Do You Need Emergency Contraception After Taking Provera?

Do I need to use emergency contraception after taking Povir tablet?

Hello, I have not had my menstrual period for a long time, so I have been seeing a gynecologist for almost a year.
The first doctor found a polyp in my uterus, which needed to be removed.
After the removal, my menstrual period still did not come, and the endometrium continued to thicken.
I underwent another curettage, and the tests indicated benign endometrial hyperplasia.
After that, I took a medication called Femara for six months.
In April of this year, I switched to a new doctor who re-evaluated my condition and advised me to stop taking Femara for one month before the next check-up.
My period came before the May appointment, so the endometrial thickness was within normal limits.
However, during the follow-up on August 14, since I had not had my period for the past three months, the endometrium had thickened again.
The doctor prescribed a five-day course of Provera, and I have already taken it for three days.
However, on the early morning of August 17, I had unprotected sexual intercourse (with ejaculation inside).
I would like to know if this means I am ovulating very rarely? Should I consider purchasing emergency contraception? Thank you.

s, 30~39 year old female. Ask Date: 2020/08/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
If you're still concerned, you might consider taking emergency contraception.
Wishing you good health.

Reply Date: 2020/08/17

More Info

When considering the need for emergency contraception after taking Provera (medroxyprogesterone acetate), it is essential to understand how this medication works and its implications for ovulation and pregnancy prevention. Provera is a synthetic form of the hormone progesterone, often used to treat various menstrual disorders, including irregular periods and endometrial hyperplasia.
In your case, you mentioned that you have been experiencing irregular menstrual cycles and have undergone procedures to address uterine polyps and thickened endometrial lining. After taking Provera for three days, you engaged in unprotected sexual intercourse. The key question here is whether Provera affects your ovulation status and if emergency contraception is necessary.

Provera can suppress ovulation, but its effectiveness in doing so depends on the timing of administration in relation to your menstrual cycle. If you have been taking Provera as prescribed, it may have inhibited ovulation during the time you had unprotected intercourse. However, if you were not consistently taking the medication or if it was not effective in suppressing ovulation, there is a possibility that ovulation could have occurred, which would increase the risk of pregnancy.

Emergency contraception (EC) is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some types can be effective up to 5 days after. The most common forms of EC include levonorgestrel (Plan B) and ulipristal acetate (Ella). These medications work primarily by delaying or inhibiting ovulation. If ovulation has already occurred, EC may not be effective.

Given your situation, here are some considerations:
1. Timing of Provera: If you have been taking Provera consistently and it has been effective, it may have suppressed ovulation, reducing the likelihood of pregnancy. However, if you were not taking it regularly or if it was not effective, there is a risk of ovulation having occurred.

2. Need for Emergency Contraception: If you are concerned about the possibility of pregnancy, it is advisable to consult with your healthcare provider about the need for emergency contraception. They can provide guidance based on your specific circumstances, including the timing of your Provera intake and your menstrual cycle.

3. Consultation with Your Doctor: Since you have been under the care of a gynecologist for your menstrual issues, it would be prudent to reach out to them for advice. They can assess your situation and recommend whether you should take emergency contraception or if your current medication regimen is sufficient.

4. Understanding Your Cycle: If you are experiencing irregular periods, it can be challenging to predict ovulation. Keeping track of your cycle and any symptoms can help you and your doctor make informed decisions about contraception and menstrual health.

In summary, while Provera may help regulate your menstrual cycle and potentially suppress ovulation, the need for emergency contraception after unprotected intercourse should be evaluated based on your individual circumstances. Consulting your healthcare provider is the best course of action to ensure you receive appropriate guidance and care.

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