Menstrual Irregularities After Emergency Contraceptive Use

Menstrual issues

I am an anonymous individual from article #146422 and would like to ask the doctor: I have taken a home pregnancy test and also tested at a gynecology clinic, both of which were negative.
I have taken emergency contraceptive pills; could this cause my menstrual cycle to be disrupted for such a long time? My period is already delayed by almost 19 days.
However, I've heard that during the use of menstrual induction medication, menstruation may not occur, yet my period has still not arrived.
Should I take another pregnancy test? When taking menstrual induction medication, does the counting of days start from the first day of taking the medication or only after finishing the course?

Niming, 10~19 year old female. Ask Date: 2019/06/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I have taken a pregnancy test at home and also at the gynecologist's office, both of which were negative.
I took emergency contraception, which can disrupt the menstrual cycle.
It has been almost 19 days since my period was due.
However, I have heard that during the course of taking medication to induce menstruation, the period may not come, but it still hasn't arrived.
Should I take another pregnancy test?
Answer: If it has been 14 days since taking the medication to induce menstruation and your period still hasn't come, it is advisable to take a pregnancy test.
The duration for taking the medication is counted from the completion of the course, not from the first day of taking it.

Answer: It is counted from the completion of the course.

Reply Date: 2019/06/02

More Info

When it comes to understanding menstrual irregularities after the use of emergency contraceptive pills (ECPs), it is essential to consider how these medications can affect the menstrual cycle. ECPs, such as levonorgestrel (Plan B) or ulipristal acetate (ella), are designed to prevent pregnancy after unprotected intercourse. They work primarily by delaying ovulation, but they can also alter the menstrual cycle in various ways.

Firstly, it is not uncommon for ECPs to cause changes in the timing of your next menstrual period. Some women may experience their period earlier than expected, while others may have a delayed period. In your case, a delay of 19 days is significant, and it is understandable that you are concerned. ECPs can disrupt the hormonal balance that regulates your menstrual cycle, leading to irregularities. This disruption can result in a late period, which may last longer than usual or be lighter or heavier than what you typically experience.

Regarding your negative pregnancy tests, both home tests and those conducted at a clinic are generally reliable when used correctly. If you have taken multiple tests and they all show negative results, it is less likely that you are pregnant. However, if your period does not arrive soon, it may be worth consulting with your healthcare provider for further evaluation. They may recommend a blood test for pregnancy, which is more sensitive than urine tests.

You mentioned taking medication to induce menstruation. It is important to clarify that the timing of your menstrual cycle in relation to these medications can vary. Typically, the days of taking the medication are counted from the first day of use. However, the effectiveness of these medications can also depend on various factors, including the specific type of medication you are taking and your individual hormonal response.

If you are experiencing significant anxiety about your menstrual irregularities or if your period does not arrive after taking the medication, it is advisable to follow up with your healthcare provider. They can assess your situation more thoroughly, possibly perform a pelvic exam, and discuss other potential causes for your delayed period, such as stress, hormonal imbalances, or other underlying health issues.

In summary, while ECPs can lead to menstrual irregularities, a delay of 19 days is noteworthy. Negative pregnancy tests are reassuring, but if your period does not come soon, or if you have concerns about the medications you are taking, it is best to consult with a healthcare professional for personalized advice and management.

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