Persistent Bleeding After Taking Postcoital Pills: What to Do Next?

Continuous bleeding after taking Postinor?

Hello Doctor, I took one dose of Postinor on the evening of October 5th and another on the morning of October 6th.
I started my menstrual bleeding on October 21st, which continued until November 1st (the amount was not heavy).
Yesterday (November 1st), I went to the hospital for an examination, and the doctor performed an ultrasound, revealing a shadow on the left side of the uterus (related to the bleeding situation).
A urine test was also done (resulting in no pregnancy).
Last night, following the doctor's prescription, I took one dose of Premarin, and as a result, the bleeding has increased today.
I am very worried.
Should I continue taking Premarin, or should I undergo further tests? During the bleeding period, I have not experienced any discomfort, but I do feel breast tenderness, fatigue, and dizziness.
Thank you for listening, and I would greatly appreciate your prompt advice.

kath, 30~39 year old female. Ask Date: 2002/11/02

Dr. Zhan Deqin reply Obstetrics and Gynecology

Premarin is primarily used for hemostasis and menstrual regulation.
Taking one tablet last night should not lead to an increase in bleeding today; it may just be coincidental that today’s bleeding is heavier.
It is recommended that you continue to take it as prescribed by your physician for a few more days.
If after three days there is no improvement in bleeding or if the bleeding increases, a medical evaluation is advised.

Reply Date: 2002/11/02

More Info

It sounds like you are experiencing a concerning situation with persistent bleeding after taking postcoital pills, and I understand how distressing this can be. Based on your description, you took the emergency contraceptive pill (often referred to as "Plan B" or "后安錠") on October 5th and 6th, and you have been experiencing bleeding since October 21st, which has continued until November 1st. You mentioned that an ultrasound showed a shadow on the left side of your uterus, and you have also taken Premarin as prescribed by your doctor.

First, it is important to understand that emergency contraceptive pills can cause changes in your menstrual cycle, including irregular bleeding or spotting. This is a common side effect and can happen as your body adjusts to the hormonal changes induced by the pills. However, the duration and persistence of your bleeding, especially with the ultrasound findings, warrant further evaluation.

Given that your bleeding has lasted for an extended period and has increased after taking Premarin, it is crucial to follow up with your healthcare provider. Here are some steps you should consider:
1. Contact Your Doctor: Since you have already had an ultrasound and are experiencing increased bleeding, it is advisable to reach out to your healthcare provider as soon as possible. They may want to perform additional tests, such as blood work or a repeat ultrasound, to assess the situation further.

2. Monitor Symptoms: Keep track of any additional symptoms you may experience, such as severe abdominal pain, dizziness, or any other unusual changes. If you notice any significant changes, such as heavy bleeding (soaking through a pad in an hour), it is essential to seek immediate medical attention.

3. Discuss Medication Use: Regarding the use of Premarin, it is important to consult your doctor before continuing or discontinuing any medication. They will provide guidance based on your specific situation and the results of your examinations.

4. Consider a Follow-Up Ultrasound: Depending on your doctor's assessment, they may recommend a follow-up ultrasound to monitor the shadow seen on your uterus. This is important to rule out any potential complications, such as retained products of conception or other issues.

5. Stay Hydrated and Rest: While you are managing this situation, ensure you are staying hydrated and getting enough rest. Fatigue can be exacerbated by blood loss, so taking care of your overall health is essential.

6. Seek Support: If you are feeling anxious or overwhelmed, consider talking to a trusted friend or family member about your concerns. Emotional support can be beneficial during stressful times.

In summary, while some irregular bleeding can be expected after taking emergency contraception, the persistence and increase in bleeding you are experiencing, especially with the ultrasound findings, should be evaluated by your healthcare provider. Do not hesitate to reach out to them for further guidance and support. Your health and well-being are paramount, and timely medical advice is crucial in this situation.

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