Science News: Problem with Plan B

First FDA-approved emergency contraception is now available to all, may only work for some

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On June 21, 2013, the Food and Drug Administration (FDA) approved the sale of Plan B One-Step, an emergency contraception, without a prescription and without age restrictions. Previously, women needed a prescription if they were under 17. The change applies only to the name-brand Plan B One-Step.

Here’s the emergency contraception (EC) breakdown:
  • Plan B One-Step, over-the-counter, no age restrictions, cost $40-$50
  • One-pill generics (Next Choice One Dose, My Way), soon to be over-the-counter, must be 17, $35-$45
  • Two-pill generics (Levonorgetrel Tablets), behind-the-counter, 17 or older can buy without prescription, 16 or younger must have prescription
  • ella, online and in-store, by prescription only, $40+

How They Work

The active ingredient is levonorgestrel, the same ingredient used in many birth control pills, in a higher concentration designed to stop the release of an egg from the ovary. Most effective when taken within 72 hours after intercourse, this method of contraception is intended as a last resort after unprotected intercourse or birth control failure. Manufacturers emphasize that none of these ECs are meant to replace regular forms of contraception. When used as such, failure rate is high.

Homeland Controversy

Literature included with Plan Be One-Step indicates that “It is possible that Plan B One-Step may also work by preventing fertilization of an egg (the uniting of sperm with the egg) or by preventing attachment (implantation) to the uterus (womb).“ For those who believe life begins at fertilization, this would mean that ECs could induce abortion. The science is fuzzy; even the scientists—and certainly the manufacturers—aren’t exactly sure when and how the pills work.

Warning from Overseas

The other difficulty is the announcement in November from a European manufacturer of an EC identical to Plan B: the drug won’t work if a woman weighs more than 176 lbs and begins to lose effectiveness after 164 lbs. The most recent data (2007–2010 and we’re not getting any skinnier) from the Centers for Disease Control and Prevention indicate the average weight of American women aged 20 years and older is 166.2lbs. According to Mother Jones, Norlevo, made by the French manufacturer, HRA Pharma, will include this warning in 2014: "Studies suggest that Norlevo is less effective in women weighing [165 pounds] or more and not effective in women weighing [176 pounds] or more" and that Norlevo "is not recommended…if you weigh [165 pounds] or more." American consumers would be wise to plan accordingly, knowing that they might not have a plan B to fall back on.

—Catherine McNiff
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