Delayed Menstruation After Emergency Contraceptive Use

Menstrual delay

On June 17, I had unprotected intercourse with my girlfriend, and she took emergency contraception three hours later.
Her expected menstrual period was from June 18 to June 21, but as of today, June 22, she still hasn't gotten her period and doesn't feel any signs of it coming.
Before taking the medication, she had some premenstrual symptoms, but after taking the pill, she experienced breast tenderness for three days, and now she feels no signs of her period.
What could be the reason for this?

Xiang En, 10~19 year old female. Ask Date: 2017/06/22

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On June 17, I had unprotected intercourse with my girlfriend, and she took emergency contraception three hours later.
Her expected menstrual period was from June 18 to June 21, but as of today, June 22, she still hasn't gotten her period and has no signs of it coming.
Before taking the medication, she felt like her period was about to start, but after taking the pill, she experienced breast tenderness for three days, and now she has no signs of her period at all.
What could be the reason for this?
Answer: The effects of taking emergency contraception.

Reply Date: 2017/06/22

More Info

Delayed menstruation after the use of emergency contraceptive pills (ECPs) is a common concern and can be attributed to several factors. In your case, your girlfriend took an emergency contraceptive pill shortly after unprotected intercourse, which is designed to prevent pregnancy by delaying ovulation, inhibiting fertilization, or preventing implantation of a fertilized egg. However, the hormonal changes induced by these pills can also affect the menstrual cycle.

Firstly, it is important to understand that ECPs, such as those containing levonorgestrel or ulipristal acetate, can cause temporary disruptions in the menstrual cycle. The hormones in these pills can lead to changes in the timing of ovulation and the subsequent menstrual period. It is not uncommon for menstruation to be delayed by a few days or even a week after taking ECPs. In your girlfriend's case, since her expected period was between June 18 and June 21, and she has not yet menstruated by June 22, this could be a normal response to the hormonal changes caused by the emergency contraceptive.

Additionally, the symptoms your girlfriend experienced, such as breast tenderness, are also common side effects of ECPs. These side effects can mimic premenstrual symptoms, which may lead to confusion about whether her period is about to start. However, the absence of menstruation can also be influenced by stress, changes in routine, or other factors unrelated to the ECP.

If your girlfriend's period does not arrive within a week or so after the expected date, it would be advisable for her to take a home pregnancy test to rule out pregnancy. ECPs are not 100% effective, and while they significantly reduce the risk of pregnancy, they do not eliminate it entirely. If the test is negative and her period still does not come, it may be worth consulting a healthcare provider for further evaluation.

In summary, delayed menstruation after taking emergency contraceptives can be a normal occurrence due to hormonal changes. It is essential to monitor the situation and consider taking a pregnancy test if menstruation does not resume within a reasonable timeframe. If there are any concerns or unusual symptoms, seeking medical advice is always a prudent step.

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