Effectiveness of Emergency Contraceptive Pills After Multiple Unprotected Intercourse - Obstetrics and Gynecology

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Having unprotected intercourse again after taking emergency contraception?


Hello, doctor.
I had sexual intercourse on the night of February 26th, which seemed to be during the fertile period.
The next day, on February 27th at 10 AM, I bought emergency contraception for my girlfriend, Ella.
Then, on February 28th at 2 AM, we had unprotected intercourse again.
I took the emergency contraception within 12 hours after the first sexual encounter, and then we had sex again within 24 hours.
I would like to know if the effectiveness of the emergency contraception is still valid in this situation.

MG, 10~19 year old female. Ask Date: 2017/02/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology


On the night of February 26th, around midnight, sexual intercourse occurred during what seemed to be a risky period.
The next day, on February 27th at 10 AM, I bought emergency contraception for my girlfriend, Ella.
Then, on February 28th at 2 AM, we had sexual intercourse again without a condom, with ejaculation inside.
I took the emergency contraceptive pill within 12 hours after the first sexual encounter, and then we had intercourse again within 24 hours.
I would like to ask if the effectiveness of the emergency contraception is still intact.
Answer: Yes, it is.

Reply Date: 2017/02/28

More Info


Emergency contraceptive pills (ECPs), such as Ella (ulipristal acetate), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. The effectiveness of ECPs can be influenced by several factors, including the timing of administration relative to the unprotected intercourse, the timing of the menstrual cycle, and the frequency of sexual activity.

In your case, you took Ella the morning after your first unprotected intercourse on February 27, which is within the recommended time frame for taking ECPs. Ella is effective for up to 120 hours (5 days) after unprotected intercourse, and it works primarily by delaying ovulation. If ovulation has already occurred, the effectiveness may be reduced, but it can still prevent fertilization or implantation.

You mentioned that you had another unprotected intercourse on February 28, approximately 36 hours after taking Ella. Since Ella is effective for up to 120 hours, it is still likely to provide some level of protection against this second instance of unprotected intercourse, especially if ovulation has not yet occurred. However, the effectiveness may be somewhat diminished due to the close timing of the two sexual encounters.

It's important to note that ECPs are not intended to be used as a regular contraceptive method and are most effective when taken as soon as possible after unprotected intercourse. The effectiveness of Ella is approximately 85% when taken within 72 hours, and it may be slightly lower if taken closer to the time of ovulation.

If you are concerned about the possibility of pregnancy, it is advisable to take a pregnancy test if your period is late or if you experience any unusual symptoms. Additionally, if you find yourself needing emergency contraception frequently, it may be beneficial to discuss more reliable, long-term contraceptive options with your healthcare provider.

In summary, while Ella should still provide some level of protection after your second unprotected intercourse, its effectiveness may be reduced due to the timing of the events. If you have any further concerns or questions, it is always best to consult with a healthcare professional for personalized advice.

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