Post-Coital Bleeding and Pregnancy Risks After Emergency Contraception

Prostatic fluid issues?

Hello Doctor, after taking the emergency contraceptive pill, the woman experienced some bleeding, but her period has not yet arrived.
During her last visit to the gynecologist, the doctor mentioned that her endometrium was 1 cm thick, and her period was expected around January 24.
However, does taking the emergency contraceptive pill alter the menstrual cycle? Could it be that the doctor made that assessment because her period had just ended when she took the medication? (The doctor previously assured her that she would not become pregnant, and she was anxious, so she took pregnancy tests on days 15 and 19 after the incident, both showing negative results.) Recently, she has been experiencing premenstrual symptoms, and today she noticed a small amount of yellowish-brown discharge.
Is this normal?
If both partners were wearing outer and inner clothing, but the male's pre-ejaculate fluid (which is confirmed not to be semen) came through the outer clothing, is there a risk of pregnancy without direct vaginal contact? Additionally, if there was some contact with the pre-ejaculate fluid through the woman's underwear, could that lead to pregnancy? Since the woman has not yet gotten her period after taking the emergency contraceptive pill, is it difficult to determine if she is in a fertile period? Please provide a detailed response, thank you.

Chen, 10~19 year old female. Ask Date: 2018/01/21

Dr. Zhang Kunmin reply Obstetrics and Gynecology

What you need is not medical advice but rather a refresher on sexual education.
For such questions, it is recommended to refer to the National Health Administration's "Sexual Well-being e-Learning" or the Obstetrics and Gynecology Society's "Consultation for Adolescent Contraceptive Guidelines" at http://goo.gl/dc6PfW.

Hello, the possibility of pregnancy exists even if ejaculation does not occur, as pre-ejaculatory fluid may contain sperm.
The effects of emergency contraception on menstruation can vary; it may cause your period to come earlier or later.
Additionally, its contraceptive effectiveness is not 100%, with a failure rate of about 3%.
Early pregnancy may not present specific symptoms, and subjective symptoms cannot be used to make a judgment.
It is advisable to take a pregnancy test if your period is more than a week late.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2018/01/21

More Info

Post-coital bleeding (PCB) can occur after taking emergency contraception (EC) and may raise concerns about pregnancy risks and menstrual cycle changes. Let's break down your questions and concerns regarding this situation.

Firstly, it’s important to understand that emergency contraception, such as Plan B or Ella, is designed to prevent pregnancy after unprotected intercourse. These medications primarily work by delaying ovulation, inhibiting fertilization, or preventing implantation of a fertilized egg. However, they can also lead to changes in the menstrual cycle, including irregular bleeding or spotting, which is often referred to as post-coital bleeding.

In your case, experiencing bleeding after taking emergency contraception is not uncommon. This bleeding can be a side effect of the hormonal changes induced by the medication. It’s also possible that the bleeding is related to the timing of your menstrual cycle. If you took the emergency contraception shortly after your period, the uterine lining may still be in a state of flux, which can lead to unexpected bleeding. The thickness of the endometrial lining, which your doctor noted as being 1 cm, indicates that your body is preparing for a potential menstrual cycle, but the hormonal influence of the EC can alter this process.

Regarding your concerns about pregnancy, the fact that both you and your partner were wearing multiple layers of clothing significantly reduces the likelihood of sperm transfer. Pre-ejaculatory fluid (pre-cum) can contain sperm, but the chances of pregnancy occurring from this fluid, especially when separated by clothing, are extremely low. The risk of pregnancy increases primarily when there is direct genital contact or ejaculation near the vaginal opening.
If you are experiencing symptoms that resemble pre-menstrual signs, such as brownish discharge, it could be a result of hormonal fluctuations caused by the emergency contraception. This discharge is often just old blood being expelled from the body and is generally not a cause for concern. However, if you notice any unusual symptoms, such as severe pain or heavy bleeding, it’s important to consult your healthcare provider.

As for your menstrual cycle, emergency contraception can indeed alter the timing of your next period. It may come earlier or later than expected, and the flow may be lighter or heavier than usual. If your period does not arrive within a week of the expected date, it would be advisable to take a pregnancy test to confirm whether or not you are pregnant.

In summary, post-coital bleeding after taking emergency contraception is generally normal and can be attributed to hormonal changes. The risk of pregnancy from the scenario you described is very low, especially with the precautions taken. If you have further concerns or if your symptoms persist, it would be best to follow up with your healthcare provider for personalized advice and reassurance.

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