Ella Side Effects: What's Normal and What's Not

If you've just taken Ella (Ulipristal Acetate) — or you're about to — it's natural to wonder what side effects to expect. The short answer: most side effects are mild and go away on their own within a day or two. But there are a few things you should watch for.

This guide covers exactly what the FDA labeling says about Ella's side effects, what's normal, what's serious, and when you should call your doctor.

What Is Ella?

Ella is a prescription emergency contraceptive that contains Ulipristal Acetate 30 mg. It's a selective progesterone receptor modulator that works primarily by delaying or preventing ovulation. Ella is effective up to 120 hours (5 days) after unprotected sex, making it the longest-acting emergency contraceptive pill available. For more details, see our complete guide: What Is Ella? Uses, Dosage, and What You Need to Know.

Common Side Effects of Ella

The following side effects were reported in clinical trials and are listed in Ella's FDA-approved labeling. Most are mild and temporary:

• Headache — Reported by about 18% of women in clinical trials. This is the most common side effect.
• Nausea — Affects about 12% of women. Taking Ella with a small snack may help, though it can be taken with or without food.
• Abdominal pain — Also reported by about 12% of women. Mild cramping or stomach discomfort is normal.
• Dysmenorrhea (menstrual pain) — About 9% of women reported increased menstrual cramps.
• Fatigue — About 6% of women felt unusually tired after taking Ella.
• Dizziness — Reported by about 5% of women.

These side effects typically show up within a few hours of taking the tablet and resolve within 24–48 hours. They're your body's normal response to the medication.

Changes to Your Menstrual Cycle

One side effect that catches many people off guard is changes in your next period. After taking Ella, your period may:

• Come earlier or later than expected
• Be heavier or lighter than usual
• Include more spotting between periods

These changes are temporary and should resolve by your following cycle. If your period is more than 7 days late after taking Ella, take a pregnancy test.

Serious Side Effects

Serious side effects from Ella are rare, but you should know what to watch for:

Ectopic Pregnancy

If Ella fails to prevent pregnancy, there's a risk of ectopic pregnancy (a pregnancy that implants outside the uterus, usually in a fallopian tube). This is a medical emergency. Seek immediate medical help if you experience:

• Severe lower abdominal pain, especially on one side, 3–5 weeks after taking Ella
• Dizziness or fainting
• Vaginal bleeding that's different from your normal period

Allergic Reactions

Though very rare, allergic reactions to Ulipristal Acetate are possible. Get medical help right away if you notice:

• Hives or skin rash
• Swelling of face, lips, tongue, or throat
• Difficulty breathing

Ella has no boxed warning (the FDA's most serious safety alert), which reflects its overall favorable safety profile for a single-dose medication.

Specific Populations

Pregnancy

Ella is contraindicated in known or suspected pregnancy. It is not intended to terminate an existing pregnancy and will not work if you're already pregnant. If you think you might be pregnant, talk to your doctor before taking Ella.

Breastfeeding

Ulipristal Acetate passes into breast milk. The recommendation is to pump and discard breast milk for 24 hours after taking Ella. You can resume breastfeeding after that 24-hour window.

Weight Considerations

Some research suggests that emergency contraceptive pills, including Ella, may be less effective in women with higher body weight. However, Ella appears to maintain better efficacy at higher weights compared to Levonorgestrel-based options like Plan B. Talk to your doctor about the best option for your situation.

Adolescents

Ella is not indicated for use before the onset of menstruation (pre-menarchal). For adolescents who have started menstruating, it's used the same way as in adults.

How to Manage Common Side Effects

If you're experiencing mild side effects after taking Ella, here are some tips:

• For headache — Over-the-counter pain relievers like Acetaminophen (Tylenol) or Ibuprofen (Advil) can help. Stay hydrated.
• For nausea — Eat small, bland meals. Ginger tea or crackers may help settle your stomach. If you vomit within 3 hours of taking Ella, contact your provider — you may need another dose.
• For fatigue — Rest when you can. This typically passes within a day.
• For abdominal pain — A heating pad and OTC pain medication can provide relief. Mild cramping is normal.
• For menstrual changes — Track your cycle so you know when to expect your period. If it's more than a week late, take a pregnancy test.

Ella vs. Plan B Side Effects

Both Ella and Plan B (Levonorgestrel) can cause similar side effects like headache, nausea, and menstrual changes. The side effect profiles are comparable, though they work through different mechanisms. Ella is a progesterone receptor modulator, while Plan B delivers a large dose of progestin. Learn more about how Ella works.

When to Call Your Doctor

Contact your healthcare provider if you experience:

• Severe abdominal or pelvic pain (especially 3–5 weeks after taking Ella)
• Heavy vaginal bleeding that soaks through a pad per hour
• Signs of an allergic reaction (hives, swelling, difficulty breathing)
• Vomiting within 3 hours of taking the tablet
• Your period is more than 7 days late
• Positive pregnancy test after taking Ella

Final Thoughts

Ella is generally well-tolerated, and most women experience only mild, temporary side effects. Headache, nausea, and abdominal discomfort are the most common — and they usually pass quickly. The important thing is knowing the warning signs that need medical attention, especially severe abdominal pain weeks after taking the medication.

If you're looking for Ella, Medfinder can help you find a pharmacy with Ella in stock near you.