Pre-Pill Use: Concerns About Spotting and Pregnancy Risks

Regarding emergency contraceptive pills?

I started taking the contraceptive pill "Yueji" (21-day regimen) on the first day of my period.
The instructions indicate that after taking it for seven days, I can have unprotected intercourse, so I began on January 26 and had intercourse for the first time on February 4.
After that, there was only a small amount of bleeding, and I experienced no discomfort the next day (this was my first time).
On February 9, after having intercourse again, I noticed bleeding that looked like it could be from a ruptured hymen, followed by brown discharge.
I also felt a dull sensation in my lower abdomen similar to menstrual cramps.
I still have about two pills left in this cycle.

Is there a chance that I could be pregnant? I've read articles where others experienced brown discharge and later found out they were pregnant.
Is this bleeding due to the contraceptive pill, or is it something else? I have been taking the pill consistently and have never missed a dose.
Some people say that breakthrough bleeding can occur when taking contraceptive pills; I only experienced that once before.
However, the bleeding after intercourse this time has me a bit worried.
The bleeding was minimal and not like a regular period.

ORZ, 20~29 year old female. Ask Date: 2018/02/13

Dr. Huang Jianzhong reply Obstetrics and Gynecology

This is my first time taking the oral contraceptive pill, Yejih (21-day regimen), starting from the first day of my menstrual period.
The instructions indicate that after taking it for seven days, I can have unprotected intercourse.
I began on January 26 and had intercourse for the first time on February 4, which resulted in only a small amount of bleeding afterward, and I experienced no discomfort the next day (this was my first time).
On February 9, after having intercourse again, I noticed bleeding that appeared to be from a ruptured hymen, followed by brownish discharge.
I also felt a dull sensation in my lower abdomen similar to menstrual cramps.
I have about two pills left in this cycle.
Is there a chance that I could be pregnant? I read that some people experienced brown discharge and later found out they were pregnant.
Is this bleeding due to the oral contraceptive pill or something else? I have been taking the pill consistently without missing any doses.
Some people say that taking the pill can cause breakthrough bleeding; I only experienced that once, but this bleeding after intercourse is concerning.
The bleeding was minimal and not like a menstrual period.

Answer: It is likely that the bleeding is a result of the oral contraceptive pill.
You can take a pregnancy test on March 1 to confirm.

Reply Date: 2018/02/13

More Info

When considering the use of birth control pills, such as the one you mentioned (悦己), it's important to understand how these medications work and the potential implications for your menstrual cycle and pregnancy. Birth control pills are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining, thereby reducing the likelihood of pregnancy. However, they can also lead to side effects, including spotting or breakthrough bleeding, especially during the initial months of use.

The spotting you experienced after starting the pill is not uncommon. Many women report light bleeding or spotting, particularly in the first few months of taking hormonal contraceptives. This can occur as your body adjusts to the hormones in the pill. The brown discharge you mentioned is often old blood, which can be a normal part of your menstrual cycle or a result of hormonal fluctuations caused by the pill.
Regarding your concerns about pregnancy, if you have taken your birth control pills consistently and correctly (i.e., at the same time each day and without missing any doses), the likelihood of becoming pregnant is significantly reduced. The effectiveness of birth control pills is very high when used correctly, with typical use showing about a 91% effectiveness rate, meaning that about 9 out of 100 women may become pregnant in a year of typical use. However, if you have had unprotected intercourse before the pill had a chance to take full effect (typically after seven consecutive days of use), there is a slight risk of pregnancy.

The symptoms you describe, such as the dull sensation in your lower abdomen and the spotting, could be attributed to the hormonal changes induced by the pill rather than an indication of pregnancy. However, if you are concerned about the possibility of being pregnant, the best course of action is to take a home pregnancy test after a missed period or consult with your healthcare provider for further evaluation.

In summary, while spotting and changes in discharge can be concerning, they are often normal side effects of starting a new birth control regimen. If you continue to experience unusual symptoms or if your concerns persist, it is advisable to reach out to your healthcare provider for personalized advice and reassurance. They can provide you with more information about what to expect while on the pill and help you address any worries regarding your reproductive health.

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