Post-Pill Bleeding: Is It Menstrual or Early Pregnancy?

Postcoital bleeding after taking emergency contraceptive pills?

The menstrual cycle is typically around 26-28 days.
My last period was from January 28 to February 12.
After having intercourse, I took the emergency contraceptive pill (1.5g) four hours later.
On February 22, I experienced bleeding (which was around the expected time for my period), and the flow was similar to my normal menstruation.
However, by the third night, the bleeding suddenly decreased, and then returned to a normal flow on the fourth and fifth days.
Could this be considered breakthrough bleeding from the emergency contraceptive pill, or can it be regarded as a normal period? I am concerned about the possibility of a false period or early pregnancy bleeding.
Recently, on March 9, I have been feeling some bloating, experiencing increased vaginal discharge, and having frequent diarrhea.
Could this indicate pregnancy? However, I did have bleeding last month...
I would appreciate your clarification on this matter.
Thank you.

SR, 10~19 year old female. Ask Date: 2018/03/10

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The menstrual cycle is typically around 26-28 days.
The last menstrual period was from January 28 to February 12.
After intercourse, the emergency contraceptive pill (1.5g) was taken 4 hours later.
On February 22, there was bleeding (which coincided with the expected menstrual time), with a volume similar to a normal period.
However, by the third night, the bleeding suddenly decreased, and by the fourth and fifth days, it returned to a normal volume.
Is this considered withdrawal bleeding from the emergency contraceptive, or can it be regarded as a normal period? Answer: It can be considered a normal period, but there is concern about it being a false period or early pregnancy bleeding.
On March 9, there has been some abdominal bloating, increased discharge, and frequent diarrhea.
Could this indicate pregnancy? But there was bleeding last month...
Answer: It is unlikely to be pregnancy.

Reply Date: 2018/03/10

More Info

Understanding post-pill bleeding can be quite complex, especially when considering the timing of your menstrual cycle, the use of emergency contraception, and the symptoms you are experiencing. Based on the information you provided, let's break down your situation.

First, it’s important to clarify what post-pill bleeding is. After taking emergency contraception, such as the Levonorgestrel pill (often referred to as Plan B or similar brands), some women may experience bleeding that can resemble a menstrual period. This bleeding is often referred to as "withdrawal bleeding" and is a result of the hormonal changes induced by the pill. It typically occurs within a few weeks after taking the medication and can vary in flow and duration.

In your case, you mentioned that your last menstrual period was from January 28 to February 12, and you had unprotected intercourse shortly before taking the emergency contraceptive pill on February 22. The timing of your bleeding on February 22, which aligns closely with your expected menstrual cycle, suggests that this could indeed be withdrawal bleeding from the emergency contraception. The fact that the bleeding was similar in volume to your normal menstrual flow but then fluctuated could also be indicative of the hormonal effects of the pill.

Regarding your concerns about early pregnancy, it’s important to note that while emergency contraception is effective, it is not 100% guaranteed. If you had unprotected intercourse shortly before taking the pill, there is a possibility of pregnancy, especially if ovulation occurred around that time. However, since you experienced bleeding shortly after taking the pill, it is less likely that you are pregnant, especially if the bleeding was consistent with your typical menstrual pattern.

The symptoms you are experiencing, such as abdominal bloating and increased discharge, can be common in the luteal phase of your menstrual cycle or as side effects of the emergency contraceptive pill. It’s also worth noting that gastrointestinal symptoms like diarrhea can occur due to hormonal changes or stress, but they are not definitive indicators of pregnancy.

To summarize, the bleeding you experienced after taking the emergency contraceptive pill is likely withdrawal bleeding rather than a sign of early pregnancy. However, if you have any doubts or if your symptoms persist or worsen, it would be wise to take a home pregnancy test approximately one week after your expected period or consult with a healthcare provider for further evaluation. They can provide you with a more accurate assessment based on your medical history and current symptoms.

In conclusion, while the timing and nature of your bleeding suggest it is related to the emergency contraception, monitoring your symptoms and considering a pregnancy test if your next period is late will help clarify your situation. Always feel free to reach out to a healthcare professional for personalized advice and support regarding your reproductive health.

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