Missed Period After Birth Control and Emergency Contraceptive: What to Know

I have taken oral contraceptives and emergency contraception, but my period is still delayed?

I usually take oral contraceptives regularly, starting from June 6.
On June 8, due to a severe cold, my doctor prescribed amoxicillin.
I asked the doctor if it was safe to take it while on birth control, and the doctor said that as long as the medications were taken at different times, it would not affect the contraceptive efficacy.
I took a total of 9 capsules of amoxicillin over three days, ensuring a 3-4 hour gap between it and my birth control pills.
I finished the amoxicillin on June 11 and did not engage in sexual intercourse until June 19.
After the intercourse on June 19, I noticed egg white-like cervical mucus on June 21.
I was concerned it might indicate ovulation (though I had experienced similar discharge 1-2 days after previous sexual encounters, so I was unsure if it was due to intercourse or ovulation).
That day, I took emergency contraception, and after June 21, I stopped taking my oral contraceptives (which I had been taking regularly before).
As of today, my period has not arrived, and I have been experiencing watery white discharge (not egg white-like, non-sticky, which I usually have before my period).
Occasionally, I feel bloated (similar to premenstrual symptoms, but I am unsure if it's psychological).
During this medication period, I did not experience breast tenderness (which I usually have during ovulation).
Therefore, I am uncertain whether the egg white-like discharge was due to ovulation or intercourse.
I believe that after finishing the antibiotics and stopping sexual activity for 7 days, along with my regular use of birth control and taking emergency contraception upon noticing the discharge, the likelihood of pregnancy should be low.
However, it has been a week since taking the emergency contraception and stopping the oral contraceptives (I usually get my period about 5-6 days after stopping the pills), and I am feeling very anxious about not having my period.
I would like to ask the doctor if the chances of pregnancy are high in this situation.
Thank you very much!

Niming, 20~29 year old female. Ask Date: 2020/06/28

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
It's best to wait a bit longer.
If your period doesn't arrive after a week, I recommend seeing a gynecologist.
Wishing you good health.

Reply Date: 2020/06/28

More Info

It sounds like you're experiencing a lot of uncertainty and anxiety regarding your menstrual cycle and the possibility of pregnancy after using birth control and emergency contraception. Let's break down the situation based on the information you've provided and some relevant medical knowledge.

First, it's important to understand how birth control pills and emergency contraceptive pills (ECPs) work. Birth control pills are designed to prevent ovulation, thicken cervical mucus, and thin the uterine lining, making it less likely for a fertilized egg to implant. When taken correctly, they are highly effective in preventing pregnancy. However, antibiotics like amoxicillin can potentially reduce the effectiveness of birth control pills, although this is a debated topic and may depend on the specific antibiotic and individual factors.

In your case, you took amoxicillin while on birth control pills but spaced them out appropriately. Since you followed your doctor's advice and maintained the correct timing, the risk of reduced effectiveness should be minimal. After stopping the antibiotic, you had unprotected intercourse and subsequently took an emergency contraceptive pill. ECPs are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but they can work up to 5 days after. They primarily work by delaying ovulation.

The absence of your period after taking the ECP can be concerning, but several factors could contribute to this. ECPs can cause changes in your menstrual cycle, including delayed periods, irregular bleeding, or even missed periods. It's also worth noting that stress and anxiety can impact your menstrual cycle, potentially causing delays.

You mentioned experiencing egg-white cervical mucus, which can indicate ovulation. However, since you took the ECP shortly after having unprotected sex, it is likely that the ECP worked to prevent ovulation, thus reducing the chances of pregnancy. The white, watery discharge you described could be a normal premenstrual symptom or a side effect of the hormonal changes from the ECP.

Given that you have not had your period for over a week after the expected time, it would be advisable to take a home pregnancy test. These tests are generally reliable and can provide you with clarity regarding your situation. If the test is negative and your period still does not arrive, it may be wise to consult with your healthcare provider for further evaluation. They can assess whether there are any underlying issues that need to be addressed, such as hormonal imbalances or other health concerns.

In conclusion, while the chances of pregnancy seem low given the precautions you took, the best course of action is to take a pregnancy test and consult with your healthcare provider if your period does not arrive soon. They can provide personalized advice and support based on your specific circumstances. Remember, it's essential to communicate openly with your healthcare provider about any concerns you have regarding your reproductive health.

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