the Risks of Delayed Emergency Contraceptive Use

The likelihood of pregnancy increases if emergency contraception is taken late or missed?

Hello, I am currently taking the oral contraceptive pill "Yueji" and have completed four packs.
I take the pills between 10 PM and midnight, starting on the fourth day of my menstrual cycle.
I stopped taking the pills on the fifth day of my cycle.
My last menstrual period started on June 7, and I began the first pill of the new pack on June 12, which was the sixth day of my cycle.
I missed a dose on June 23, took a pill on June 24 in the morning (within 12 hours), and then took another pill at 10 PM that night.
On June 26, I had unprotected intercourse, and on July 3 (the first day of stopping the pills), I had unprotected intercourse again.
I have been taking the pills consistently between 10 PM and midnight.
I would like to know what the chances of pregnancy are and whether I should take emergency contraception or wait until July 7 to see if my period arrives.
Thank you.

Yǒudiǎn hàipà de wǒ, 20~29 year old female. Ask Date: 2019/07/04

Dr. Hou Fangmin reply Pharmacology

Hello, I apologize for the late response regarding the hospital evaluation.
Typically, the chances of pregnancy increase after stopping medication for more than 7 days.
If, as you mentioned, you had unprotected intercourse on the first day after stopping the medication, the likelihood of implantation is low.
Although the probability is low, it is still important to monitor for any bleeding or signs of pregnancy, or to visit a gynecologist for a pregnancy test.
I have attached the instructions for what to do if you missed a dose; please take a look.
Wishing you peace, well-being, and good health.

Reply Date: 2019/07/04

More Info

When it comes to understanding the risks associated with delayed emergency contraceptive use, it's essential to consider several factors, including the timing of your menstrual cycle, the effectiveness of your current contraceptive method, and the nature of the sexual encounter.

First, let's clarify the situation regarding your use of the oral contraceptive pill (OCP). You mentioned that you have been taking your OCP consistently, starting from the fourth day of your menstrual cycle, and that you have been diligent about taking it within the specified time frame (between 10 PM and midnight). This consistency is crucial because the effectiveness of OCPs relies heavily on regular intake. When taken correctly, OCPs are over 99% effective in preventing pregnancy.

However, you also mentioned a specific incident of unprotected intercourse on June 26 and subsequent unprotected intercourse on July 3. Since you were on the pill and had been taking it consistently, the likelihood of pregnancy from these encounters is relatively low, especially if you had been taking your pills as directed. The OCP works primarily by preventing ovulation, and if you are taking it correctly, ovulation should not occur.

Regarding the use of emergency contraception (EC), it is generally recommended for situations where there is a concern about contraceptive failure or if unprotected intercourse occurs outside of the effective window of your regular contraceptive method. Since you have been taking your OCP consistently, the need for emergency contraception may not be necessary. However, if you are feeling anxious about the possibility of pregnancy, taking an emergency contraceptive pill (like Plan B) can provide peace of mind. It's most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but can be taken up to 5 days after.

In your case, since you are already on a regular contraceptive regimen, it may be more prudent to wait until your expected period on July 7. If your period does not arrive, you can take a pregnancy test to confirm whether or not you are pregnant. If you do experience any unusual symptoms or have concerns about your menstrual cycle, it is always best to consult with your healthcare provider for personalized advice.

In summary, based on the information provided, the likelihood of pregnancy appears low due to your consistent use of OCPs. If you are still concerned, you may consider taking emergency contraception, but it may not be necessary. Waiting for your period and taking a pregnancy test if it does not arrive is a reasonable approach. Always feel free to reach out to your healthcare provider for further guidance tailored to your specific situation.

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