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 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 pills, is it okay to do so? Thank you for your response.

Ri Yun, 10~19 year old female. Ask Date: 2018/07/28

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, emergency contraceptive pills can sometimes cause irregular menstruation, and the chances of pregnancy are low.
The bleeding on July 27 could possibly be a menstrual period.
It is recommended to start taking the contraceptive pills on the fifth day of your menstrual cycle.
Wishing you good health.

Reply Date: 2018/07/28

More Info

After a medical abortion, it is common for women to experience various physiological changes and have questions regarding their menstrual cycle and contraception. In your case, you had a medical abortion on June 30, and then you engaged in sexual intercourse on July 20, followed by taking emergency contraception within 36 hours. You also experienced some bleeding after taking the emergency contraceptive, and then you had another episode of bleeding on July 27 that resembled a normal menstrual flow.

1. Understanding the Bleeding: The bleeding you experienced after taking the emergency contraceptive pill (ECP) could be a side effect of the medication. ECPs can cause changes in your menstrual cycle, including irregular bleeding or spotting. The bleeding you experienced on July 27, which was similar to a normal menstrual period, could indeed be your first menstrual cycle after the abortion. It is important to note that after an abortion, the menstrual cycle can take some time to regulate, and the first period may not be as predictable as usual.

2. New Menstrual Cycle: If the bleeding on July 27 was similar to your regular menstrual flow, it is reasonable to consider it the start of a new menstrual cycle. Typically, a menstrual cycle is counted from the first day of bleeding until the day before the next period begins. If this bleeding was indeed your period, you can start tracking your cycle from this point onward.

3. Starting Contraception: If you are considering starting a regular contraceptive method (like the pill, IUD, or other forms), it is generally advisable to wait until your menstrual cycle has returned to a more regular pattern. However, you can start taking hormonal contraceptives at any time, but if you start them outside of the first five days of your cycle, you may need to use a backup method (like condoms) for the first seven days to ensure effective contraception.

4. Contraceptive Options: There are various contraceptive methods available, including hormonal options (like the pill, patch, or ring) and non-hormonal options (like condoms or copper IUDs). It is essential to discuss with your healthcare provider which method is best for you, considering your health history and personal preferences.

5. Monitoring Your Health: After an abortion, it is crucial to monitor your health and any unusual symptoms. If you experience heavy bleeding, severe pain, or any signs of infection (such as fever or foul-smelling discharge), you should seek medical attention promptly.

In conclusion, the bleeding you experienced on July 27 could likely be your first menstrual period post-abortion, and you can consider it the start of a new cycle. If you wish to start a regular contraceptive method, consult with your healthcare provider for personalized advice. It’s essential to ensure that you are taking care of your reproductive health and making informed decisions regarding contraception.

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