Post-Abortion Contraception and Menstrual Cycle Changes

Contraceptive pill issues

Hello, doctor.
I would like to ask you a question.
On June 30, I underwent a medical abortion, and then 22 days later (on July 20), I had sexual intercourse with ejaculation.
I took emergency contraception within 36 hours.
That afternoon, I experienced a little bit of bleeding, which stopped by that night.
Five days after taking the medication (on July 27), I had bleeding again, but this time it was similar to a normal menstrual flow.
I would like to know if this is considered a menstrual period and if it can be counted as a new cycle.
If I want to start taking regular birth control, is it okay to do so? Thank you for your response.

Tao Tao, 10~19 year old female. Ask Date: 2018/07/27

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On June 30, I underwent a medical abortion.
Then, 22 days later (on July 20), I had sexual intercourse with ejaculation.
I took emergency contraception within 36 hours, and that afternoon I experienced a little bit of bleeding, which stopped by that night.
Five days after taking the medication (on July 27), I had bleeding again, but this time it was similar to a normal menstrual flow.
I would like to know if this is considered a menstrual period and if it can be counted as a new cycle.
Answer: Yes, this is considered a menstrual period and can be counted as a new cycle.
If I want to start taking preemptive contraception, is that okay? Answer: Yes, it is okay.

Reply Date: 2018/07/27

More Info

After undergoing a medical abortion on June 30, it is understandable to have questions regarding post-abortion contraception and the changes in your menstrual cycle. Let's break down your concerns and provide clarity based on medical knowledge.

1. Understanding Post-Abortion Bleeding: After a medical abortion, it is common for women to experience some bleeding. This bleeding can vary in amount and duration. The light bleeding you experienced shortly after taking the emergency contraceptive pill (ECP) could be a side effect of the medication, as ECPs can cause changes in your menstrual cycle. The subsequent bleeding you experienced on July 27, which was similar to a regular menstrual flow, could indeed be your first menstrual period post-abortion.
2. Menstrual Cycle Resumption: Following an abortion, it is typical for the menstrual cycle to take some time to normalize. The first period after an abortion may not be as regular or predictable as your previous cycles. However, if the bleeding on July 27 was similar to your usual menstrual flow, it is reasonable to consider it the start of a new cycle. Generally, a menstrual cycle is counted from the first day of bleeding until the day before the next period begins.

3. Starting Contraception: If you are considering starting a contraceptive method, it is advisable to do so after your first period post-abortion. This allows for better tracking of your cycle and ensures that you are not at risk of unintended pregnancy. If you wish to start hormonal contraception (like the pill), it is often recommended to begin taking it at the start of your new cycle. However, if you start taking it at another time, it may take a few days for the contraceptive to become effective, and you may need to use a backup method (like condoms) during this time.

4. Emergency Contraceptive Pills (ECPs): You mentioned taking ECPs within 36 hours after unprotected intercourse. ECPs are most effective when taken as soon as possible after unprotected sex, and they can help prevent pregnancy by delaying ovulation. However, they do not terminate an existing pregnancy. If you have concerns about the effectiveness of the ECP or if you experience any unusual symptoms, it is advisable to consult with your healthcare provider.

5. Monitoring Your Health: After an abortion, it is essential to monitor your health closely. If you experience heavy bleeding (soaking through a pad or tampon every hour for several hours), severe pain, or any signs of infection (such as fever or foul-smelling discharge), you should seek medical attention promptly.

In summary, the bleeding you experienced on July 27 could likely be your first period post-abortion, and you can consider starting contraception after this cycle begins. Always consult with your healthcare provider for personalized advice and to discuss the best contraceptive options for your situation. It is crucial to ensure that you are taking care of your reproductive health and making informed decisions regarding contraception.

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