The emergency contraceptive pill, commonly known by brand names like Plan B, contains the hormone levonorgestrel and is intended to prevent pregnancy after unprotected intercourse or contraceptive failure. This medication is designed to be taken as a single, optimized dose. This article will detail the physiological effects and the implications for both safety and effectiveness of taking two pills.
Understanding the Standard Dosage
The standard, single-dose regimen for levonorgestrel-based emergency contraception (EC) is 1.5 milligrams (mg) of the progestin hormone. This is typically delivered in one single-tablet product. The primary function of this high dose of levonorgestrel is to prevent or delay the process of ovulation, which is the release of an egg from the ovary. If ovulation has not yet occurred, the hormone surge can effectively stop it, thereby preventing fertilization.
Levonorgestrel is most effective when taken as soon as possible, ideally within 72 hours of unprotected sex. The medication works by temporarily disrupting the hormonal signals necessary for the egg to be released. It is important to note that levonorgestrel is not an abortion pill and will not end an established pregnancy.
Immediate Physical Effects of Double Dosing
Ingesting two levonorgestrel tablets results in a 3.0 mg dose, which is double the standard amount. While this elevated dose is not considered toxic or life-threatening, it significantly increases the concentration of the hormone in the bloodstream. This hormonal overload can intensify many of the common, expected side effects associated with the medication.
The most frequently reported adverse effects include nausea, vomiting, headaches, and abdominal pain. With a double dose, you are more likely to experience these symptoms with greater severity, particularly nausea and dizziness. This higher hormone level can also lead to more pronounced or irregular menstrual changes, such as heavier or lighter bleeding, and breast tenderness. If vomiting occurs within two hours of taking the pill, absorption may be compromised, and a healthcare provider may advise taking another pill.
Impact on Efficacy
For most individuals, taking a double dose of levonorgestrel does not provide a significant, measurable increase in the pill’s effectiveness in preventing pregnancy. The standard 1.5 mg dose is already engineered to saturate the necessary receptors in the body to delay or inhibit ovulation. Doubling the dose does not make the drug “work better” because the mechanism of action is already maximized by the standard regimen.
The most important factor determining the pill’s efficacy remains the timing of administration relative to the unprotected sex and the woman’s ovulatory cycle. There are certain medical exceptions where a 3.0 mg dose may be recommended, such as when a patient is taking certain enzyme-inducing medications that can rapidly break down the hormone. Doubling the dose in these specific circumstances helps to compensate for the drug interaction, ensuring that the effective concentration of levonorgestrel is reached.
When to Seek Professional Medical Care
While the side effects of a double dose are generally temporary, certain symptoms warrant immediate medical attention. You should seek emergency care if you experience signs of a severe allergic reaction, such as difficulty breathing, swelling of the face or throat, or a widespread rash.
Persistent and severe abdominal pain, particularly 3 to 5 weeks after taking the pill, is a serious concern. This type of pain could be a warning sign of an ectopic pregnancy, where a fertilized egg implants outside the uterus. Additionally, if you experience heavy vaginal bleeding that is significantly heavier than a normal menstrual period, you should contact a healthcare provider. If your next menstrual period is delayed by more than one week past its expected date, you should take a pregnancy test and follow up with a medical professional.