Is It Normal Menstruation, Side Effects, or Early Pregnancy?

Is it a normal menstrual period, a side effect of medication, or pregnancy?

Hello Doctor: My menstrual period was from May 31 to June 5.
On June 22, I had intercourse using a condom, but it accidentally broke during ejaculation.
I took the emergency contraceptive pill (Ella) one hour after the incident.
In the days following the pill, I did not experience any side effects.
Today, June 29, I feel like my period is starting, as I have some bleeding (reddish), but two days ago, on June 27, I had some bleeding (brownish) that came and went, along with lower abdominal pain.
Is this my period or early pregnancy symptoms? Given this situation, when would be the best time to take a pregnancy test?

JP, 20~29 year old female. Ask Date: 2018/06/29

Dr. Huang Jianzhong reply Obstetrics and Gynecology

From May 31 to June 5 was the menstrual period.
On June 22, I had intercourse using a condom, but the condom accidentally broke during ejaculation.
I took emergency contraception (Ella) one hour after the incident.
In the days following the emergency contraception, I did not experience any side effects.
On June 29, I felt like my period was starting, with bleeding that was reddish in color.
However, two days prior, on June 27, I had some bleeding that was brownish, and sometimes there was no bleeding at all.
I also have symptoms of lower abdominal pain.

1.
Is this my menstrual period or early pregnancy symptoms?
Answer: It is likely your menstrual period.

2.
Given this situation, when would be the best time to take a pregnancy test?
Answer: Now would be appropriate.

Reply Date: 2018/06/29

More Info

When it comes to understanding the nuances of early pregnancy symptoms, menstruation, and the potential side effects of medications, it's essential to consider various factors. Based on your situation, it appears that you experienced a potential contraceptive failure on June 22 due to a broken condom, followed by the timely administration of emergency contraception (the "morning-after pill").
The bleeding you are experiencing on June 29 could be attributed to several factors. First, it is not uncommon for women to experience irregular bleeding or spotting after taking emergency contraception. This can manifest as a change in menstrual flow, which may include lighter bleeding, spotting, or even a delay in the onset of the next menstrual period. The hormonal changes induced by the emergency contraceptive can lead to these variations in bleeding patterns.

The fact that you experienced a mix of red and brownish discharge is also noteworthy. Brown discharge often indicates older blood that has taken longer to exit the body, which can occur at the beginning or end of a menstrual period. The presence of abdominal pain can be a common symptom associated with menstruation, but it can also occur in early pregnancy.
To determine whether you are experiencing a normal menstrual cycle or early pregnancy symptoms, it is advisable to wait until at least the first day of your expected period to take a home pregnancy test. This is typically around two weeks after ovulation, which would be approximately July 6 in your case, assuming a regular cycle. Testing too early may result in a false negative, as the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy, may not be at detectable levels yet.

If your bleeding continues or becomes heavier, or if you experience severe abdominal pain, it is crucial to consult with a healthcare provider. They can perform a more thorough evaluation, including a blood test for pregnancy or an ultrasound if necessary, to rule out any complications such as an ectopic pregnancy or other underlying conditions.

In summary, while the symptoms you are experiencing could be related to either menstruation or early pregnancy, the timing of your emergency contraception and the nature of your bleeding suggest that it may be a side effect of the medication. Waiting until your expected period to take a pregnancy test will provide the most accurate results. If you have any concerns or if your symptoms worsen, do not hesitate to seek medical advice.

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