Emergency Contraceptive Pills and Menstrual Cycle Management

Emergency contraceptive pill

Hello Doctor, I plan to travel in April and early May and would like to adjust my menstrual cycle with birth control pills to avoid having my period during my trip.
I am currently taking Yaz.
My recent menstrual dates were December 4, January 3, and February 1.
I had sexual intercourse on February 16, 19, and 24, during which I only put on a condom halfway through, and ejaculation occurred inside the condom.
On February 27 (Tuesday), I suddenly felt like my period was coming, and when I checked in the bathroom, I noticed brown discharge.
Since it was not long after my last period, I assumed it was the start of my menstruation.
On February 28 (Wednesday), I noticed that the flow was not heavy, but it was red.
By March 1 (Thursday), it suddenly stopped, and I only saw red when I wiped after using the bathroom.
On March 2 (Friday), the flow increased slightly, and I needed to use a small pad.
On March 3 (Saturday), I went to see a gynecologist and explained the situation.
The doctor had me take a urine test, which showed I was not pregnant.
An ultrasound indicated that my endometrium was thickening, suggesting that my period was approaching.
I asked the doctor if I could take birth control pills, and the doctor confirmed that I could, so I started taking Yaz that same evening.
The next day, March 4 (Sunday), the flow decreased again to a level that only required a small pad.
By March 5 (Monday) and March 6 (Tuesday), there was only blood when I wiped after using the bathroom.
I was worried that I might be experiencing early pregnancy instability, so I bought a pregnancy test, which also showed negative.
I have been feeling discomfort in my abdomen, similar to menstrual cramps, and my lower back has been sore.
Today, I went back to see the doctor, who performed another ultrasound and noted that my endometrium was still thick.
The doctor prescribed progesterone and advised me to take it alongside the birth control pills, stating that Yaz might not be suitable for me.
I asked the doctor if this meant that my period had not come, and if taking the birth control pills would prevent my period from coming.
The doctor did not provide a clear response, only saying that it would not affect my situation.

I have the following questions:
1.
Does this mean my period has not come?
2.
If my period has not come but I am taking birth control pills, is this really not harmful to my body?
3.
Should I finish this course of birth control pills along with the progesterone?
4.
Can I continue taking Yaz next month, or would you recommend switching to another brand? Thank you, Doctor.

TIFFANY, 20~29 year old female. Ask Date: 2018/03/07

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Recently, my menstrual cycle was on December 4, January 3, and February 1.
I had sexual intercourse on February 16, 19, and 24, during which we only put on a condom halfway through, and ejaculation occurred inside the condom.
On February 27 (Tuesday), I suddenly felt like my period was about to start, and when I went to the bathroom, I noticed brown discharge.
Since it was not long after my last period, I assumed it was the start of my menstruation.
On February 28 (Wednesday), I felt the flow was not heavier, but it was red.
By March 1 (Thursday), it suddenly stopped, and only when I wiped after using the bathroom was there red discharge.
On March 2 (Friday), it suddenly increased a bit, still red, and I needed to use a small pad.
On March 3 (Saturday), I went to see a gynecologist and explained the situation.
The doctor had me take a urine test, which showed I was not pregnant.
An ultrasound indicated that my endometrium was thickened, suggesting that my period was about to come.
I asked the doctor if I could take birth control pills, and the doctor confirmed that I could, so I started taking Yaz that same night.
The next day, March 4 (Sunday), the bleeding decreased again to a level that only required a small pad.
By March 5 (Monday) and March 6 (Tuesday), there was only blood when I wiped after using the bathroom.
I was worried that I might be experiencing early pregnancy instability, so I bought a pregnancy test, which also showed I was not pregnant.
I continued to feel discomfort in my abdomen, similar to menstrual cramps, and my lower back was sore.
Today, I went back to see the doctor, who performed another ultrasound and confirmed that my endometrium was still thick.
The doctor prescribed progesterone and advised me to take it along with the birth control pills, stating that Yaz was not suitable for me.
I asked the doctor if this meant my period had not come, and if taking the birth control pills would further delay it.
The doctor did not provide a clear answer, only saying that it would not affect my situation.

My questions are:
1.
Does this mean my period has not come?
Answer: On February 27 (Tuesday), when I saw brown discharge, this indicates that my period has started.

2.
If my period has not come but I took birth control pills, is this really not harmful to my body?
Answer: This is not harmful to the body.

3.
Should I finish this course of birth control pills and take the progesterone?
Answer: Yes, you can continue taking them.

4.
Can I continue taking Yaz next month, or should I switch to another brand?
Answer: You can continue taking Yaz.

Reply Date: 2018/03/07

More Info

Understanding emergency contraceptive pills (ECPs) and menstrual cycle management is crucial for individuals seeking to regulate their menstrual cycles, especially when planning for events or vacations. Based on your situation, let’s address your concerns systematically.

1. Is my period coming?
From your description, it seems you experienced some irregular bleeding, which can be confusing. The brown discharge you noticed initially is often old blood, which can occur at the beginning or end of a menstrual cycle. The subsequent red bleeding you experienced could be a light period or breakthrough bleeding due to hormonal fluctuations, especially after starting the contraceptive pill. Since you have been taking the pill, it is possible that your body is adjusting to the hormones, which can lead to irregular bleeding patterns.
2. What if my period doesn’t come but I’m taking birth control pills?
Taking birth control pills can alter your menstrual cycle. It is not uncommon for women to experience lighter periods or even missed periods while on hormonal contraceptives. This is because the hormones in the pills can thin the uterine lining, leading to less bleeding. If you are taking the pill correctly, the chances of pregnancy are significantly reduced, and it is generally safe for your body. However, if you have concerns about potential pregnancy, it is advisable to continue monitoring your symptoms and consult your healthcare provider.

3. Should I finish this pack of birth control pills and take the progesterone?
Yes, it is typically recommended to finish the pack of birth control pills you are currently on, as stopping mid-cycle can lead to further irregularities. The addition of progesterone (like the one your doctor prescribed) can help stabilize your cycle and may assist in managing any irregular bleeding. It’s important to follow your doctor’s instructions regarding the use of both medications.

4. Can I continue taking the same brand of birth control next month?
Whether to continue with the same brand of birth control pills (in this case, 悅姿) or switch to another brand depends on how your body responds to the current medication. If you continue to experience irregular bleeding or discomfort, it may be worth discussing with your healthcare provider about trying a different formulation that may be more suitable for you. Each individual reacts differently to hormonal contraceptives, and finding the right one can sometimes take a few tries.

In summary, your current symptoms and experiences are not uncommon when starting hormonal contraceptives. It is essential to maintain open communication with your healthcare provider, especially if you have concerns about your menstrual cycle or potential side effects. Regular follow-ups can help ensure that your contraceptive method is effective and suitable for your needs. Additionally, if you experience severe discomfort or any unusual symptoms, do not hesitate to seek medical advice promptly.

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