Concerns About Emergency Contraceptive Use and Pregnancy Risks

Concerns about taking emergency contraception?

Hello, doctor.
On June 28, I was intimate with my boyfriend.
I confirmed that there was no ejaculation, but there was a secretion similar to pre-ejaculate fluid.
My boyfriend's finger, possibly contaminated with this fluid, was inserted into my vagina (though his genitalia did not fully enter).
He assured me that he dried his fingers before touching me, but since he couldn't be 100% sure, I am concerned.
Additionally, I am unsure about the exact date of my last menstrual period, which was around June 9.
Due to these uncertainties, I took emergency contraception on July 1 (within 72 hours).
My next expected period is around July 5-10, and I worry that taking the emergency contraception might cause bleeding that overlaps with my menstrual cycle, making it difficult to determine if the contraception was effective.
Given these concerns, I have the following questions:
1.
In the situation described, can pregnancy occur if the finger was contaminated with pre-ejaculate fluid, or after drying the finger before insertion?
2.
I have researched online, and it seems the likelihood of pregnancy in this scenario is low.
However, could the side effects of the emergency contraception cause bleeding in this case? (As it seems not everyone experiences this side effect.)
3.
Is it easy to distinguish between bleeding from the emergency contraception and a regular menstrual period?
4.
If my period appears as it usually does, does that indicate successful contraception? If not, when should I visit a gynecologist for a pregnancy test?
Thank you, doctor, for your response and assistance.

C, 20~29 year old female. Ask Date: 2017/07/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On June 28, I was intimate with my boyfriend.
He confirmed that there was no ejaculation, but there was a secretion similar to prostate fluid.
After possibly having some of that fluid on his fingers, he inserted them into my vagina (though his genitalia did not fully enter).
He said he was sure he dried his fingers before touching me, but since he couldn't be 100% certain, he was worried.
Additionally, I couldn't confirm the exact date of my last menstrual period, which was around June 9.
Due to these uncertainties, I took emergency contraception on July 1 (within 72 hours).
My next expected period was estimated to be around July 5-10, and I was concerned that taking the pill might cause bleeding that would overlap with my period, making it difficult to determine if the contraception was effective.
However, due to various concerns, I decided to take it.
1.
Given the situation described, is there a possibility of pregnancy from fingers that may have been in contact with prostate fluid, or if they were dried before insertion?
Answer: Since there was no ejaculation and the fingers may have been in contact with a secretion similar to prostate fluid, the likelihood of pregnancy is low.
If the fingers were dried before insertion, the possibility of pregnancy is even lower.
2.
Will the emergency contraception cause bleeding as a side effect in this situation? (Because bleeding does not seem to be a side effect experienced by everyone.)
Answer: Yes.
3.
Is it easy to distinguish between this bleeding and a regular menstrual period?
Answer: Since the emergency contraception was taken on July 1 and the expected period is around July 5-10, the bleeding can be considered as part of the menstrual cycle.
4.
Does having a menstrual period that is similar to previous cycles indicate that the contraception was successful?
Answer: Yes.
5.
If it is not successful, when should I visit a gynecologist for a pregnancy test?
Answer: You can take a home pregnancy test on July 12.

Reply Date: 2017/07/02

More Info

When it comes to concerns about emergency contraceptive use and the associated risks of pregnancy, it’s essential to understand the mechanisms of emergency contraception, the likelihood of pregnancy from the described scenario, and the potential side effects of the medication.

1. Risk of Pregnancy from Pre-Ejaculate: In your situation, the risk of pregnancy from pre-ejaculate (the fluid released before ejaculation) is generally considered low, especially if there was no ejaculation. However, it is important to note that pre-ejaculate can contain sperm, albeit in smaller quantities. If your boyfriend was confident that he wiped his fingers clean before any contact, the risk further diminishes. Nonetheless, since you were uncertain about the timing of your ovulation and your menstrual cycle, taking emergency contraception was a prudent choice.

2. Effects of Emergency Contraceptive Pills (ECPs): Emergency contraceptive pills, such as Plan B or Ella, are designed to prevent ovulation or fertilization. They can cause side effects, including changes in menstrual bleeding patterns. Some women experience spotting or bleeding after taking ECPs, which can be mistaken for an early period. This bleeding is not the same as a regular menstrual period and can vary in timing and intensity. It is not uncommon for women to experience some irregular bleeding after taking ECPs, and this does not necessarily indicate that the contraception was unsuccessful.

3. Distinguishing Between Bleeding and Menstrual Period: It can sometimes be challenging to differentiate between bleeding caused by the emergency contraceptive and a regular menstrual period. Typically, a menstrual period will follow a more predictable pattern in terms of timing and flow. If you notice bleeding that is lighter or shorter than your usual period, it may be a side effect of the ECP. If you are unsure, tracking your cycle and any changes in bleeding can help clarify the situation.

4. Confirming Pregnancy Status: If your next period is delayed by more than a week from when you expect it, it is advisable to take a home pregnancy test. These tests are most accurate when taken after a missed period. If you experience any unusual symptoms or have concerns, visiting a healthcare provider for a blood test can provide more definitive results.

In summary, while the risk of pregnancy from the scenario you described is low, taking emergency contraception was a responsible decision given your uncertainties. The side effects of ECPs can include irregular bleeding, which may complicate your ability to determine if you are pregnant. If your period does not arrive as expected, taking a pregnancy test will be the best way to confirm your status. Always feel free to consult with a healthcare provider for personalized advice and support regarding your reproductive health.

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