Emergency Contraceptive Pills: Delayed Menstruation Concerns

Q: Emergency Contraceptive Pills: Delayed Menstruation Concerns

Hello： After discussing with the obstetrician-gynecologist at our hospital, here are a few points for your reference： (1) If emergency contraception is taken within 24 hours, the effectiveness is generally quite good. <br>(2) Taking emergency contraception can easily cause irregu

Emergency contraceptive pill

Your girlfriend's menstrual period started around August 11 and ended around August 18.
On August 20, they had sexual intercourse (with a condom), but the condom slipped off, and it is uncertain if there was any ejaculation inside.
On August 21, they had sexual intercourse again (without a condom), and there was ejaculation inside.
After that, she took emergency contraception within half an hour.
They had sexual intercourse twice within 24 hours and took emergency contraception again within that timeframe.
However, as of now, August 26, it has been five days since her expected period, and it has not arrived.
In the previous one or two months, she also took emergency contraception, and her period came three days after taking it.
Why has her period not come this time after five days, and it seems like she has no symptoms of it arriving?

Lao Die, 10~19 year old female. Ask Date: 2018/08/26

Dr. Hong Kunyi reply Pharmacology

Hello: After discussing with the obstetrician-gynecologist at our hospital, here are a few points for your reference: (1) If emergency contraception is taken within 24 hours, the effectiveness is generally quite good.
(2) Taking emergency contraception can easily cause irregular menstrual cycles.
(3) If your period is expected around August 11 and lasts until about August 18, under normal circumstances without the influence of medication or other factors, your period should not have arrived yet.
The obstetrician-gynecologist recommends that if your period has not started by September 11, you should consult with the obstetrics and gynecology outpatient department.
I hope this answers your questions, and I wish you all the best.

Reply Date: 2018/08/26

More Info

When it comes to understanding emergency contraceptive pills (ECPs) and their effects on menstrual cycles, it's important to consider several factors that can influence the timing of menstruation after taking these medications. In your case, it seems that your girlfriend has taken ECPs after unprotected intercourse, and now she is experiencing a delay in her menstrual cycle.

Emergency contraceptive pills, such as Plan B (levonorgestrel) or Ella (ulipristal acetate), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They work primarily by delaying ovulation, which means that if taken before ovulation, they can prevent the egg from being released and thus prevent fertilization. However, if ovulation has already occurred, ECPs may not be effective.

One of the common side effects of ECPs is a disruption in the menstrual cycle. After taking ECPs, some women may experience their next period earlier or later than expected. The hormonal changes induced by the ECPs can lead to variations in the timing of menstruation, and this can be influenced by several factors, including:
1. Timing of the Cycle: If your girlfriend was close to ovulation when she took the ECPs, it might take longer for her body to readjust and for her period to arrive.

2. Previous Use of ECPs: Since your girlfriend has taken ECPs in the past, her body may respond differently this time. Each cycle can vary, and previous use of ECPs can also affect her hormonal balance.

3. Stress and Lifestyle Factors: Stress, changes in weight, illness, or changes in routine can all impact the menstrual cycle. If your girlfriend has been under stress or has experienced any lifestyle changes recently, this could contribute to the delay.

4. Pregnancy: Although she took ECPs, there is still a possibility of pregnancy if the timing was right. If her period is significantly delayed, it may be advisable for her to take a home pregnancy test to rule out pregnancy.

5. Hormonal Imbalance: Sometimes, hormonal imbalances unrelated to ECP use can cause menstrual irregularities. If her cycle continues to be irregular, it may be worth consulting a healthcare provider.

In your situation, since it has been five days since the expected period and there are no signs of menstruation, it would be wise for your girlfriend to take a pregnancy test. If the test is negative and her period does not arrive soon, or if she experiences any unusual symptoms, it would be a good idea for her to consult a healthcare professional for further evaluation.

In summary, while ECPs are effective in preventing pregnancy, they can also lead to changes in the menstrual cycle. Delayed menstruation can be a common side effect, but it is essential to rule out pregnancy and consult a healthcare provider if there are ongoing concerns.

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