Can I Get Pregnant? Risks After Unprotected Sex

Can I get pregnant?

Hello Dr.
Huang: My girlfriend's menstrual cycle lasts about 7 days, and we had unprotected intercourse on the third day after her period ended, with ejaculation inside.
She took the emergency contraceptive pill within an hour.
During intercourse, she experienced pain, and there was fresh blood when I withdrew, which lasted less than half a day.
I would like to know if this could be ovulation bleeding or if there was a vaginal abrasion during intercourse.
Three days after taking the emergency contraceptive pill, she experienced light spotting that lasted less than a day.
Is this a side effect of the emergency contraception? Does this indicate that the contraception was successful? What is the likelihood of pregnancy? I am concerned that fertilization could occur within an hour after ejaculation; is that possible?

Youxin, 10~19 year old female. Ask Date: 2017/12/14

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Your girlfriend's menstrual cycle lasts about 7 days, and you had unprotected intercourse on the third day after her period ended, followed by taking emergency contraception within an hour.
During intercourse, your girlfriend experienced pain, and there was fresh blood upon withdrawal, which lasted less than half a day.
Is this ovulation bleeding or a vaginal abrasion from intercourse?
Answer: The bleeding during intercourse may indicate a vaginal abrasion, especially since she experienced spotting (light bleeding) after taking the emergency contraception three days later, which lasted less than a day.
Is this bleeding a side effect of the emergency contraception?
Answer: Yes, this bleeding can be a side effect of the emergency contraception.
Does this indicate that the contraception was effective? Is the risk of pregnancy high?
Answer: The risk of pregnancy is low because fertilization typically occurs shortly after unprotected intercourse, but there is still a possibility.

Is there a chance that fertilization could occur within an hour?
Answer: Yes, there is a possibility.

Reply Date: 2017/12/14

More Info

When it comes to the question of whether you can get pregnant after unprotected sex, especially in the context you've described, there are several factors to consider. First, let's break down the situation:
1. Timing of Ovulation: Understanding your girlfriend's menstrual cycle is crucial. If her cycle is around 28 days, ovulation typically occurs about 14 days after the first day of her last period. Engaging in unprotected sex just before or during ovulation increases the risk of pregnancy. However, if the sexual encounter occurred just after her period, the likelihood of pregnancy is lower, but not impossible.

2. Emergency Contraceptive Pill (ECP): Taking an emergency contraceptive pill (like Plan B or similar) within an hour after unprotected sex significantly reduces the chances of pregnancy. ECPs are most effective when taken as soon as possible after unprotected intercourse and can prevent ovulation, fertilization, or implantation of a fertilized egg. However, they are not 100% effective.

3. Bleeding After Intercourse: The fresh blood you mentioned could be due to several reasons. It might be related to ovulation bleeding, which can occur around the time of ovulation, or it could indicate some form of trauma or irritation to the vaginal walls during intercourse, especially if your girlfriend experienced pain. If the bleeding was light and short-lived, it might not be a cause for concern, but if it continues or is accompanied by severe pain, it would be wise to consult a healthcare professional.

4. Spotting After Taking ECP: The spotting that occurred three days after taking the emergency contraceptive pill can be a side effect of the medication. ECPs can cause changes in the menstrual cycle, including spotting or irregular bleeding. This does not necessarily indicate whether the contraceptive method was successful or not.

5. Pregnancy Risk: Given that your girlfriend took the emergency contraceptive pill shortly after unprotected sex, the risk of pregnancy is significantly reduced. However, if her next period is delayed by more than a week, it would be advisable for her to take a pregnancy test to confirm whether or not she is pregnant.

6. Understanding Fertilization Timing: It is important to note that sperm can live inside the female reproductive tract for up to five days. Therefore, if ovulation occurs shortly after the unprotected sex, there is a possibility of fertilization. However, the ECP works primarily by preventing ovulation, so if taken promptly, it should effectively reduce the risk of pregnancy.

In conclusion, while the risk of pregnancy exists after unprotected sex, taking emergency contraception within an hour significantly lowers that risk. The bleeding your girlfriend experienced could be due to various factors, including the effects of the ECP. If there are any concerns about ongoing bleeding or pain, or if her period is late, seeking medical advice is recommended. Always remember that using condoms or other forms of contraception can help prevent unintended pregnancies and sexually transmitted infections in the future.

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