Side Effects of Emergency Contraceptive Pills and Menstrual Changes

Side effects of emergency contraceptive pills: How to interpret menstrual cycles after experiencing breakthrough bleeding?

On December 2nd, around 10 PM, I had intercourse with my boyfriend for the first time.
Since it was our first time, he couldn't fully penetrate, and he didn't ejaculate, so there was no internal ejaculation.
However, I was still a bit worried, so on December 4th, I took the emergency contraceptive pill.
On December 9th, I started bleeding, which should be withdrawal bleeding, and it lasted for 5 days.
For the first two days, I had some mild abdominal pain, but it went away afterward.
Then on December 16th, my boyfriend mentioned that he felt my breasts were larger, but I don't think they are; I feel they have become softer.
Is this a side effect of taking the contraceptive pill, or is it just an illusion? I didn't pay attention to this before.
I took the emergency contraceptive pill on December 4th and bled from December 9th to December 13th.
The first two days, the bleeding was similar to my menstrual flow, with some abdominal pain, but it decreased afterward, and by December 13th, there were only a few drops.
This is withdrawal bleeding, right? If this is withdrawal bleeding, how should I track my next menstrual cycle?

Niming, 10~19 year old female. Ask Date: 2017/12/17

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On the night of December 2nd, I had intercourse with my boyfriend.
Since it was our first time, penetration was not very deep; he only penetrated a little, so he did not ejaculate, and naturally, there was no internal ejaculation.
However, I was still a bit worried, so on December 4th, I took the emergency contraceptive pill, Ella.
On December 9th, I started bleeding, which should be withdrawal bleeding, and it lasted for 5 days.
The first two days, I experienced some mild abdominal pain, but it went away afterward.
Then on December 16th, my boyfriend mentioned that he felt my breasts had gotten bigger, but I don’t think so; I feel they have become softer.
Is this a side effect of taking the contraceptive pill, or is it just an illusion? I hadn’t noticed this before.

1.
I took the emergency contraceptive pill on December 4th and bled from December 9th to December 13th.
The first two days, the bleeding was similar to my menstrual flow, and I had some abdominal pain, but it decreased afterward, and by December 13th, there were only a few drops.
This is withdrawal bleeding, right?
Answer: It should be.
2.
If this is withdrawal bleeding, how should I expect my next period?
Answer: It should occur in about a month.

Reply Date: 2017/12/17

More Info

Emergency contraceptive pills (ECPs), such as the one you took (commonly known as "Plan B" or "Ella"), are designed to prevent pregnancy after unprotected intercourse. They can cause various side effects and changes in your menstrual cycle, which can be confusing. Let's break down your concerns regarding side effects, menstrual changes, and what to expect moving forward.

Understanding Side Effects of Emergency Contraceptive Pills
1. Common Side Effects: After taking ECPs, many individuals report side effects such as nausea, fatigue, headache, dizziness, breast tenderness, and changes in menstrual bleeding. The breast tenderness you mentioned, where your boyfriend noted a change, could be a result of hormonal fluctuations caused by the pill. It's not uncommon for breasts to feel different after taking hormonal medications.

2. Menstrual Changes: ECPs can lead to changes in your menstrual cycle. You experienced bleeding starting on December 9, which you suspect is withdrawal bleeding. This is a common response after taking ECPs. Withdrawal bleeding can mimic a normal period but may be lighter or heavier than your usual menstrual flow. The abdominal pain you felt during the first couple of days of bleeding is also a common symptom associated with hormonal changes.

3. Timing of Your Next Period: After taking ECPs, your next period may come earlier or later than expected. It can also vary in flow and duration. If your cycle is typically regular, you might expect your next period to arrive around the time it usually does, but it could be off by a few days. If your next period is more than a week late, it would be advisable to take a pregnancy test to rule out pregnancy.

Side Effects and Their Duration
- Withdrawal Bleeding: The bleeding you experienced from December 9 to December 13 is likely withdrawal bleeding, which is a response to the sudden change in hormone levels after taking the ECP. This bleeding can last a few days and may vary in intensity.

- Breast Changes: The feeling of breast softness or tenderness can persist for a short time after taking the pill, as your body adjusts to the hormonal changes. This is typically temporary and should resolve as your hormone levels stabilize.

Future Considerations
- Monitoring Your Cycle: Keep track of your menstrual cycle following the use of ECPs. Note any irregularities, such as changes in flow, timing, or symptoms. This information can be helpful if you have concerns in the future.

- Consulting a Healthcare Provider: If you experience significant changes in your menstrual cycle, persistent side effects, or if your next period is significantly delayed, it’s important to consult a healthcare provider. They can provide guidance and support based on your individual health needs.

- Understanding ECPs: It's crucial to understand that ECPs are not intended for regular use as a contraceptive method. They are designed for emergency situations. If you find yourself needing contraception regularly, consider discussing long-term contraceptive options with a healthcare provider.

Conclusion
In summary, the side effects you are experiencing, including breast tenderness and withdrawal bleeding, are common after taking emergency contraceptive pills. Your menstrual cycle may be temporarily disrupted, but it should normalize in the following months. If you have any concerns about your symptoms or menstrual changes, don’t hesitate to reach out to a healthcare professional for personalized advice.

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