Can Abdominal Pain Indicate Pregnancy After Emergency Contraception?

Why does my stomach hurt? Could it be pregnancy?

Last month, I took the emergency contraceptive pill, and my period came twice.
This month, it also came twice.
The second period ended on January 25, and on the 26th, I had intercourse without a condom.
There was no ejaculation inside or outside; it was just a brief moment before he pulled out.
He said he didn't notice any fluid coming out.
Later, I cleaned myself, but then I experienced bleeding for one day.
The next day, I had a small amount of brown discharge, which stopped after that.
That night, I had severe abdominal pain, but it went away after I slept.

Amei, 20~29 year old female. Ask Date: 2018/02/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Last month, I took the emergency contraceptive pill, and my period came twice.
This month, it also came twice.
The second period ended on January 25, and on the 26th, I had intercourse without a condom.
There was no ejaculation inside or outside; it was brief, and the male partner said there was no fluid leakage.
Afterward, I cleaned myself, but I experienced bleeding for just one day.
The next day, I noticed brown discharge, which stopped afterward.
On the night I had the brown discharge, I had severe abdominal pain, but it went away after I slept.
Answer: Since there was unprotected intercourse on the 26th, if your period is delayed, you should take a pregnancy test.

Reply Date: 2018/02/02

More Info

Abdominal pain can indeed be a concerning symptom, especially in the context of potential pregnancy following the use of emergency contraception. After taking emergency contraceptive pills (ECPs), it is not uncommon for women to experience changes in their menstrual cycle, including irregular bleeding or abdominal discomfort.
In your case, you mentioned that you took emergency contraception last month and experienced two menstrual periods, which can sometimes happen as a side effect of the hormonal changes induced by the ECPs. The occurrence of two periods in one month may indicate that your body is adjusting to the hormonal fluctuations. Following your last period on January 25th, you had unprotected intercourse on the 26th, which raises the question of whether you could be pregnant, especially since you experienced abdominal pain and some unusual bleeding afterward.

Abdominal pain after unprotected intercourse can have several explanations. It could be related to ovulation, especially if you are nearing the time when you typically ovulate. Some women experience mittelschmerz, which is a one-sided abdominal pain that can occur during ovulation. Alternatively, the pain could be due to other factors such as hormonal changes, gastrointestinal issues, or even stress and anxiety related to the possibility of pregnancy.

The brief episode of bleeding you described, particularly if it was light and of a brownish color, could be implantation bleeding, which occurs when a fertilized egg attaches to the lining of the uterus. However, given that you have taken emergency contraception, it is also possible that this bleeding is a side effect of the medication rather than an indication of pregnancy.

If you are concerned about the possibility of pregnancy, the best course of action would be to take a home pregnancy test. These tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy. If the test is positive, it is advisable to schedule an appointment with your healthcare provider for further evaluation and guidance.

In summary, while abdominal pain can be a symptom of pregnancy, it can also arise from various other causes, especially after taking emergency contraception. If the pain persists, worsens, or is accompanied by other concerning symptoms such as heavy bleeding, severe cramping, or dizziness, it is crucial to seek medical attention promptly. Your healthcare provider can perform a thorough evaluation, including a physical examination and possibly an ultrasound, to determine the cause of your symptoms and provide appropriate care.

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