What Plus Size Women Need to Know About Emergency Contraception

Let’s start with a little background info — the FDA-approved emergency contraception pills Plan B, Take Action and Julie all use the same active ingredient, 1.5mg of levonorgestrel. These pills carry the same instructions and warnings: are all meant to be taken within 72 hours after unprotected sex, won’t harm an existing pregnancy, and work better the sooner you take it.

These are the basics and are explicitly explained on each brand’s packaging. What’s less widely known is how these pills in this dosage affect plus size and curvy bodies.

According to Planned Parenthood, if you weigh more than 165 pounds, levonorgestrel will not work as well. And while the FDA hasn’t made this distinction, in Canada a special label calls this out and warns that the active ingredient is completely ineffective for anyone over 175 pounds.

Taking more than one EC pill won’t address the weight issue, but Plan Parenthood does suggest a brand called ella for women over 155 pounds with reduced efficacy for patients over 195 pounds. Oh, and to add another layer to the issue, ella is not over-the-counter like Plan B and you would need a prescription. (Wisp can typically get it to your local pharmacy in a matter of hours and since ella can work within five days of unprotected sex, there’s a lot more wiggle room.)

Unfortunately options for higher BMI patients are limited and the research isn't as conclusive as it could be. Anyone over 200 pounds will most likely be advised to get a copper IUD although they are not only painful but come with a host of other issues.

If you are someone who relies on emergency contraception, here's the takeaways to keep in mind:

1. Reduced efficacy is better than nothing, if all you have access to is levonorgestrel emergency contraception — take it.

2. Over 200 pounds? Make an appointment with your doctor for a more reliable birth control plan while we wait for EC brands to catch up.