Emergency Contraceptive Pills: Effectiveness and Concerns

I would like to inquire about the efficacy of contraceptive pills?

I took emergency contraception from the gynecology department, which is to be taken in two doses.
If I vomited the second dose about two hours after taking it, but I successfully took the first dose (after a condom broke and I took the first dose within 2 hours), what are the chances of pregnancy? Is it possible that the medication has already taken effect? The sexual intercourse occurred 4 days after my period ended, and there are still 11 days until my ovulation period.
Do I need to see a gynecologist again? (Even though it has been more than 72 hours.)

Lin Qi, 20~29 year old female. Ask Date: 2020/05/31

Dr. Wu Xianghui reply Obstetrics and Gynecology

For pregnancy concerns, please take a home pregnancy test or consult a gynecologist for evaluation four weeks after sexual intercourse.

Reply Date: 2020/05/31

More Info

Emergency contraceptive pills (ECPs) are designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. The effectiveness of ECPs, particularly those containing levonorgestrel or ulipristal acetate, is highest when taken as soon as possible after the incident, ideally within 72 hours, but they can still be effective up to 120 hours (5 days) after unprotected sex, depending on the type of pill used.

In your case, you mentioned that you took the first dose of the emergency contraceptive pill within two hours of the condom breaking, which is a good practice. However, you also indicated that you vomited approximately two hours after taking the second dose. The concern with vomiting is that it can affect the absorption of the medication. If vomiting occurs within two hours of taking the pill, it is generally recommended to take another dose, as the body may not have had enough time to absorb the medication effectively.

Given that you took the first dose correctly and that you were within the time frame for the second dose, there is still a chance that the first dose provided some level of protection. However, since you vomited the second dose, it is advisable to consult with your healthcare provider or return to the gynecology clinic for further evaluation. They may recommend taking another dose of the emergency contraceptive pill or discuss other options based on your specific situation.

Regarding your menstrual cycle, you mentioned that the sexual encounter occurred 11 days before your expected ovulation. This timing suggests that you were in the follicular phase of your cycle, which is generally considered to be a lower-risk time for pregnancy compared to the luteal phase. However, sperm can live in the female reproductive tract for up to five days, and ovulation can sometimes occur earlier or later than expected, so there is still a risk of pregnancy.

If you are concerned about the possibility of pregnancy, it may be beneficial to take a home pregnancy test if your period is late or if you experience any unusual symptoms. Additionally, if you have any ongoing concerns or questions about your reproductive health, it is always a good idea to follow up with your healthcare provider for personalized advice and support.

In summary, while the first dose of the emergency contraceptive pill you took may still provide some protection, the vomiting of the second dose could affect its effectiveness. Consulting with your healthcare provider is the best course of action to ensure you receive appropriate care and guidance.

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