Could I Be Pregnant? Signs and Symptoms - Obstetrics and Gynecology

Am I pregnant?

My menstrual cycle is quite regular.
My last period started on March 23 (I am certain there was no possibility of pregnancy before that).
I had intercourse with my boyfriend using a condom on March 26, and on March 27, we had unprotected intercourse but used withdrawal.
During these two days, my menstrual flow was still quite heavy, so I felt more at ease.
On March 31, we had unprotected intercourse with withdrawal again, but I immediately went to buy emergency contraception to take.
On April 1, 2, 4, and 5, we had intercourse with a condom, but on the night of April 5, I suddenly started bleeding, and the flow was similar to the first day of my period.
I don't have any abdominal pain, but I feel more tired than usual.
Could this be a sign of pregnancy? I am sure that the condoms did not break during intercourse.
Please help me with your answer, doctor.

Xiao Luo, 10~19 year old female. Ask Date: 2016/04/06

Dr. Tian Yiwen reply Obstetrics and Gynecology

Emergency contraceptive pills contain high doses of hormones, and taking them may lead to breakthrough bleeding a few days later.
It is recommended that women who engage in frequent sexual activity consider long-term use of regular contraceptive pills (which provide the best contraceptive effect) along with the male partner using condoms (to prevent sexually transmitted infections), thereby protecting both themselves and their partners.
Methods such as tracking safe periods, withdrawal, or relying solely on condoms are not appropriate contraceptive measures.
Frequent use of emergency contraceptive pills can lead to irregular menstrual cycles and should only be considered as a last resort for contraception; regular use is not advised.
By practicing effective pre-coital contraception, there is no need to worry after each sexual encounter.
For further information, it is recommended to refer to the National Health Administration's "Sexual Happiness e-Learning" or the Society of Obstetrics and Gynecology's "Adolescent Contraceptive Guidance Consultation" at http://goo.gl/dc6PfW.

Reply Date: 2016/04/06

More Info

Based on the information you provided, it seems you are experiencing some symptoms that could be concerning, especially regarding the possibility of pregnancy. Let's break down your situation and address your concerns.

First, you mentioned that your menstrual cycle is quite regular, with your last period starting on March 23. You engaged in sexual activities on March 26 and 27, with both protected (using condoms) and unprotected (withdrawal method) intercourse. It's important to note that while using condoms significantly reduces the risk of pregnancy, no contraceptive method is 100% effective. The fact that you used a condom during most of your sexual encounters is reassuring, but the unprotected intercourse does raise some questions.

You also mentioned taking emergency contraception (the morning-after pill) shortly after the unprotected intercourse on March 31. Emergency contraception is most effective when taken as soon as possible after unprotected sex, ideally within 72 hours, but it can work up to 5 days after. Since you took it on the same day, you maximized your chances of preventing pregnancy.

Now, regarding the bleeding you experienced on April 5, which you described as similar to the first day of your menstrual period, this could be a few things. It might be a side effect of the emergency contraception, as these medications can cause changes in your menstrual cycle, including early or unexpected bleeding. This type of bleeding is often referred to as "breakthrough bleeding" and is not uncommon after taking emergency contraception.

Additionally, the fatigue you mentioned could be attributed to several factors, including hormonal changes due to the emergency contraception, stress, or even the onset of your menstrual period. It's also worth noting that some women experience symptoms similar to pregnancy, such as fatigue and mood changes, after taking emergency contraception, which can sometimes lead to confusion.

To determine if you are pregnant, the most reliable method is to take a pregnancy test. Since you are still within the window where a test could yield accurate results, I recommend waiting a few days after your expected period (which would be around March 23) to take a home pregnancy test. If you test negative but still have concerns or if your period does not arrive, it would be wise to consult with a healthcare provider for further evaluation.

In summary, while the bleeding you experienced could indicate that your period is starting or could be a side effect of the emergency contraception, the best way to confirm whether you are pregnant is through a pregnancy test. If you have any further symptoms or concerns, please do not hesitate to reach out to a healthcare professional for personalized advice and support.

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