Post-Pill Bleeding After Taking PGSTOP Emergency Contraceptive

Bleeding after taking the emergency contraceptive pill PGSTOP?

Hello, doctor.
My menstrual period was from April 27 to May 2, with a cycle of about 28 days.
After having intercourse with my boyfriend on May 5, I took emergency contraception on the evening of May 6.
I have not experienced any adverse effects, but five days later, on May 11, I suddenly started to bleed.
It is not as heavy as my menstrual flow, just some light spotting, and I do not feel any discomfort such as nausea or abdominal pain.

(1) On the night of May 10, I took antibiotics prescribed by my doctor for a toothache.
Could this have any effect?
(2) Can this be considered an early onset of menstruation, or is it due to the thinning and fragility of the endometrium caused by progesterone, leading to irregular bleeding?
(3) Is this situation normal? Under what circumstances should I see a gynecologist for further evaluation? I am very concerned because I took emergency contraception a year ago without experiencing this bleeding.
I appreciate your help.
Thank you very much.

Niming, 20~29 year old female. Ask Date: 2017/05/11

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The menstrual period occurred from April 27 to May 2, with a cycle of approximately 28 days.
After having intercourse with my boyfriend on May 5, I took emergency contraception on the evening of May 6.
My body felt normal with no unusual symptoms, but five days later, on May 11, I suddenly started to experience light bleeding, which was not as heavy as a menstrual period, just some slight blood traces.
I did not feel any discomfort such as nausea or abdominal pain.

(1) On the night of May 10, I took antibiotics prescribed by my doctor for a toothache.
Will this have any effect?
Answer: No, it will not have any effect.
(2) Can this be considered an early menstrual period, or is it due to progesterone causing the endometrium to become thinner and more fragile, leading to regular bleeding?
Answer: This is ovulatory bleeding, not an early menstrual period, and it is not due to progesterone causing the endometrium to become thinner and more fragile, leading to regular bleeding.
(3) Is this situation normal, and under what circumstances should I see a gynecologist for further changes in my body?
Answer: If you experience severe abdominal pain, you should see a gynecologist.

Reply Date: 2017/05/11

More Info

Post-pill bleeding, often referred to as withdrawal bleeding, can occur after taking emergency contraceptive pills (ECPs) like PGSTOP. This bleeding is typically not the same as a regular menstrual period and can vary in volume and duration. Let's address your concerns one by one.

1. Impact of Antibiotics: The antibiotic you took for your toothache is unlikely to affect the efficacy of the emergency contraceptive pill. Most antibiotics do not interfere with the hormonal mechanisms of ECPs. However, there are a few exceptions, such as rifampin and rifabutin, which can reduce the effectiveness of hormonal contraceptives. Since you did not mention taking any of these specific antibiotics, it is safe to conclude that your antibiotic treatment should not have impacted the effectiveness of PGSTOP.

2. Timing of Bleeding: The bleeding you experienced on May 11, five days after taking the emergency contraceptive, could be a result of the hormonal changes induced by the pill. ECPs work primarily by delaying ovulation, preventing fertilization, or preventing implantation of a fertilized egg. The hormones in these pills can cause the uterine lining to shed, leading to withdrawal bleeding. This bleeding is not the same as a menstrual period and can occur earlier or later than expected. It is possible that this bleeding could be considered an early period, but it is more accurately described as a response to the hormonal changes from the ECP.

3. Normalcy of the Situation: Experiencing light bleeding after taking an emergency contraceptive is generally considered normal. Many women report similar experiences, and it does not usually indicate a problem. However, if you notice any unusual symptoms such as severe abdominal pain, heavy bleeding (soaking through a pad in an hour), or if the bleeding lasts longer than a week, it is advisable to consult a healthcare provider. Additionally, if you experience symptoms of pregnancy (such as nausea, breast tenderness, or missed periods) after this bleeding, you should take a pregnancy test and consult a doctor.

In summary, the light bleeding you experienced after taking PGSTOP is likely a normal response to the emergency contraceptive. It is essential to monitor your body for any significant changes or symptoms that may warrant medical attention. If you have any ongoing concerns or if this situation repeats itself in future cycles, it would be beneficial to discuss your contraceptive options with a healthcare provider. They can provide personalized advice based on your health history and needs. Remember, while ECPs are effective, they are not intended for regular use, and discussing long-term contraceptive methods with a healthcare professional can help you find a more suitable solution for your needs.

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