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Contraceptive Pearl: Introducing ella, A New Emergency Contraception Option

The emergency contraception (EC) pill ella – available in Europe since 2009 as ellaOne – is now available in the US.

ella contains ulipristal acetate, a progestin agonist/antagonist. It can be taken up to 120 hours (five days) after unprotected intercourse.  Although levonorgestrel EC (Plan B, Plan B One Step and Next Choice) declines in efficacy over time, ulipristal seems to maintain almost full effectiveness even when taken five days after unprotected intercourse.  Like levonorgestrel, ulipristal prevents pregnancy by delaying ovulation.

When it comes to recommending EC to patients, here are some key points to remember:

  • Ulipristal is more effective than levonorgestrel, especially on the 4th or 5th day after unprotected sex or contraceptive failure.
  • The only contraindication to ulipristal is pregnancy.
  • After taking EC, women may find that their next menses comes a few days earlier or later than expected.
  • Because ulipristal may lower the effectiveness of hormonal contraceptives, women should use a barrier method until the beginning of their next menstrual cycle.

Counseling patients on EC options will help them make an informed decision.

We appreciate your feedback! Please write us at with any questions, comments or additional resources to add to our list.


Helpful Resources

Emergency Contraception – Which EC is Right for Me? Fact Sheet

Emergency Contraception vs. Medication Abortion – What’s the Difference Fact Sheet

Birth Control User Guide: Emergency Contraception Pills

Reproductive Health Technologies Project ella Fact Sheet


The Reproductive Health Access Project does not accept funding from pharmaceutical companies. We do not promote specific brands of medication or contraception. The information in the Contraceptive Pearls is unbiased, based on science alone.