Post-Pill Menstrual Changes: When to Seek Medical Advice

Emergency contraceptive pill menstruation

On January 19, I had unprotected intercourse on the second day of my menstrual period, which has a cycle of 28 days.
I took emergency contraception on January 24.
I experienced bleeding on January 29 and 30, which was similar to the amount of my period on the third day.
Eighteen days later, on February 7, I took a pregnancy test, which was negative.
If January 18 is considered the first day of my period, then February 20 is my expected menstrual date.
If January 29 is counted as the first day of my period, then February 26 is the scheduled date.
I used a pregnancy test on February 20 and 23, both of which were negative.
From February 9 to 16, I experienced nausea, which then disappeared.
Since February 16, I have had noticeable breast tenderness, but I don't feel much in my abdomen.

P.S.
I am feeling very anxious.

1.
When should I go to the clinic if my period does not arrive?
2.
Should I ask the doctor for medication to induce my period after the examination?
3.
How long does emergency contraception typically delay menstruation?
4.
Should my expected menstrual date be based on February 20?

Niming, 20~29 year old female. Ask Date: 2018/02/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

1.
If January 18 is considered the first day of your menstrual period, then February 20 is your expected period date.
Since you tested negative on pregnancy tests on February 20 and 23, if you do not get your period by March 4, you should visit a clinic for an examination.
2.
After the examination, you can discuss with the doctor about the possibility of prescribing medication to induce menstruation.
3.
Emergency contraception typically does not delay menstruation.
4.
Your expected menstrual date should indeed be based on February 20.

Reply Date: 2018/02/25

More Info

Understanding post-pill menstrual changes can be quite complex, especially after taking emergency contraception. Based on your timeline and symptoms, let’s break down your situation and address your questions.

1. When to Seek Medical Advice: Given that your expected menstrual period is around February 20th, and you have already taken a pregnancy test on February 20th and 23rd with negative results, it is generally advisable to wait until at least a week after your expected period to take another pregnancy test. If your period does not arrive by February 27th, it would be prudent to consult a healthcare provider. They can perform a more sensitive blood test for pregnancy and evaluate any other underlying issues.

2. Consulting a Doctor About Menstrual Regulation: If you find that your period is significantly delayed (more than a week past your expected date), it is reasonable to discuss with your doctor the possibility of taking medication to induce your period. However, this is typically only recommended after confirming that you are not pregnant. Your doctor will assess your overall health, menstrual history, and any other symptoms you may be experiencing before making a recommendation.

3. Effects of Emergency Contraceptive Pills on Menstrual Cycle: Emergency contraception (like the pill you took) can cause changes in your menstrual cycle. It is common for it to delay your next period by a few days to a week. Some women may experience lighter or heavier bleeding than usual, and symptoms like nausea or breast tenderness can occur as well. These side effects are usually temporary and should resolve as your body readjusts.

4. Determining Your Expected Menstrual Date: Your expected menstrual date should be based on your typical cycle length. If you consider January 18th as the first day of your last period, then February 20th would indeed be your expected date for the next period, assuming a regular 28-day cycle. However, since you took emergency contraception, it’s possible that your cycle may be disrupted, which could affect when you actually menstruate.

In summary, it’s important to monitor your symptoms and menstrual cycle closely. If your period does not arrive by the end of February, or if you have any concerning symptoms (like severe pain or unusual discharge), seeking medical advice is essential. Your healthcare provider can offer personalized guidance based on your specific situation, including whether further testing or treatment is necessary. Remember, while it’s normal to feel anxious about these changes, many women experience similar situations, and healthcare professionals are there to help you navigate through them.

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