is for queer folks who take testosterone, too.

September 27, 2023
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This article was clinically reviewed by Haley, FNP.

  • You can take emergency contraception to prevent unplanned pregnancy, either over the counter or via a prescription.
  • People who take testosterone can also take emergency contraception, as it doesn’t actually contain estrogen.
  • FOLX clinicians can help prescribe emergency contraception, discuss side effects, and answer your birth control or sexual health questions.

Emergency contraception (EC) is for queer people, too! Depending on your partner's anatomy and your sexual practices, you may wind up with contraception mishaps. Bisexuals, lesbians, queer cis women, trans men, trans women, and enbys (or anyone with a uterus and ovaries) can get pregnant if they get sperm in their vaginas. (Or front holes, glitter caves–use the word of your choice here!) Maybe you forgot to take your birth control, or you got caught up without a condom in the heat of the moment. However you identify, if you have sex that puts you at risk for pregnancy, emergency contraception is an option for you.

If you have ovaries and a uterus, even if you don’t get a period or menstrual cycle, you may still be able to get pregnant. Unfortunately, many clinicians (outside of FOLX) believe that for transmasculine folks, there is no chance of getting pregnant if they no longer get a period. However, testosterone is not a reliable contraceptive. If you've had sex that could put you at risk for pregnancy, or you've experienced contraceptive failure (like a broken condom), you can use emergency contraception pills like Plan B or Ella. This applies to cisgender women, too!

Emergency contraception works best when taken as soon as possible after sex. FOLX can prescribe EC for you, or you can get meds from a pharmacist over the counter. When it comes to reproductive health, sometimes unexpected situations arise, and being informed about your options can make all the difference.

What is emergency contraception?

Emergency contraception, often called the "morning-after pill," is a form of birth control used after unprotected sex to prevent pregnancy. It is essential to understand that emergency contraception is not meant to be used as a regular contraceptive method. Emergency contraception is a backup birth control option for emergencies.

How does emergency contraception work?

There are several types of emergency contraception, but they all work by either preventing or delaying ovulation (the release of an egg from the ovary), stopping fertilization, or intercepting the uterine implantation of a fertilized egg. How effective the emergency contraception pill you take depends on timing and the medication that you take.

What are the emergency contraception medication options?

There are two emergency contraception pills, one of which is available over the counter. A copper IUD may also be used as an emergency contraception method.

Levonorgestrel (Plan B or Plan B One Step)

This over-the-counter pill contains levonorgestrel, a hormone that can prevent pregnancy–if taken within 72 hours (three days) after unprotected sex. It's important to take Plan B as soon as possible. Fortunately, you don't need a prescription to take Plan B! However, you may want to make an appointment with your health care provider to discuss any side effects.

Ulipristal acetate (Ella)

Ella can be more effective than Plan B. It can be taken up to 120 hours (five days) after unprotected sex. It may be a better option if you can't access Plan B (levonorgestrel) or are closer to the 72-hour window post-unprotected sex. You'll need a prescription, which our clinicians or your health care provider can write.

Copper Intrauterine Device (IUD)

A copper IUD (intrauterine device) can be inserted by a healthcare provider up to five days after unprotected sex. It provides effective emergency contraception and can also be used as a regular birth control method. Some IUD side effects include abdominal pain and mild vaginal bleeding or spotting.

Taking emergency contraception on testosterone

If you’re taking testosterone and need to take emergency contraception, know that emergency birth control does not actually contain estrogen. Ella (ulipristal), for example, is a progestin receptor modulator. Progestin receptor modulators prevent the release of the egg from the ovary. Plan B (levonorgestrel) is in the drug class progestins. Progestins prevent the release of the egg from the ovary, and the fertilization of the ovary by sperm.

Sometimes, after taking Ella or Plan B, folks experience bleeding. If you no longer get a period or rarely get a period, know that irregular bleeding is normal and expected after taking emergency contraception.

When to use emergency contraception

When is the right time to use emergency contraception? It totally depends on you and your situation. However, to prevent pregnancy after unprotected sex, it's important to take emergency contraception as soon as possible.

Other situations where you may want to use emergency contraception include:

  1. Birth control method failure. If your contraceptive method fails (like a broken condom or missed birth control pill), using emergency contraception can provide an extra layer of protection from unwanted pregnancy.
  2. Sexual assault. If you have been sexually assaulted and fear pregnancy, emergency contraception can be an option to consider. You will also want to see a gynecologist or other health care professional. It's important to seek mental health support, resources, and care for yourself if you have been sexually assaulted.

If you have unprotected sex, you’ll also want to get tested for STIs (sexually transmitted infections). Common STIs to test for include gonorrhea, syphilis, chlamydia, trichomoniasis, and HIV. Our clinicians are here to support your sexual health, and you can get STI testing with FOLX. You can request STI testing during your emergency contraception appointment if you like. You can also discuss STI testing at a follow-up appointment.

Regardless of your reason for emergency contraception, acting quickly is important. The sooner you take emergency birth control, the less likely you will become pregnant.

Where can I get emergency contraception?

  • If you are within 72 hours of unprotected sex, you can go to the pharmacy or drug store and get Plan B over the counter.
  • If it has been between three to five days, you can get a prescription for Ella. Contact a health care provider or schedule a clinician visit to obtain it. FOLX clinicians can consult on your emergency contraception needs and prescribe Ella.
  • You can also get emergency contraception from a healthcare provider or family planning clinic, like planned parenthood. This option may be beneficial if you prefer a copper IUD or need medical guidance.
  • Some telemedicine services, like FOLX, allow you to consult with a healthcare provider online and receive a prescription for emergency contraception if appropriate. If you’re someone who frequently forgets to take your birth control, or if you want to be prepared in the future, we can also write you a prescription to keep for future emergencies.

Emergency contraception is a valuable option for preventing unintended pregnancies after unprotected sex or contraceptive failure. Knowing what it is, how it works, when to use it, and where to obtain it is essential for making informed decisions about your reproductive health. Remember that while emergency contraception is effective, it should not replace regular birth control. It also does not protect against STIs (sexually transmitted infections).

Your reproductive health matters, and being informed empowers you to make the right choices for your well-being. Talk with one of our affirming LGBTQIA-expert clinicians to get guidance tailored to your individual situation.


FOLX Health is the first digital healthcare company designed by and for the LGBTQIA+ community. Our services include virtual primary care, gender-affirming hormone therapy including estrogen and testosterone (HRT), mental health care, sexual and reproductive health care, preventive care, and fertility consultations. FOLX memberships give you access to LGBTQIA+ expert clinicians, peer support, thousands of LGBTQIA+ resources, and more. Whether you’re lesbian, gay, bisexual, transgender, queer, gender non-conforming, or nonbinary, you can find LGBTQIA+-specialized health care that helps you meet your wellness goals. FOLX Health is health care that's queer all year. Get all the benefits of becoming a FOLX member and sign up today!