Post-Pill Bleeding After Emergency Contraceptive Use

Postcoital contraceptive bleeding

Hello, Doctor: I have been taking oral contraceptives until April 18, and since I have been on them for a year, I temporarily stopped taking them for one month after my period on April 22.
However, I had sexual intercourse on May 5, and the condom slipped off afterward.
I took emergency contraception on May 6, and I experienced bleeding on May 11.
Can this bleeding be considered a menstrual period, or do I still need to wait 12 days to take a pregnancy test? Additionally, if I do get my period now, can I start taking oral contraceptives again? Thank you.

Dou Dou, 30~39 year old female. Ask Date: 2020/05/11

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, irregular menstruation may occur afterward.
You can take a pregnancy test 12 days later, and once your period is confirmed, you can start taking the pre-emptive contraceptive pill.
Wishing you good health.

Reply Date: 2020/05/11

More Info

Understanding post-pill bleeding after using emergency contraception can be quite complex, especially when considering the various hormonal influences at play. Let's break down your situation and provide some clarity.

Firstly, it’s important to understand how emergency contraceptive pills (ECPs) work. ECPs, such as Plan B (levonorgestrel) or Ella (ulipristal acetate), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. They work primarily by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. However, they can also cause changes in your menstrual cycle.

In your case, you stopped taking your regular birth control pills after a year of consistent use and had unprotected intercourse shortly thereafter, followed by taking an ECP. The bleeding you experienced on May 11, just a few days after taking the ECP, could be a side effect of the hormonal changes induced by the emergency contraceptive. This bleeding is often referred to as "withdrawal bleeding" and can occur as your body adjusts to the sudden influx of hormones from the ECP.

To address your questions:
1. Is the bleeding on May 11 considered a menstrual period?
- It may not be a true menstrual period. Withdrawal bleeding can occur after taking ECPs and may not follow the typical pattern of your menstrual cycle. It’s essential to monitor your cycle and note any changes, as the ECP can cause your next period to be earlier, later, lighter, or heavier than usual.

2. Should you wait 12 days to take a pregnancy test?
- Yes, it is generally recommended to wait at least 14 days after unprotected intercourse to take a pregnancy test for the most accurate results. This is because it takes time for the hormone hCG (human chorionic gonadotropin) to build up in your system if you are pregnant.

3. Can you start taking your regular birth control pills now?
- If you have experienced withdrawal bleeding, it is typically safe to resume your regular birth control pills. However, it is advisable to consult with your healthcare provider for personalized guidance based on your specific situation. They can provide recommendations on when to start taking the pills again and whether any additional contraceptive methods should be used during the transition.

In summary, the bleeding you experienced after taking the emergency contraceptive may not be your regular menstrual period but rather a response to the hormonal changes. It is crucial to wait for the appropriate time to take a pregnancy test and consult with your healthcare provider about resuming your regular birth control method. They can help ensure that you are protected and address any concerns you may have regarding your reproductive health.

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