Is Post-Coital Bleeding Related to Emergency Contraceptive Pills?

Will emergency contraception cause bleeding?

Hello, I had my first sexual intercourse on March 20 (with a condom), after which I experienced bleeding and felt a sharp pain while using the restroom.
My period started on March 28 and ended on April 4.
I had unprotected sex from April 4 to April 9, and I took emergency contraception on April 10 (within 24 hours).
After masturbating on April 16, I noticed bleeding again.
Is this bleeding related to the emergency contraception, or could it be due to inflammation or something else? Additionally, how long after sexual intercourse should I wait to get tested for sexually transmitted infections (STIs)?

Wu, 20~29 year old female. Ask Date: 2016/04/16

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effects of emergency contraception on menstruation or bleeding can vary; it may cause your period to come early or late, and its contraceptive effectiveness is not 100%.
It is recommended to check for pregnancy if your period is more than a week late.
For sexually transmitted infections, it is advised to get tested immediately, at four weeks, and again at six months.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2016/04/16

More Info

Post-coital bleeding, or bleeding that occurs after sexual intercourse, can be concerning and may arise from various causes, including the use of emergency contraceptive pills (ECPs). In your case, the timeline of events you provided indicates that you had your first sexual encounter on March 20, followed by a menstrual period starting on March 28, and then an unprotected sexual encounter on April 9, after which you took an emergency contraceptive pill on April 10. You reported experiencing bleeding after masturbation on April 16.

Firstly, it is important to understand that ECPs, such as Plan B or Ella, work primarily by delaying ovulation, preventing fertilization, or preventing implantation of a fertilized egg. They can cause hormonal changes in the body, which may lead to side effects, including changes in menstrual bleeding patterns. Some women may experience spotting or bleeding after taking ECPs, which can be a normal response to the hormonal fluctuations induced by the medication. This bleeding is often lighter than a regular menstrual period and may occur a few days to a week after taking the pill.

In your situation, the bleeding you experienced after masturbation could indeed be related to the emergency contraceptive pill. However, it is also essential to consider other potential causes of post-coital bleeding, such as:
1. Cervical Irritation: If there was any irritation or trauma to the cervix during intercourse or masturbation, it could lead to bleeding. This is especially true if there was any vigorous activity or if you were feeling tense or anxious, which can lead to muscle tension and discomfort.

2. Infections: Sexually transmitted infections (STIs) or other infections can cause inflammation of the cervix (cervicitis) or vaginal irritation, leading to bleeding. If you have any symptoms such as unusual discharge, itching, or burning, it is advisable to seek medical attention.

3. Hormonal Changes: The hormonal changes caused by the emergency contraceptive pill can also lead to breakthrough bleeding, which is not uncommon.

4. Other Medical Conditions: Conditions such as polyps, fibroids, or other abnormalities in the reproductive system can also cause post-coital bleeding.

Regarding your question about when to get tested for sexually transmitted infections (STIs), it is generally recommended to wait at least two weeks after potential exposure to allow for accurate testing. Some infections may take longer to become detectable, so if you have any symptoms or concerns, it is best to consult with a healthcare provider for guidance on testing and treatment.

In summary, the bleeding you experienced after taking the emergency contraceptive pill could be related to the hormonal changes it induces. However, it is crucial to consider other potential causes, including cervical irritation or infections. If the bleeding persists or if you experience any other concerning symptoms, it is advisable to seek medical evaluation to rule out any underlying issues.

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