Post-Pill Effects: Milk Production and Menstrual Changes

Breast engorgement two weeks after taking emergency contraception?

On August 29, there was sexual intercourse with a condom, but it seemed to have come into contact with semen, so emergency contraception was taken within an hour.
On September 2, there was some light bleeding, but starting on September 3, the bleeding increased significantly, with more volume than a regular period and the presence of blood clots.
A doctor was consulted, both Western and Traditional Chinese Medicine (TCM).
The Western doctor addressed the issue of large blood clots and heavy bleeding, stating that there was poor uterine contraction.
A few days later, the TCM practitioner noted that the uterus felt enlarged and diagnosed it as uterine inflammation.
By the time of the TCM consultation on September 9, the menstrual period had already lasted seven days, with the end date projected for September 11.
However, on September 14, it was noticed that my girlfriend had breast engorgement, and on that day, I manually stimulated her vagina, concerned about the potential introduction of prostaglandins.
I also manually stimulated her vagina on September 15.

I would like to ask the doctor if the heavy bleeding and blood clots after taking the emergency contraceptive, which were similar to but slightly heavier than her usual menstrual flow, can be considered a period? Why did breast engorgement occur four days after the period? Could this be related to the approach of ovulation? Given that the sexual activity on August 29 was followed by emergency contraception and subsequent menstrual bleeding, and that both TCM and Western medicine consultations did not indicate any signs of pregnancy, what is the likelihood of pregnancy from manual stimulation on September 14 and 15? I am concerned about the possibility of being in the ovulation period.

Zi Zi, 10~19 year old female. Ask Date: 2018/09/16

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On August 29, there was sexual intercourse with a condom, but it seemed to have come into contact with semen, so I immediately bought emergency contraception an hour later.
On September 2, there was some bleeding, but it was not much.
Starting from September 3, the bleeding increased and was heavier than the previous menstrual period, with blood clots.
I consulted both Western and Traditional Chinese Medicine.
The Western doctor addressed the issue of large blood clots and heavy bleeding, suggesting poor uterine contractions.
A few days later, the Traditional Chinese Medicine doctor noted that the uterus felt enlarged and diagnosed it as uterine inflammation.
By the time I saw the Traditional Chinese Medicine doctor, it was already the seventh day of menstruation on September 9, with the menstrual period ending on September 11.
However, on September 14, I noticed my girlfriend had breast engorgement, and that day I manually stimulated her vagina, fearing that prostaglandins might enter.
I also manually stimulated her vagina on September 15.
I would like to ask the doctor if the heavy bleeding and blood clots my girlfriend experienced after taking the emergency contraception, which were similar to but slightly heavier than her usual menstrual flow, is considered menstruation?
Answer: Yes, it is menstruation.
Why did she experience breast engorgement four days after her period? Is it because ovulation is approaching?
Answer: The bleeding started on September 3, and breast engorgement was noticed on September 14.
This is due to hormonal changes.
The sexual intercourse on August 29 likely did not result in pregnancy since she took emergency contraception and experienced menstrual bleeding.
During the bleeding period, both Traditional Chinese Medicine and Western Medicine did not indicate any signs of pregnancy.
So, what is the likelihood of pregnancy from manually stimulating her vagina on September 14 and 15? I am concerned it might be during the ovulation period.

Answer: There is no likelihood of pregnancy.

Reply Date: 2018/09/16

More Info

Understanding the post-pill effects on milk production and menstrual changes can be quite complex, especially when considering the various hormonal influences at play. In your situation, it seems that your girlfriend experienced a series of events that could be attributed to the use of emergency contraception, her menstrual cycle, and possibly other factors.

Firstly, the use of emergency contraception (the "morning-after pill") can lead to changes in menstrual bleeding patterns. It is not uncommon for women to experience heavier bleeding, spotting, or even changes in the timing of their menstrual cycle after taking such medication. The bleeding you observed on September 2nd, which increased in volume and included blood clots, could very well be a side effect of the emergency contraceptive. This type of bleeding is sometimes referred to as "withdrawal bleeding" and can occur as the body adjusts to the sudden hormonal changes induced by the pill.

Regarding the breast engorgement or "milk production" observed on September 14th, this can also be influenced by hormonal fluctuations. After taking emergency contraception, the body may experience a surge in certain hormones, which can lead to breast tenderness or fullness. This does not necessarily indicate pregnancy, especially since your girlfriend had a significant menstrual bleed just a few days prior. Breast changes can occur due to various factors, including hormonal shifts unrelated to pregnancy.

As for the concern about the likelihood of pregnancy from manual stimulation of the vagina, the risk is generally low, especially if there was no direct ejaculation or seminal fluid introduced into the vaginal canal. The timing of your girlfriend's cycle is also crucial; if she had just finished her period, she would likely not be in her fertile window. Ovulation typically occurs around 14 days before the next expected period, but this can vary widely among individuals.

In summary, the heavy bleeding and blood clots following the use of emergency contraception are likely a result of the hormonal changes from the pill, rather than a sign of pregnancy. The breast changes observed shortly after are also likely due to these hormonal fluctuations. If there are ongoing concerns about potential pregnancy or if unusual symptoms persist, it would be advisable for your girlfriend to take a pregnancy test or consult with a healthcare provider for further evaluation.
It's essential to keep in mind that every woman's body reacts differently to hormonal changes, and while some may experience significant alterations in their menstrual cycle or breast changes, others may not notice any effects at all. Regular follow-ups with healthcare professionals can provide clarity and reassurance during such times.

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