Menstrual Changes After Emergency Contraceptive Use

Emergency contraceptive pills, menstrual issues?

Hello doctor, I have polycystic ovary syndrome (PCOS) and was originally taking Sivena film-coated tablets (not a contraceptive).
The ingredients of Sivena include 12 blue tablets, each containing estradiol 2 mg; 10 white tablets, each containing estradiol 2 mg and norethisterone acetate 1 mg; and 6 orange tablets, each containing estradiol 1 mg.
At the end of last month, I had intercourse with my boyfriend and discovered that the condom broke, so I purchased the emergency contraceptive pill ELLA and took it.
I continued taking Sivena as well.
I had previously consulted online and was told that I could switch to taking Yaz (the contraceptive pill).
During this time, I experienced no discomfort.
On August 19, which was also the day my period was due, I noticed light brown discharge.
I thought my period was starting and began taking Yaz.
The light brown discharge continued for two to three days, and as of today, August 28, I still have my period, but the flow is not heavy.
I can't remember exactly when the red blood started; I only recall that it began with light brown discharge before turning red.
I feel like my period is unusually long, and I believe there is little chance of pregnancy, as I have tested myself and had an ultrasound with my doctor.
Today, the doctor prescribed the following medications: Ergometrine Maleate 0.2 mg (Ergonovine), Tranexamic Acid 250 mg (Trand capsules), and Mefenamic Acid 250 mg (Ponstal).
I have taken Yaz before without experiencing any bleeding.
I would like to ask if the use of ELLA last month could have caused my menstrual cycle to become longer and irregular.
Is my current situation considered irregular menstruation? Additionally, I would like to know if the three medications prescribed are for stopping bleeding or for helping to expel menstrual blood from the body.
If that is the case, will I still have menstrual bleeding after taking them for three days, or will it stop? Thank you, doctor, for taking the time to read and answer my questions.

LILY, 20~29 year old female. Ask Date: 2017/08/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have polycystic ovary syndrome (PCOS) and was originally taking the medication Sivena (not a contraceptive pill).
The components of Sivena include 12 blue tablets, each containing estradiol 2 mg; 10 white tablets, each containing estradiol 2 mg and norethisterone acetate 1 mg; and 6 orange tablets, each containing estradiol 1 mg.
At the end of last month, I had intercourse with my boyfriend and discovered that the condom had broken, so I purchased the emergency contraceptive pill ELLA and took it while continuing to take Sivena.
I had previously consulted online about whether I could switch to taking Yaz (a contraceptive pill), and the doctor confirmed that it was fine.
During this time, I experienced no discomfort.
On August 19, which was also the day my period was due, I noticed light brown discharge, which I thought was the onset of my period, and I started taking Yaz.
The light brown discharge persisted for two to three days, and as of today, August 28, I have been experiencing what seems like a prolonged period, although the flow is not heavy.
I can't recall exactly when the red blood started; I only remember that it began with light brown discharge before turning red.
I believe there is little chance of pregnancy, as I have done a home pregnancy test and had an ultrasound with my doctor.
During my visit today, the doctor prescribed the following medications, and I was advised to continue taking Yaz: Ergometrine Maleate 0.2 mg (Ergonovine), Tranexamic Acid 250 mg, and Mefenamic Acid 250 mg.
I have taken Yaz before without experiencing any bleeding.
1.
Is it possible that taking ELLA last month caused my menstrual cycle to become longer and irregular?
Answer: Yes, it is possible.
2.
Is my current situation considered irregular menstruation?
Answer: Yes, it is irregular menstruation.
3.
Do the three medications prescribed help stop bleeding or facilitate the expulsion of menstrual blood?
Answer: They facilitate the expulsion of menstrual blood and help stop bleeding.
4.
After taking the medications for three days, will I still have menstrual bleeding, or will it stop?
Answer: It should stop.

Reply Date: 2017/08/28

More Info

Understanding menstrual changes after the use of emergency contraceptives, such as ELLA, can be quite complex, especially for individuals with pre-existing conditions like polycystic ovary syndrome (PCOS). ELLA contains ulipristal acetate, which is a selective progesterone receptor modulator. It works primarily by delaying ovulation and altering the endometrium, which can lead to changes in menstrual patterns.

When you take ELLA, it can cause your menstrual cycle to be disrupted. This disruption can manifest as changes in the timing, flow, and duration of your menstrual period. In your case, the appearance of light brown discharge followed by a prolonged period of light bleeding could indeed be attributed to the hormonal changes induced by ELLA. It is not uncommon for women to experience irregular bleeding or spotting after taking emergency contraception, and this can sometimes be mistaken for a prolonged menstrual period.

The medications prescribed by your doctor—Ergometrine Maleate, Tranexamic Acid, and Mefenamic Acid—serve different purposes.
1. Ergometrine Maleate: This medication is often used to help contract the uterus and can be prescribed to manage postpartum hemorrhage or to help with uterine contractions. It may also help in reducing excessive menstrual bleeding.

2. Tranexamic Acid: This is an antifibrinolytic agent that helps to reduce bleeding by preventing the breakdown of blood clots. It is commonly used to treat heavy menstrual bleeding.

3. Mefenamic Acid: This is a non-steroidal anti-inflammatory drug (NSAID) that can help relieve pain and reduce menstrual flow. It is often used for dysmenorrhea (painful periods) and can also help in managing heavy menstrual bleeding.

The combination of these medications is likely aimed at managing your menstrual symptoms, particularly if you are experiencing prolonged or heavy bleeding. The use of these medications should help regulate your menstrual cycle and reduce the amount of bleeding you experience. However, the exact outcome can vary from person to person.

Regarding your concerns about whether your current situation constitutes irregular menstruation, it is important to note that after taking emergency contraception, it is common for menstrual cycles to become irregular. The light brown discharge you experienced could be old blood, which is not unusual at the beginning or end of a menstrual period. If the bleeding continues to be light and does not resolve, or if you experience any other concerning symptoms, it is advisable to follow up with your healthcare provider.

In summary, the changes in your menstrual cycle after taking ELLA are likely related to the hormonal effects of the emergency contraceptive. The medications prescribed by your doctor are intended to help manage your symptoms and regulate your menstrual flow. If you have further concerns or if your symptoms persist, it is essential to maintain open communication with your healthcare provider for appropriate evaluation and management.

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