Concerns About Unprotected Intercourse During Menstruation and Emergency Contraception

Menstrual intercourse with ejaculation inside?

I would like to ask the doctor, I had unprotected intercourse with my boyfriend on the second day of my period, and I took the emergency contraceptive pill within two hours after that.
However, the next day my menstrual flow decreased significantly, and I felt a bit nauseous in the evening.
I would like to know if this medication and the decrease in my menstrual flow could indicate a possibility of pregnancy.
Additionally, my menstrual cycle has been very irregular, occurring every two months recently, and I have tried menstrual regulation treatments without much success.
Thank you :)

Ruby, 20~29 year old female. Ask Date: 2017/07/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On the second day of my period, I had unprotected intercourse with my boyfriend, and I took the emergency contraceptive pill within two hours afterward.
However, the next day my menstrual flow decreased significantly, and I felt a bit nauseous in the evening.
I would like to ask the doctor if taking the emergency contraceptive pill and the decrease in my menstrual flow could indicate a possibility of pregnancy.

Answer: The likelihood of pregnancy is extremely low after having unprotected intercourse on the second day of your period.
The decrease in menstrual flow may be related to taking the emergency contraceptive pill.
Additionally, my menstrual cycle has been very irregular, with periods occurring every two months recently, and I have tried regulating my cycle, but it hasn't been effective.

Reply Date: 2017/07/27

More Info

When it comes to concerns about unprotected intercourse during menstruation and the use of emergency contraception (EC), there are several important factors to consider. First, let's address the situation you've described: having unprotected intercourse on the second day of your menstrual period and taking emergency contraception (EC) within two hours afterward.

Understanding Emergency Contraception
Emergency contraception pills, such as those containing levonorgestrel or ulipristal acetate, are designed to prevent pregnancy after unprotected intercourse. They work primarily by delaying ovulation. If taken within the recommended time frame (ideally within 72 hours for levonorgestrel and up to 120 hours for ulipristal acetate), they can significantly reduce the risk of pregnancy.

Menstrual Cycle and Timing
During menstruation, especially in the early days, the likelihood of ovulation is generally low, particularly if you have a regular cycle. However, if your menstrual cycle is irregular, as you mentioned, predicting ovulation can be more challenging. Irregular cycles can lead to unexpected ovulation, which is why it's crucial to use protection consistently if you want to avoid unintended pregnancy.

Side Effects of Emergency Contraception
After taking EC, it is common to experience side effects such as nausea, fatigue, and changes in your menstrual cycle. The fact that you noticed a decrease in menstrual flow after taking the EC could be a side effect of the medication. EC can cause your next period to be lighter, heavier, earlier, or later than usual. Nausea is also a common side effect, and it can occur shortly after taking the pill.

Pregnancy Risk
Regarding your concern about the possibility of pregnancy, if you took the EC within two hours of unprotected intercourse, the chances of becoming pregnant are significantly reduced. However, if your menstrual cycle is irregular, it is still possible to experience unexpected ovulation, which could lead to pregnancy despite taking EC.

Recommendations
1. Monitor Your Symptoms: Keep track of your menstrual cycle and any side effects you experience after taking the EC. If your period is significantly delayed (more than a week), consider taking a pregnancy test.

2. Consult a Healthcare Provider: Given your history of irregular cycles and the recent changes in your menstrual pattern, it may be beneficial to consult with a healthcare provider. They can help assess your menstrual health, discuss potential underlying issues, and explore options for more consistent contraception.

3. Consider Regular Contraception: If you are sexually active and want to avoid unintended pregnancies, consider discussing regular contraceptive options with your healthcare provider. There are various methods available, including hormonal birth control pills, IUDs, and barrier methods, which can provide more reliable protection than relying solely on emergency contraception.

4. Addressing Irregular Cycles: Since you've mentioned that your menstrual cycles have been irregular, it may be helpful to explore this further with a healthcare provider. They can help identify any underlying issues and suggest appropriate treatments or lifestyle changes to help regulate your cycle.

Conclusion
In summary, while the use of emergency contraception shortly after unprotected intercourse significantly reduces the risk of pregnancy, it is essential to monitor your menstrual cycle and any side effects. If you have concerns about your menstrual irregularities or the effectiveness of your contraception, seeking guidance from a healthcare professional is advisable. They can provide personalized advice and support based on your specific health needs.

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