Concerns About Taking Emergency Contraceptive Pills: What to Expect

Taking birth control pills twice a month?

Hello, I would like to ask about my girlfriend's menstrual cycle.
Her period started on January 10th, then on February 8th, and her periods have been arriving around the same time.
On March 1st, due to concerns about pre-ejaculation, she took emergency contraception within an hour.
Then on March 3rd, we used a condom, but it broke and ejaculation occurred inside.
She took the emergency contraceptive pill Ella within an hour after that.
On March 12th, she experienced some typical premenstrual symptoms, such as mild breast tenderness, but her period has not arrived yet.
I would like to know if there is a possibility of pregnancy in this situation.
On March 6th, there was some bleeding, but it stopped after that day.
On March 7th, she noticed some bleeding again, but it only occurred when she used the restroom, and it seemed like it wasn't flowing, as her panty liner was clean.
Could this be related to the emergency contraception? Will there be any further implications? If her period does not come by early next month, should we consider taking a pregnancy test?

Skan, 20~29 year old female. Ask Date: 2019/03/14

Dr. Chen Liqin reply Obstetrics and Gynecology

Dear Scan, based on your description, your girlfriend's menstrual bleeding in March was not typical.
It is recommended to take a pregnancy test and consult a healthcare provider.
Birth control pills can potentially affect the menstrual cycle, so it would be advisable to discuss this with a gynecologist before proceeding with further examinations.

Reply Date: 2019/03/14

More Info

When it comes to concerns about taking emergency contraceptive pills (ECPs) and what to expect afterward, it’s important to understand how these medications work and the potential effects they may have on your body.

Emergency contraceptive pills, such as Ella (ulipristal acetate) or Plan B (levonorgestrel), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure (like a broken condom). They work primarily by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus. However, they are most effective when taken as soon as possible after the incident, ideally within 72 to 120 hours, depending on the type of pill.

In your case, you mentioned taking ECPs after two separate instances of unprotected intercourse. The first instance was on March 1, and you took the pill within an hour. The second instance was on March 3, after a condom failure, and you took another ECP shortly after. Given that you took the pills promptly, the likelihood of preventing pregnancy is relatively high, but it is not guaranteed.

Now, regarding your menstrual cycle and the symptoms you are experiencing:
1. Menstrual Changes: ECPs can cause changes in your menstrual cycle. It is not uncommon for women to experience irregular bleeding or spotting after taking ECPs. The bleeding you noticed on March 6 and 7 could be a side effect of the emergency contraceptive, as these pills can cause hormonal fluctuations that lead to unexpected bleeding.

2. Premenstrual Symptoms: Symptoms like breast tenderness can also occur due to hormonal changes after taking ECPs. These symptoms can mimic those of premenstrual syndrome (PMS), which may lead to confusion about whether your period is coming or if you might be pregnant.

3. Delayed Period: It’s not unusual for your period to be delayed after taking emergency contraception. The timing of your next period can be affected by the hormonal changes induced by the ECPs. If your period is more than a week late, it is advisable to take a pregnancy test to rule out pregnancy.

4. Next Steps: If your period does not arrive by early April, taking a home pregnancy test would be a prudent step. If the test is positive, or if you have any concerns about your symptoms or the possibility of pregnancy, it’s essential to consult with a healthcare provider for further evaluation and guidance.

5. Future Considerations: If you find yourself needing emergency contraception frequently, it may be worth discussing long-term contraceptive options with your partner and a healthcare provider. There are various methods available that can provide more reliable protection against unintended pregnancy.

In summary, while it’s understandable to be concerned about the possibility of pregnancy after using emergency contraception, the symptoms you are experiencing could be related to the hormonal effects of the pills. Monitoring your cycle and taking a pregnancy test if your period is late will help clarify your situation. Always feel free to reach out to a healthcare professional for personalized advice and support.

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