Ella and Birth Control Pills: When to Restart the Pill

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Ella is not the same as Plan B, and this matters a lot if you use birth control pills. Ella is an emergency contraception pill that contains ulipristal acetate. It can be a strong option after unprotected sex or a birth control mistake, especially later in the 5-day emergency contraception window. But because of how ella works, you should not treat it like Plan B when restarting hormonal birth control.

What Is Ella?

Ella is a prescription emergency contraception pill. It contains ulipristal acetate, often shortened to UPA. The CDC lists ulipristal acetate as one of the emergency contraception pill options available in the US. Emergency contraception pills should be taken as soon as possible within 5 days after unprotected sex.

Ella is not the abortion pill. It is used to help prevent pregnancy before it starts, mainly by delaying ovulation.

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Why Ella Is Different from Plan B

Plan B and many generic morning-after pills contain levonorgestrel. After levonorgestrel emergency contraception, the CDC says regular contraception can be started or resumed immediately.

Ella is different because it works as an antiprogestin. Hormonal birth control pills contain progestin. If you take progestin-containing birth control too soon after ella, there is concern it may reduce ella's ability to delay ovulation. That is why the restart instructions are different.

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When Should You Restart Birth Control Pills After Ella?

CDC guidance recommends starting or resuming hormonal contraception no sooner than 5 days after using ulipristal acetate.

In plain language:

• Take ella as directed.
• Wait at least 5 days before restarting birth control pills.
• After restarting the pill, use condoms or avoid sex for 7 days.

This can feel frustrating because waiting to restart your pill may feel like losing control of your contraception routine. But the waiting period is meant to help ella do its job.

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What Should You Do During the 5-Day Wait?

During the 5 days after ella:

• Do not rely on hormonal birth control pills for protection.
• Use condoms if you have sex.
• Consider avoiding sex if that feels simpler.
• Mark the date and time you took ella.
• Set a reminder for the day you can restart your pill.

After you restart your pill, keep using condoms or avoid sex for 7 more days.

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What If You Already Restarted Your Pill Too Soon?

Do not panic, but do contact a pharmacist, doctor, OB-GYN, or healthcare provider for advice. The concern is that restarting hormonal contraception too soon may make ella less effective. A healthcare provider can help you decide what to do next based on:

• When you had sex
• When you took ella
• When you restarted the pill
• Whether you had sex again
• Your pill type
• Where you are in your cycle

Use condoms until you get clear guidance.

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What If You Took Plan B, Not Ella?

If you took Plan B or another levonorgestrel emergency contraception pill, the restart rule is different. CDC guidance says regular contraception may be started or resumed immediately after levonorgestrel emergency contraception, with condoms or abstinence for 7 days.

So the product name matters. Check the box, receipt, pharmacy label, or online order to confirm which one you took. See when you need backup birth control on the pill for a broader overview.

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Does Ella Protect You for Sex After Taking It?

No. Ella is for sex that already happened. It does not give ongoing protection for sex later in the week. If you have sex after taking ella and before your birth control pill is protective again, use condoms.

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When Should You Take a Pregnancy Test?

The CDC advises a pregnancy test if you do not have a withdrawal bleed within 3 weeks after emergency contraception. You should also consider testing if your period is more than a week late, you have pregnancy symptoms, you had sex again without condoms after taking ella, or you are unsure whether you restarted pills too soon.

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