Post-Coital Contraceptive Bleeding: Your Questions Answered

Post-coital bleeding?

Hello Doctor, I finished my menstrual period on August 25 and had sexual intercourse on August 28, during which a condom was used.
However, it slipped a bit when I pulled out, and I was worried about pregnancy, so I took the emergency contraceptive pill (Plan B) within 4 hours after intercourse.
I have a few questions:
1.
The pharmacist gave me two glass vials of medication, saying to drink one after taking the emergency contraceptive pill and the other one the next morning.
What is the purpose of these medications?
2.
After taking the emergency contraceptive pill, I started experiencing lower back pain the next day.
Is this a side effect of the pill?
3.
I started bleeding on September 3; is this normal? Thank you, Doctor, for your answers.
Thank you!

Weiwei, 20~29 year old female. Ask Date: 2017/09/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The menstrual period ended on August 25.
Sexual intercourse occurred on August 28 with a condom, but it loosened slightly during withdrawal.
Concerned about pregnancy, I took the emergency contraceptive pill (Ella) within 4 hours after intercourse.
I would like to ask: 1.
The pharmacist gave me two glass bottles of medication, saying to take the emergency contraceptive and then drink one bottle, followed by the other bottle the next morning.
What is the purpose of that medication? Answer: Two glass bottles of medication? 2.
After taking the emergency contraceptive, I started experiencing lower back pain the next day.
Is this a side effect of the emergency contraceptive? Answer: Lower back pain is not a side effect of the emergency contraceptive.
3.
I started bleeding on September 3; is this normal? Answer: This is likely a side effect of taking the emergency contraceptive.

Reply Date: 2017/09/03

More Info

Understanding post-coital contraceptive bleeding can be a source of confusion and concern for many individuals. Let's address your questions one by one, while also providing some additional context regarding emergency contraception and its effects on the menstrual cycle.

1. About the Two Glass Bottles of Medication: It sounds like you were given a regimen that includes emergency contraception (like Plan B or Ella) and possibly an anti-nausea medication or another supportive treatment. Some emergency contraceptive pills can cause nausea, and sometimes healthcare providers will prescribe or recommend an anti-nausea medication to help mitigate this side effect. It's essential to follow the instructions provided by your pharmacist or healthcare provider regarding how to take these medications. If you have any doubts about the purpose of the second bottle, it would be best to consult with your pharmacist or doctor for clarification.

2. Lower Back Pain After Taking Emergency Contraception: Experiencing lower back pain after taking emergency contraception can occur, but it is not a common side effect. Emergency contraceptive pills can cause various side effects, including nausea, fatigue, headache, dizziness, and changes in your menstrual cycle. Back pain could be related to hormonal changes triggered by the medication, but it could also be coincidental or related to other factors, such as stress or physical activity. If the pain persists or worsens, it would be wise to consult a healthcare professional to rule out other potential causes.

3. Bleeding Starting on September 3rd: It is not uncommon for individuals to experience bleeding after taking emergency contraception. This bleeding can occur for several reasons. Emergency contraceptive pills can disrupt your normal hormonal cycle, leading to withdrawal bleeding, which may resemble a menstrual period. This bleeding can occur within a few days to a few weeks after taking the medication. If the bleeding is light and short-lived, it may be a side effect of the emergency contraception. However, if you experience heavy bleeding, severe pain, or if your period is significantly delayed, it is advisable to take a pregnancy test and consult with a healthcare provider.

Additional Context on Emergency Contraception
Emergency contraception is designed to prevent pregnancy after unprotected intercourse or contraceptive failure. It works primarily by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus. The effectiveness of emergency contraception is highest when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some types can be effective up to 120 hours later.

Hormonal fluctuations caused by emergency contraception can lead to changes in your menstrual cycle, including earlier or later periods, heavier or lighter bleeding, and spotting. These changes are typically temporary and should normalize in subsequent cycles.

If you have any further concerns about your menstrual cycle, the effects of emergency contraception, or if you suspect you might be pregnant, it’s essential to consult with a healthcare provider. They can provide personalized advice and support based on your specific situation. Always remember that while emergency contraception is a safe and effective way to prevent pregnancy, it is not intended for regular use and should not replace regular contraceptive methods.

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