What if plan B doesn't work?

The emergency contraception may not work for women over 165 pounds.

Posted on Dec. 26, 2013 at 12:00 a.m. | Updated on Dec. 26, 2013 at 5:25 p.m.

ELKHART — A well-known emergency contraceptive, Plan B One-Step, may not work for women who weigh more than 165 pounds, according to nonprofit news organization Mother Jones.

According to HRA Pharma, a French company that manufactures a pill that is identical to Plan B, the drug begins to lose effectiveness when women reach 165 pounds and is completely ineffective for women over 176 pounds.

The Centers for Disease Control and Prevention report that the average American woman weighs 166 pounds. On top of this, the Henry J. Kaiser Foundation found about 59 percent of Indiana women are overweight, suggesting the finding might disproportionately affect women here.

This means that a drug many women know and trust may not be effective for a large percentage of women.

“Thinking about the average woman ... 165 is not that heavy — that's most people I know,” Elkhart resident Corinne Straight-Reed said, adding she's taken Plan B twice without thinking that its effectiveness could be linked to body weight.

She said that at 6 feet tall, she's weighed more than 165 pounds for her entire adult life.

It doesn't surprise her that weight could affect medication — she pointed out that she consults a weight chart when she gives her two sons pain reliever.

And Plan B, while not her only resource when it comes to contraception, is something that Straight-Reed said has always been “an extra safety net” for her.

Plan B is the only emergency contraception that's available without a prescription. That means that heavier women who don't want to see a doctor for emergency contraception may be out of luck.

Straight-Reed said that having no over-the-counter alternative to Plan B may be a problem, especially for young women who would need parental cooperation to see a doctor.

“I would not have been able to go to my parents and ask to call the doctor and get other options,” she said. “Even for adult women, it's (seeing a doctor) a co-pay, it's having to go in.”

She would like to see a warning label about the weight issue on Plan B packaging. She also wonders if prescription-only emergency contraception that might work better for women greater than 165 pounds could be made available over the counter, like Plan B.

“There are a lot of women, myself included until recently, that don't really know there were more choices (other than Plan B),” Straight-Reed said. “This information needs to be out there, and the conversation needs to continue.”

Liz Carroll, vice president of patient services for Planned Parenthood Indiana Kentucky, said that Planned Parenthood does counsel women that “certain kinds of emergency contraception may not be as effective for women who are overweight.”

“I think what we can say is that Plan B One-Step, and anything that has that same hormone, may not be as effective, but it may have some efficacy,” Carroll said, adding, “There's some evidence suggesting that (Plan B) is less effective for women over 165 pounds and may not be effective for women over 175 pounds.”

Alternatives to Plan B include the IUD — a T-shaped device that's inserted into the uterus, or Ella — another emergency contraceptive in pill form that “might be more effective for women who are heavier” said Carroll.

She also said that Planned Parenthood staff gives women advice on emergency contraception based on the best evidence available. Because of that, Planned Parenthood isn't telling women over the potential weight limit that they shouldn't take Plan B.

“We don't want to discourage women from taking something that may prevent an unplanned pregnancy,” she said.

A generic version of Plan B called Next Choice “the same hormone at the same dosage is available to women at the Elkhart Planned Parenthood office on a sliding fee scale “that could slide down to zero,” said Carroll.

The Elkhart office is one of seven Planned Parenthood sites in Indiana that receive federal family planning funding to offer the drug at a reduced price, she said. At other sites that don't have that funding, patients can purchase the drug at full price.

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