Emergency Contraception: Risks and Next Steps After Unprotected Sex

No condom after taking emergency contraception?

Hello Doctor, my last menstrual period was from July 10 to July 15.
On July 23, during intercourse, I discovered that the condom had broken, and there was ejaculation inside.
I went to see a doctor and took Plan B (emergency contraceptive pill) within two hours.
After taking it, I had unprotected intercourse again (with withdrawal) two more times within an hour.
Is there a chance I could be pregnant? My menstrual cycle is about 30-31 days, and my periods last around 5-6 days.
The doctor mentioned that I likely hadn't ovulated yet and that I didn't need to take the pill, but I was still concerned because of the ejaculation, so I took it.
Should I take a pregnancy test? When would be the best time to test? Also, I experienced abdominal pain and headaches for three days after taking the emergency contraceptive, along with some nausea.
Is that normal? Thank you, Doctor, please make sure to respond.

A, 20~29 year old female. Ask Date: 2020/07/26

Dr. Wu Xianghui reply Obstetrics and Gynecology

For pregnancy concerns, please perform a home pregnancy test or consult a specialist in obstetrics and gynecology for evaluation four weeks after sexual intercourse.

Reply Date: 2020/07/26

More Info

After experiencing a contraceptive failure, such as a broken condom during intercourse, it's understandable to feel anxious about the possibility of pregnancy. In your case, you took emergency contraception (Plan B) shortly after the incident, which is a responsible step to mitigate the risk of unintended pregnancy.

Understanding Emergency Contraception
Emergency contraception pills (ECPs) like Plan B are most effective when taken as soon as possible after unprotected intercourse. They work primarily by delaying ovulation, which means if you haven't ovulated yet, the chances of becoming pregnant are significantly reduced. Since you mentioned that your last menstrual period was from July 10 to July 15 and the incident occurred on July 23, it is likely that you were still in the follicular phase of your cycle, which is before ovulation typically occurs in a 30-31 day cycle. This timing is crucial because if you haven't ovulated, the chances of pregnancy are lower.

Risk of Pregnancy After Taking ECP
Regarding the two subsequent instances of unprotected sex (with external ejaculation), the risk of pregnancy from those encounters is also relatively low, especially since you took the emergency contraception shortly after the first incident. However, it’s important to note that ECPs are not 100% effective, and the risk of pregnancy can never be entirely eliminated.

When to Take a Pregnancy Test
If your menstrual cycle is typically around 30-31 days, you can expect your next period around August 9-10. If your period is late by a week or more, it would be advisable to take a home pregnancy test. Most home pregnancy tests are reliable if taken after a missed period, as they measure the hormone hCG, which is produced after a fertilized egg implants in the uterus.

Side Effects of Emergency Contraception
Experiencing side effects such as abdominal pain, headaches, and nausea after taking emergency contraception is common. These symptoms are usually temporary and should resolve within a few days. If the symptoms persist or worsen, or if you experience severe pain, it would be wise to consult a healthcare provider to rule out any complications.

Conclusion and Next Steps
In summary, based on your timeline and the use of emergency contraception, the likelihood of pregnancy is low, but not impossible. Monitor your menstrual cycle, and if your period is late, take a pregnancy test. If you have any concerns about your symptoms or the effectiveness of the emergency contraception, don’t hesitate to reach out to your healthcare provider for further advice and support. Remember, practicing safe sex in the future can help prevent similar situations and provide peace of mind.

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