Emergency Contraception: What to Do After Condom Failure? - Obstetrics and Gynecology

More Info

---

When it comes to emergency contraception (EC) and the concerns surrounding condom failure, it's essential to understand the options available and the effectiveness of those options based on the timing of sexual activity in relation to the menstrual cycle.

In your case, your girlfriend's last menstrual period started on May 7, and you had unprotected intercourse on May 11, during which the condom broke. You took emergency contraception (EC) within 19 hours of that incident, which is a crucial step in preventing unintended pregnancy. The effectiveness of most emergency contraceptive pills (ECPs) is highest when taken as soon as possible after unprotected intercourse, ideally within 72 hours. However, some ECPs, like ulipristal acetate (Ella), can be effective up to 120 hours after unprotected sex.

After taking the first dose of EC, you had another incident of condom failure approximately 28 hours later. Given that you had already taken EC after the first incident, the question arises whether you should take another dose. The general recommendation is that if you have unprotected intercourse again after taking EC, you should take another dose of emergency contraception as soon as possible. This is because the first dose of EC does not provide ongoing protection against subsequent acts of unprotected intercourse.

Regarding the effectiveness of the first dose of EC, it is important to note that while ECPs can significantly reduce the risk of pregnancy, they are not 100% effective. Factors such as the timing of ovulation in your girlfriend's cycle can influence the likelihood of pregnancy. If she was close to ovulation during the first incident, the risk of pregnancy could be higher. However, since you took the EC promptly, it would have reduced that risk.

In summary, you should take another dose of emergency contraception after the second incident of condom failure. It is also advisable for your girlfriend to monitor her menstrual cycle closely in the following weeks. If her period is delayed by more than a week, she should take a pregnancy test to confirm whether or not she is pregnant.
Additionally, it is worth mentioning that while emergency contraception is a useful option for preventing pregnancy after unprotected intercourse, it should not be relied upon as a regular form of contraception. For ongoing sexual activity, consider discussing more reliable contraceptive methods with your girlfriend, such as hormonal birth control, intrauterine devices (IUDs), or other long-term contraceptive options that can provide better protection against unintended pregnancies.

Lastly, if either of you has concerns about sexually transmitted infections (STIs), it would be prudent to consult a healthcare provider for testing and advice on safe sex practices moving forward.