Menstrual Cycle and Ovulation After Medical Abortion: Key Insights

I would like to inquire about the menstrual cycle and ovulation days after a medical abortion?

Hello Dr.
Tsao: My girlfriend took the first dose of RU486 on October 21 at an obstetrics and gynecology clinic, and after taking the second dose two days later on October 23, she experienced bleeding.
On November 1, during a follow-up ultrasound, the doctor said no embryo was seen, but since she was still bleeding, the doctor advised another follow-up.
On November 7, during the second follow-up ultrasound and urine test, it was confirmed that the pregnancy had ended.
However, we had sexual intercourse on November 18 using a condom, and when I felt I was about to ejaculate, I withdrew from her vagina, but we discovered the condom had broken.
At that moment, considering the recent miscarriage and bleeding had just stopped, we did not take emergency contraception.
Now, reflecting on this, I am quite worried.
Therefore, I would like to ask the doctor when my girlfriend's next menstrual cycle and ovulation day might be based on the situation I described.
Is it possible for her to ovulate on November 18?

D.H.H, 20~29 year old female. Ask Date: 2016/12/01

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, after a miscarriage, it's difficult to determine when ovulation occurs.
It's best to use contraceptive measures at all times and not to rely on the safe period.
If your period is more than a week late, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2016/12/01

More Info

After a medical abortion, understanding the menstrual cycle and ovulation can be crucial for couples considering future pregnancies or contraception. In your case, your girlfriend underwent a medical abortion on October 21 and 23, with subsequent follow-up appointments confirming that the pregnancy had been terminated by November 7.
Typically, after a medical abortion, it can take some time for the menstrual cycle to return to its normal rhythm. The first menstrual period usually occurs within 4 to 6 weeks after the abortion, but this can vary from person to person. Factors such as hormonal levels, individual health, and the timing of the abortion can influence when menstruation resumes.

Regarding ovulation, it is important to note that ovulation can occur before the first menstrual period. In fact, some women may ovulate as soon as two weeks after the abortion, which means that it is possible to conceive if unprotected intercourse occurs during this time. Given that you had sexual intercourse on November 18, it is plausible that ovulation could have occurred around that time, especially if your girlfriend's body was returning to its normal cycle.

To estimate when ovulation might occur, one can consider the average menstrual cycle length. If your girlfriend typically has a cycle of about 28 days, ovulation usually occurs around 14 days before the start of her next period. If her cycle is irregular or longer, ovulation could occur later. Since she had just experienced a medical abortion, her cycle might be disrupted, making it more challenging to predict ovulation accurately.

In your specific situation, since the abortion was confirmed to be complete by November 7, it is possible that your girlfriend could have ovulated around the time of your sexual encounter on November 18. If she has a shorter cycle, ovulation could occur earlier than expected, increasing the likelihood of conception.

If you are concerned about the possibility of pregnancy following the incident with the broken condom, it may be advisable for your girlfriend to take a home pregnancy test if her next period does not arrive as expected. Additionally, if she experiences any unusual symptoms or has concerns about her health, consulting a healthcare provider is recommended.

In summary, after a medical abortion, menstrual cycles can take some time to normalize, and ovulation can occur before the first period. Given the timing of your sexual encounter, there is a possibility of ovulation and conception. Monitoring her menstrual cycle and being aware of any changes will be important moving forward. If there are any concerns, seeking medical advice is always a prudent step.

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