Emergency Contraceptives: Common Questions and Concerns

I would like to inquire about emergency contraceptive pills?

Hello, Doctor: I have a few questions I would like to ask you.
1.
To my understanding, taking oral contraceptives suppresses ovulation, so there shouldn't be an ovulation phase during the medication period, and without ovulation, pregnancy should not occur.
However, I am confused as to why some people still get pregnant.
2.
My last menstrual period was from September 4 to September 8.
Close to my ovulation period on September 17, my boyfriend accidentally ejaculated inside me, and I took emergency contraception.
At the end of the month, on September 26, my period came.
This time, I tried taking oral contraceptives for the first time (Xing Wuneng, with dosages of 0.03 mg and 0.15 mg).
I took the first pill on September 30 and continued for about two to three days.
My discharge started to turn brown, and the color became darker, but I didn't see any blood, resembling the days just before my period ends.
① I would like to ask the doctor if this is a symptom of bleeding? ② Is this Xing Wuneng a combination oral contraceptive containing estrogen and progestin? ③ I usually take vitamin C, CLA, and fat burners.
Will taking these during the use of oral contraceptives have any effects? I apologize for the many questions, and thank you, Doctor, for taking the time to clarify these issues.

Shan, 20~29 year old female. Ask Date: 2016/10/07

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the contraceptive pill you mentioned is a combined oral contraceptive (COC) that contains hormones to prevent ovulation.
These hormones also cause changes in the body, such as thickening of the cervical mucus, which makes it difficult for sperm to enter the uterus, and thinning of the endometrium, making it harder for a fertilized egg to implant.
These bodily changes help to effectively prevent pregnancy.
However, the aforementioned suppressive effects are not 100% guaranteed; with correct usage, the effectiveness can reach up to 99%, but not 100%.
During the usage period, if menstruation occurs or bleeding happens, there is no need to stop taking the pill; continue to take it as scheduled.
Once the body adapts to the contraceptive, irregular bleeding should cease.
However, if irregular bleeding persists for more than three months or if there is heavy bleeding, it is advisable to consult a physician.
Certain medications can indeed affect the efficacy of contraceptive pills, including some antibiotics, enzyme inducers, and certain HIV treatment medications.
Among these, cold medications commonly contain antibiotics, so if you need to take any of these related medications while on the contraceptive pill, it is best to use additional contraceptive measures for seven days.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2016/10/07

More Info

Understanding emergency contraceptives and their mechanisms can be quite complex, and it’s great that you’re seeking clarity on this topic. Let’s address your questions one by one.

1. Why do some people still get pregnant while taking birth control pills?
Birth control pills, including those taken for emergency contraception, work primarily by preventing ovulation. However, several factors can contribute to unintended pregnancies even when using these methods. These include:
- Missed doses: If a pill is missed or taken late, it can reduce the effectiveness of the contraceptive.

- Drug interactions: Certain medications, such as some antibiotics or herbal supplements like St. John’s Wort, can interfere with the effectiveness of birth control pills.

- Individual variations: Each person’s body metabolizes hormones differently. Some may not respond as effectively to hormonal contraceptives due to metabolic differences.

- Timing: If the pill is not taken consistently or correctly, especially around the time of ovulation, the risk of pregnancy increases.

2. Regarding your menstrual cycle and the brown discharge after starting the pill:
The brown discharge you’re experiencing after starting the birth control pill could be a form of breakthrough bleeding or spotting, which is relatively common when beginning hormonal contraceptives. This can happen as your body adjusts to the new hormones. It’s not unusual for the discharge to be brown, as this typically indicates older blood that is taking longer to exit the body. If the discharge continues or is accompanied by other symptoms, it would be wise to consult with your healthcare provider.

3. Is "欣無妊" a combination pill?
Yes, "欣無妊" (which is likely a brand name for a combined oral contraceptive) typically contains both estrogen and progestin (synthetic progesterone). These combination pills work by inhibiting ovulation, thickening cervical mucus to prevent sperm from reaching an egg, and thinning the uterine lining to prevent implantation.

4. Effects of taking vitamin C, CLA, and fat burners while on birth control:
Generally, vitamin C is safe to take with birth control pills and may even have some benefits. However, CLA (Conjugated Linoleic Acid) and fat burners can vary in their effects. Some fat burners may contain ingredients that could potentially affect hormone levels or liver metabolism, which might interfere with the effectiveness of birth control pills. It’s essential to read labels carefully and consult with your healthcare provider about any supplements you are taking while on hormonal contraceptives to ensure they do not interact negatively.

In conclusion, while birth control pills are effective at preventing pregnancy, they are not foolproof, and understanding how they work, along with being aware of potential interactions with other substances, is crucial. If you have ongoing concerns about your menstrual cycle, the effects of your supplements, or the effectiveness of your contraceptive method, I recommend discussing these with your healthcare provider for personalized advice and guidance. They can help you navigate your options and ensure you are using the most effective methods for your needs.

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