Emergency Contraceptive Pills and Pregnancy Test Confusion Explained

One day after unprotected intercourse, I took the emergency contraceptive pill. A pregnancy test showed two lines, and I am experiencing bleeding with clots?

On June 1, my last menstrual period started.
On June 20, I had unprotected intercourse, and on June 21, I took emergency contraception.
On June 28, I experienced some bleeding after intercourse, and again on June 30, there was light bleeding twice, both times only a small amount of light pink blood.
After that, there was no more bleeding, but I noticed a discharge that was strawberry milk color (it really looked like strawberry milk).
On July 2, I had intercourse in the morning and experienced bleeding.
I had previously thought my period was coming, so I had some light bleeding, but it felt unusual, so I took a pregnancy test, which showed two lines, one of which was faint but clear.
When I wiped, I noticed a deep red blood clot that was less than the size of a coin.

Doctor, does emergency contraception affect pregnancy test results? Am I experiencing a miscarriage? If so, how long after a miscarriage would it take for the pregnancy test to show only one line? (Because I am currently not in Taiwan, I cannot go for a check-up.)

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

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last menstrual period was on June 1.
Engaged in unprotected intercourse on June 20 and took emergency contraception on June 21.
Experienced light spotting after intercourse on June 28 and again on June 30, both instances being a small amount of light pink blood.
There was also a discharge that resembled strawberry milk (truly strawberry milk colored).
On the morning of July 2, after intercourse, there was bleeding.
Initially, I thought my period was coming, so I had slight bleeding, but it felt unusual, so I took a pregnancy test, which showed two lines, one of which was faint but clear.
Upon wiping, I noticed a deep red blood clot about the size of a coin.

1.
Does emergency contraception affect pregnancy test results?
Answer: Emergency contraception does not affect pregnancy test results.
2.
Is this a miscarriage, and how long after a miscarriage will a pregnancy test no longer show two lines?
Answer: The pregnancy test shows two lines, one faint but clear.
Test again on July 9.
If it is a miscarriage, it may take up to a month for the test to no longer show two lines.

Reply Date: 2017/07/02

More Info

When it comes to understanding the relationship between emergency contraceptive pills (ECPs), pregnancy tests, and potential pregnancy complications, it’s essential to clarify several key points.
First, emergency contraceptive pills, such as Plan B or Ella, are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They work primarily by delaying ovulation, inhibiting fertilization, or preventing implantation of a fertilized egg. Importantly, ECPs do not terminate an existing pregnancy; therefore, if you are already pregnant, taking ECPs will not affect the pregnancy or the results of a pregnancy test.

In your case, you mentioned having unprotected intercourse on June 20 and taking emergency contraception the following day. The timing of your menstrual cycle and the use of ECPs can lead to some confusion regarding bleeding and pregnancy test results. After taking ECPs, it is common for women to experience changes in their menstrual cycle, including spotting or breakthrough bleeding, which can be mistaken for a period. The light pink or strawberry milk-colored discharge you experienced could be a result of hormonal fluctuations caused by the ECPs rather than an indication of menstruation or miscarriage.

Regarding your pregnancy test results, a faint line on a home pregnancy test indicates the presence of the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy. However, the intensity of the line can vary based on several factors, including how far along you are in your pregnancy and the sensitivity of the test. If you are testing very early, it is possible to get a faint line, which may become darker as the pregnancy progresses.

The presence of a small blood clot and the timing of your bleeding could raise concerns about a possible miscarriage. However, it’s important to note that not all bleeding during early pregnancy indicates a miscarriage. Some women experience implantation bleeding, which can occur when a fertilized egg attaches to the uterine lining. This can happen around the time your period is due and may be accompanied by light spotting.

If you suspect a miscarriage, it is crucial to monitor your symptoms. If the bleeding becomes heavier, accompanied by severe cramping, or if you pass larger clots, it is advisable to seek medical attention. In terms of how long it takes for hCG levels to return to zero after a miscarriage, this can vary widely among individuals. Generally, it can take a few weeks for hCG levels to drop to undetectable levels, which means that you may continue to receive positive results on a pregnancy test for some time after a miscarriage.

In conclusion, while emergency contraceptive pills do not affect the accuracy of pregnancy tests, they can influence your menstrual cycle and cause unexpected bleeding. If you are experiencing confusion regarding your pregnancy status, it is best to consult a healthcare professional for further evaluation, especially if you are unable to visit a clinic in person. They may recommend a blood test to measure hCG levels, which can provide more definitive information about your pregnancy status. In the meantime, keep track of your symptoms and any changes in your bleeding patterns, as this information will be helpful for your healthcare provider.

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