Post-Pill Pain: Causes and Concerns After Taking Ella

Emergency contraceptive pill

Hello, doctor: A few days ago, I had unprotected sexual intercourse with my girlfriend during her fertile period.
As a result, I took Ella, an emergency contraceptive pill.
However, after taking it, I started experiencing abdominal pain.
Today is the fifth day.
I had severe pain on the night I took the medication, which gradually decreased over the next few days, reaching its lowest point on the third day.
However, the pain returned on the fourth day, and today I am experiencing intense pain (even worse than on the first day).
The pain during the first to third days was on the left and right sides of my lower abdomen, while on the fourth and fifth days, the pain is in the middle and sides of my lower abdomen, resembling menstrual cramps.
I have never experienced this sensation before my period.
There has been no discharge from my genital area, unlike the usual premenstrual symptoms.

Could you please explain to me what might be causing this severe pain? Is it due to the contraceptive pill, anxiety, or a sign of impending menstruation? If the pain remains severe, can I take pain relievers to alleviate it? Will taking pain relievers affect the efficacy of the contraceptive pill or have any adverse effects on my body? Thank you for your patient response, doctor.

liù, 10~19 year old female. Ask Date: 2020/12/12

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is recommended to see a doctor, preferably a gastroenterologist.
Wishing you good health.

Reply Date: 2020/12/12

More Info

After taking Ella, a post-coital contraceptive pill, it is not uncommon for individuals to experience abdominal pain or discomfort. This can be attributed to several factors, primarily related to the hormonal changes induced by the medication. Ella contains ulipristal acetate, which works by delaying ovulation and altering the uterine lining to prevent pregnancy. The hormonal fluctuations can lead to side effects such as nausea, abdominal pain, and changes in menstrual patterns.

In your case, the severe abdominal pain you experienced on the night of taking Ella, which then decreased but returned with increased intensity, could be a result of the medication's side effects. It is also possible that anxiety or stress related to the situation may exacerbate the perception of pain. The pain you describe, which resembles menstrual cramps, is not unusual as the body adjusts to the hormonal changes caused by the pill.
It is important to note that while some discomfort is expected, severe or worsening pain should not be ignored. If the pain persists or intensifies, it is advisable to consult a healthcare professional to rule out other potential causes, such as ectopic pregnancy or ovarian cysts, especially since you mentioned that your period is expected soon.
Regarding the use of pain relief medications such as ibuprofen (found in products like EVE), it is generally safe to take these alongside Ella. There is no significant interaction between ulipristal acetate and common over-the-counter pain relievers. However, it is always best to follow the dosage instructions on the medication and consult with a healthcare provider if you have any concerns about taking additional medications.

In summary, while abdominal pain after taking Ella can be a common side effect, it is essential to monitor the severity and duration of the pain. If you experience any alarming symptoms, such as heavy bleeding, severe pain, or signs of an allergic reaction, seek medical attention promptly. Additionally, using pain relief medications should not interfere with the effectiveness of Ella, allowing you to manage discomfort while ensuring the contraceptive remains effective. Always prioritize your health and well-being by consulting with a healthcare professional when in doubt.

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