Why Your Period Might Be Delayed After Taking Emergency Contraception

Q: Why Your Period Might Be Delayed After Taking Emergency Contraception

Hello, Miss Loll： You are concerned about pregnancy, but a urine test must be taken after a missed period to be accurate. <br>For example, if your last menstrual period started on August 13, a urine test would only be meaningful after September 13. <br>Your irregular menstrual cy

The menstrual period did not arrive after taking the medication?

I took oral contraceptives for six months and decided to stop for a month.
My menstrual period started on August 13, and I stopped taking the pills after that (I had a 28-day cycle).
On August 20 in the afternoon, I had unprotected intercourse, and on the morning of August 21, I took Ella.
Fifteen days later, I took a pregnancy test, which showed one line.
I was still worried, so I went to see a doctor.
I was very anxious and didn’t ask clearly, but the conclusion was that I went too early for a check-up; I should wait until my period was due.
The last sexual intercourse was on September 6, and aside from the time I took the emergency contraception, I used condoms.
On September 10 (I initially thought my period would arrive, but it didn’t), I took another pregnancy test, which also showed one line.

My concern is that before taking contraceptives, I had been on menstrual regulation medication for four months, so my periods have been very regular for nearly a year.
However, prior to that, my menstrual cycle was irregular, sometimes 40 days apart, sometimes 20 days.
I have seen a doctor and had an ultrasound, which showed everything was normal.
Could taking Ella have caused my period to be irregular this time? Lastly, is it necessary to take a break from the pill every six months? If it’s not very necessary, I would prefer to take it for a longer duration to avoid constant worry.
Thank you.

Loll, 20~29 year old female. Ask Date: 2016/09/11

Dr. Huang Yiwen reply Obstetrics and Gynecology

Hello, Miss Loll: You are concerned about pregnancy, but a urine test must be taken after a missed period to be accurate.
For example, if your last menstrual period started on August 13, a urine test would only be meaningful after September 13.
Your irregular menstrual cycle this time may be related to taking Ella, but your periods have often been irregular even without hormonal contraceptives, which is also related to your original health condition.
Birth control pills are indeed a good option for those with irregular periods who wish to prevent pregnancy, as they can help regulate menstruation while providing contraception.
However, most doctors recommend taking birth control pills for no longer than a year before taking a break, as this allows the ovaries time to restore a normal ovulation cycle.
Since your periods have always been irregular, I suggest that you may not need to stop taking the pills; it should not pose any issues, and this way, you can avoid worrying about pregnancy while also having regular monthly periods.
However, if you are using birth control pills long-term, it is important to have regular checks on your lipid levels.

Reply Date: 2016/09/11

More Info

The delay of your menstrual period after taking emergency contraception, such as Ella, can be attributed to several factors, particularly hormonal fluctuations and the body's response to the medication. Emergency contraceptive pills (ECPs) work primarily by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. However, these hormonal changes can also disrupt your regular menstrual cycle, leading to a delay in your period.

In your case, you mentioned that you had been taking regular birth control pills for about six months before stopping and subsequently taking Ella after unprotected intercourse. The transition from hormonal birth control to a non-hormonal state can cause your body to readjust, which may lead to irregularities in your menstrual cycle. This is especially true if you had a history of irregular periods prior to starting hormonal contraception. The hormonal fluctuations caused by stopping the birth control pills and then taking emergency contraception can create a temporary imbalance, resulting in a delayed period.

Additionally, stress and anxiety can significantly impact your menstrual cycle. You mentioned feeling nervous and anxious about the possibility of pregnancy, which can further delay your period. Stress can affect the hypothalamus, the part of the brain that regulates hormones related to the menstrual cycle, leading to changes in ovulation and menstruation.

It's also important to note that even if you have a history of regular cycles, the body can react unpredictably to hormonal changes. The fact that you had been on hormonal birth control for an extended period may mean your body needs time to readjust to its natural hormonal rhythm. This adjustment period can lead to variations in cycle length, including delays.

Regarding your question about the necessity of taking breaks from hormonal birth control, it is generally recommended to consult with your healthcare provider. Some women may benefit from periodic breaks, while others may not need to. The decision should be based on individual health needs, potential side effects, and personal comfort with the contraceptive method being used. If you are experiencing significant anxiety about your menstrual cycle or the possibility of pregnancy, it may be helpful to discuss these concerns with your healthcare provider. They can provide guidance tailored to your specific situation and help you understand what to expect moving forward.

In summary, the delay in your period after taking Ella can be attributed to hormonal changes from both stopping your regular birth control and taking emergency contraception, as well as potential stress factors. If your period does not arrive soon, or if you have further concerns about your menstrual cycle or pregnancy, it is advisable to follow up with your healthcare provider for further evaluation and reassurance.

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