Emergency Contraception: Effects and Concerns After First Intercourse

Taking emergency contraception?

My girlfriend is a virgin and today was our first time.
We used a condom and after ejaculation, I pulled out and put on a new condom.
At first, I put it on the wrong way, but then I put it on correctly before penetration.
I was worried about any residual semen, so I took emergency contraception an hour later.
However, a few hours after that, she had a little bit of bleeding, not much.
Is this bleeding caused by the emergency contraception or is it due to the breaking of the hymen? Initially, there was some bleeding after the hymen broke, and then I took the emergency pill an hour later.
A couple of hours after that, there was a little bit of bleeding, but it eventually stopped.
When she urinated before bed, there was a little bit of bleeding again.
Is this normal? Does taking emergency contraception cause an early onset of menstruation?

zuò zài, 10~19 year old female. Ask Date: 2018/08/30

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My girlfriend is a virgin and today was her first time.
We used a condom and after ejaculation, I pulled out and put on a new condom.
At first, I put it on the wrong way but then corrected it before penetration.
I was worried about residual semen, so she took emergency contraception an hour later.
However, a few hours after that, she experienced a little bit of bleeding, not much.
Is this bleeding caused by the emergency contraception or is it due to the breaking of the hymen?
Answer: It is due to the breaking of the hymen.
Initially, there may be some bleeding from the hymen breaking.
After taking the emergency contraception an hour later, she experienced a little bit of bleeding one to two hours later, but it eventually stopped.
She also noticed a little bit of bleeding after urinating before bed.
Is this normal? Will taking emergency contraception cause her period to come early?
Answer: Yes, this is normal.

Reply Date: 2018/08/30

More Info

When it comes to emergency contraception and the concerns surrounding its use, especially after the first sexual intercourse, there are several important factors to consider. Your situation involves the use of a condom, the potential for semen leakage, and the subsequent use of emergency contraception (EC) within an hour after intercourse. Additionally, you mentioned experiencing some light bleeding after taking the EC, which raises questions about its causes and implications.

Firstly, it's essential to understand how emergency contraception works. Emergency contraceptive pills (ECPs), 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 they prevent the egg from being released from the ovary. If ovulation has already occurred, ECPs may not be effective. The sooner they are taken after unprotected intercourse, the more effective they are.

In your case, since you used a condom and then took emergency contraception shortly after, the likelihood of pregnancy is significantly reduced. However, the bleeding you experienced could be attributed to several factors.
1. Breaking of the Hymen: If your girlfriend is a virgin and had her first sexual experience, it is possible that the act of intercourse caused the hymen to stretch or tear, which can lead to light bleeding. This is a common occurrence and is often referred to as "maidenhead" bleeding. The amount of blood can vary from person to person.

2. Side Effects of Emergency Contraception: ECPs can cause side effects, including changes in menstrual bleeding patterns. Some women experience spotting or light bleeding after taking the pill, which can be a normal response to the hormonal changes induced by the medication. This bleeding is usually not a cause for concern unless it is heavy or accompanied by severe pain.

3. Menstrual Cycle Changes: Taking emergency contraception can sometimes lead to an earlier or later onset of the next menstrual period. It is not uncommon for women to experience changes in their cycle after taking ECPs, including lighter or heavier periods, or even spotting between periods.

Regarding your question about whether taking the emergency contraception will cause an early period, it is possible. Some women report that their next period comes earlier than expected, while others may experience a delay. The hormonal changes caused by the ECP can disrupt the normal menstrual cycle temporarily.

In summary, the light bleeding you observed could be due to the tearing of the hymen during first intercourse or a side effect of the emergency contraception. It is generally considered normal, but if the bleeding continues or becomes heavy, or if there are any other concerning symptoms, it would be wise to consult a healthcare provider for further evaluation.
Lastly, if your girlfriend's next period is significantly delayed beyond a week of the expected date, it would be advisable to take a pregnancy test to rule out the possibility of pregnancy. Always remember that while emergency contraception is effective, it is not 100% guaranteed, and using condoms consistently and correctly is the best way to prevent unintended pregnancies and sexually transmitted infections.

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