Post-Coital Contraception: Side Effects and Pregnancy Risks

Emergency Contraceptive Pill Consultation

On June 3rd, it was the last day of my menstrual period.
I had sexual intercourse with my boyfriend while using a condom, but it broke.
By mutual agreement, we decided to purchase an emergency contraceptive pill, specifically one dose of Ella (ulipristal acetate), which I took within about an hour.
On June 6th, I visited a doctor due to a headache and took medication.
On June 8th, I experienced light bleeding that felt somewhat like the 3rd or 4th day of my menstrual cycle.
I would like to ask the doctor: 1.
Is this bleeding situation normal? 2.
How many days is it expected to last? 3.
Will taking cold medicine affect the efficacy of the emergency contraceptive pill? 4.
What is the likelihood of pregnancy?

DD, 10~19 year old female. Ask Date: 2017/06/10

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, emergency contraceptive pills can sometimes cause irregular menstruation, but the chances of pregnancy are low.
Cold medications do not affect the efficacy of emergency contraceptive pills.
It is best to use preventive measures beforehand.
If your period is more than a week late, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2017/06/10

More Info

Post-coital contraception, commonly known as emergency contraception, is a method used to prevent pregnancy after unprotected sexual intercourse or contraceptive failure, such as a broken condom. In your case, you took the emergency contraceptive pill (ECP) within an hour after the incident, which is a timely response. Let’s address your questions one by one.

1. Is the bleeding normal?
Yes, the bleeding you experienced after taking the emergency contraceptive pill can be considered normal. This bleeding is often referred to as "withdrawal bleeding," which can occur due to the hormonal changes induced by the ECP. The hormones in the pill can cause the lining of the uterus to shed, similar to a menstrual period. This bleeding can vary in amount and duration, and it may not resemble your typical menstrual flow.

2. How long will the bleeding last?
The duration of withdrawal bleeding can vary from person to person. Typically, it may last anywhere from a few days to a week. If the bleeding is light and resembles your usual menstrual cycle, it is generally not a cause for concern. However, if you experience heavy bleeding or if the bleeding lasts longer than a week, it would be advisable to consult a healthcare provider.

3. Will taking cold medicine affect the efficacy of the emergency contraceptive pill?
Most common cold medications do not significantly affect the efficacy of emergency contraceptive pills. However, some medications, particularly those that induce liver enzymes (like certain anti-seizure medications and some herbal supplements), can reduce the effectiveness of hormonal contraceptives. If you took a standard over-the-counter cold medication, it is unlikely to have impacted the ECP's effectiveness. If you have concerns about specific medications you took, it’s best to discuss them with your healthcare provider.

4. What are the chances of pregnancy?
The chances of pregnancy after taking emergency contraception depend on several factors, including when you took the pill relative to your ovulation cycle. Since you mentioned that your last menstrual period ended on June 3, and you had unprotected intercourse shortly after, it is possible that you were approaching ovulation. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but they can be taken up to 5 days after. If you took the pill within an hour, you maximized your chances of preventing pregnancy.
In summary, the bleeding you experienced is likely a normal response to the emergency contraceptive pill. The duration of this bleeding can vary, and it should resolve within a week. Standard cold medications should not affect the efficacy of the ECP, and given that you took the pill promptly, your chances of pregnancy are reduced. However, if you have any concerns or if your symptoms change, it is always a good idea to consult with a healthcare professional for personalized advice and reassurance.

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