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Emergency Contraception: Is Ella The Answer?

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Emergency Contraception: Is Ella The Answer?

In spite of widespread availability of effective birth control, half of all pregnancies are still unintended. And although “morning after pills” (or “emergency contraception”) have been available over the counter since 2006, this rate has not fallen. Which leads OB/GYNs like myself to sit up and take notice whenever people get all atwitter about new ways to prevent unwanted pregnancy.

The News

So here’s the skinny: a federal advisory board that usually whispers into the ear of the FDA voted unanimously on Thursday to approve a new type of emergency contraception, called Ella. This medication, which blocks progesterone, a hormone that is a necessary part of both ovulation and maintaining a healthy pregnancy, is a close cousin of the abortion pill RU-486 (mifepristone). As you can imagine, this has caused ripples in the red-and-blue tinged waters of our politically charged American population.

Why We Might Get Excited About Ella

Currently available emergency contraception options like Plan B, Plan B One Step, or Next Choice, which are all available over the counter without a prescription for those 17 and over (and by prescription for younger women), must be taken within 72 hours of unprotected sex and are most effective when taken in the first 24 hours.

But what happens if you’re an 18-year-old college kid who doesn’t even know Plan B exists? You lament to your roommate about the date rape you just experienced, and she eventually gets you to go to the university clinic where they offer you emergency contraception — but by then it’s too late. That was five days ago.

Enter Ella. Studies show that Ella is effective up to five days after unprotected sex, and seems to be equally effective whether you take it on day one or day five.

The Controversy

The mechanism of action behind what fuels Ella is still a bit iffy. We know that it blocks progesterone, which is a necessary hormone in pregnancy. What’s unclear is whether the drug acts to block ovulation (as manufacturers suggest), or to prevent a new pregnancy from implanting (as anti-abortion advocates insist).

What trips people up is that some say five days would be too long after intercourse to prevent ovulation. And if you’re actually preventing implantation, are you aborting a fetus (even though you don’t even know you’re pregnant yet, and may not know for weeks)?

Does Ella Cause Abortions?

Unlike RU-486, which aborts pregnancies in animals, animal studies show that Ella does not appear to abort already existing pregnancies — at least not the ones that are far enough along to diagnose. But there’s the rub. Does it abort a new pregnancy that is too early to be diagnosed? Maybe. No one seems to know for sure. And if you’re one of the women who took it — and it worked — you’d never know the difference.

Does Emergency Contraception Work?

Yes, it does. An episode of unprotected intercourse leads to a 1/20 chance of conceiving. Plan B, Next Choice, and Plan B One Step reduce this chance to 1/40, while Ella appears to reduce it to 1/50.


So if emergency contraception exists, why do we still have so many unplanned pregnancies? Ah — there’s the big question. The bummer is that too many women still don’t know emergency contraception even exists. So ladies, do me a favor. Tell your daughters. Tell your girlfriends. Tell your sisters. This way, we can all make our own choices about what is right for our individual bodies, minds, and spirits. Let’s not let ignorance rule our reproductive lives. Spread the word.

Next: Choosing an Emergency Contraceptive: A Shopper’s Guide

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Read more: College Life, Gynecology, Health, Obstetrics, Pregnancy, Sexual Health, Women's Health, , , , , , , , , , ,

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Lissa Rankin

Lissa Rankin, MD is a mind-body medicine physician, founder of the Whole Health Medicine Institute training program for physicians and other health care providers, and the New York Times bestselling author of Mind Over Medicine: Scientific Proof That You Can Heal Yourself.  She is on a grassroots mission to heal health care, while empowering you to heal yourself.  Lissa blogs at and also created two online communities - and She is also the author of two other books, a professional artist, an amateur ski bum, and an avid hiker. Lissa lives in the San Francisco Bay area with her husband and daughter.


+ add your own
9:53PM PDT on Jul 29, 2012


11:18AM PDT on May 19, 2011

ella is a great new alternative to Plan B, not only is it more effective but it works for a longer period of time (5 days instead of 3). Women can have it prescribed online which is great for those who do not want to go to an actual doctor's office when they can have a doctor collect the same information online.

5:58AM PST on Mar 7, 2011

Thanks for the information

12:31AM PST on Mar 5, 2011

Thanks for the article.

5:44AM PST on Jan 9, 2011

Thanks for the info.

10:17AM PDT on Aug 21, 2010

Of COURSE it's a good thing--and the nonsense about "what if it's an ABORTION? is just not relevant!

Well, on second thought, it probably IS relevant to the anti-choice mob. They want to control your body and mine, just in case an embryo MIGHT be stopped from implanting on a uterine wall.

As if that is THEIR business....

3:42PM PDT on Aug 20, 2010


2:41AM PDT on Jul 1, 2010

My daughter is named Ella and having a baby is probably the best contraceptive around! (lol)

6:04AM PDT on Jun 29, 2010

Lika, it's not as simple as wearing a condom. I got pregnant when I was 18 and the guy was wearing a condom. My mother got pregnant with me while on the pill and pregnant with my sister while using the sponge and spermicide. In these three cases, Ella wouldn't have been the answer since we thought we were protected but sometimes condoms do break or slide off at the worst time possible. I've personally never seen one break but the sliding off thing happens a lot.

2:04AM PDT on Jun 29, 2010

Why is this on the woman's responsibility? Obviously, date rape and other issues are still a great concern. Because hormone pills can have severe side effects, if a man (of any age) really loves his woman, he would wear a condom, or just plain not pressure her into it.

For the cases of rape, victims still are afraid to come forth, which is a travesty. It seems as if the rapist is innocent til proven guilty, which makes the victim a liar until redeemed. I have a problem with that.

For those who chose to have unprotected sex, it should be talked about, and the first time, fine, but more than that, it's irresponsible. We must make sure people are informed and are being responsible with these issues. Knowledge wields wisdom. With wisdom comes self discipline...

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Disclaimer: The views expressed above are solely those of the author and may not reflect those of
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people are talking

I agree with Sue H

Interesting info. I'm searching for a small tree that will not send out runners all over the yard.

thank you for sharing


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