Pregnancy Chances After Multiple Emergency Contraceptive Pills

Pregnancy probability

On March 15, I had unprotected intercourse with my girlfriend, and on the 17th, she took the emergency contraceptive pill.
On the 27th of the same month, the condom slipped off during intercourse and was left inside her body.
Out of fear, she took another emergency contraceptive pill approximately 63 hours later, but that day she used a pregnancy test which showed no pregnancy before taking the second pill.
On April 3, my girlfriend got her period, but the flow seemed lighter than usual, about half of what she normally experiences, and it lasted for six days.
Around April 9, she started feeling nauseous and had a decreased appetite, but in the past few days, the nausea has subsided, although she still feels full after eating only a little.
I would like to know if taking the emergency contraceptive pill twice in the same month reduces its effectiveness, and what are the chances of pregnancy?

Huang, 30~39 year old female. Ask Date: 2016/04/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, emergency contraceptive pills should be taken within 48 hours.
A pregnancy test should be taken at least 12 days after conception to yield accurate results.
The chances of pregnancy are low, but it is best to use preventive measures beforehand.
If your period is more than a week late, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2016/04/15

More Info

When considering the chances of pregnancy after taking multiple emergency contraceptive pills (ECPs), it is essential to understand how these medications work and their potential effects on the menstrual cycle and overall reproductive health.

Emergency contraceptive pills, such as Plan B (levonorgestrel) and Ella (ulipristal acetate), are designed to prevent ovulation or fertilization after unprotected intercourse. They are most effective when taken as soon as possible after the incident, ideally within 72 hours for levonorgestrel and up to 120 hours for ulipristal acetate. However, taking ECPs does not guarantee that pregnancy will be prevented, especially if ovulation has already occurred.

In your case, you mentioned that your girlfriend took ECPs twice within a short period due to two separate incidents of unprotected intercourse. While taking ECPs multiple times in a single menstrual cycle is not uncommon, it can lead to some irregularities in the menstrual cycle. The hormonal fluctuations caused by ECPs can result in lighter or heavier menstrual bleeding, delayed periods, or even symptoms that mimic early pregnancy, such as nausea or changes in appetite.

Regarding your specific questions:
1. Effectiveness of Multiple ECPs: Taking ECPs twice in one cycle does not necessarily reduce their effectiveness, but it can lead to hormonal imbalances that may affect the menstrual cycle. The first dose should ideally prevent ovulation if taken before ovulation occurs. If ovulation has already taken place, the second dose may not have any effect on preventing pregnancy.
2. Chances of Pregnancy: The chances of pregnancy after taking ECPs depend on several factors, including the timing of ovulation relative to when the pills were taken. If your girlfriend's period arrived on April 3rd, it suggests that the ECPs were effective in preventing pregnancy, as menstruation typically indicates that no fertilization occurred. However, the lighter flow could be a side effect of the ECPs, which can alter menstrual patterns.

3. Symptoms of Nausea and Changes in Appetite: The symptoms your girlfriend experienced, such as nausea and changes in appetite, could be side effects of the ECPs rather than signs of pregnancy. ECPs can cause gastrointestinal symptoms, fatigue, and mood changes due to the hormonal content. If her symptoms persist or worsen, it would be advisable for her to consult a healthcare provider for further evaluation.

4. Next Steps: If there is still concern about the possibility of pregnancy, it would be prudent for your girlfriend to take a home pregnancy test a week after her expected period date. If the test is negative and her symptoms continue, she should seek medical advice to rule out other potential issues.

In summary, while taking ECPs can significantly reduce the chances of pregnancy after unprotected intercourse, their effectiveness can be influenced by timing and individual hormonal responses. If there are any lingering concerns about pregnancy or unusual symptoms, consulting a healthcare professional is the best course of action for reassurance and guidance.

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