Is It Too Late to Take Emergency Contraceptive Pills After Unprotected Sex?

Is it still possible to take emergency contraception now?

Hello, doctor.
My menstrual cycle is approximately 28-34 days.
In January, my period was delayed by over 10 days, and it only started after I took medication to induce menstruation on February 1.
I'm not sure why it was suddenly delayed, and I took multiple pregnancy tests during that time.
I use a menstrual tracking app, which indicates that my period is expected around March 4.
If I calculate backwards, ovulation should have occurred around February 18, correct? Does this mean that February 13-19 would be considered a fertile window? However, I had unprotected intercourse with ejaculation outside on February 20.
Is this risky? I am currently using contraception, and if I take emergency contraception now, is it still effective? (I found online that Ella can be taken within 5 days after intercourse.)

Bobb, 20~29 year old female. Ask Date: 2021/02/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it seems that emergency contraception may be too late, and the chances of pregnancy are likely low.
You can only monitor the situation.
Wishing you good health.

Reply Date: 2021/02/24

More Info

When it comes to emergency contraception and the timing of its use after unprotected sex, it's essential to understand the mechanisms involved and the effectiveness of different options available. Based on your situation, let's break down the key points regarding your menstrual cycle, ovulation, and the use of emergency contraceptive pills (ECPs).

Firstly, you mentioned that your menstrual cycle typically ranges from 28 to 34 days, and you experienced a delay in your period in January, which was resolved with medication. This irregularity can sometimes make it challenging to predict ovulation accurately. Generally, ovulation occurs about 14 days before the start of your next period. If your cycle is regular, and you expect your period around March 4, then your estimated ovulation date would indeed be around February 18. This means that the days leading up to and including ovulation (approximately February 13 to February 19) would be considered your fertile window.

Now, regarding the unprotected intercourse that occurred on February 20, this date falls just after your estimated ovulation period. While sperm can survive in the female reproductive tract for up to five days, the likelihood of conception decreases significantly after ovulation has occurred. However, since the timing is close to your ovulation, there is still a risk of pregnancy.

Emergency contraceptive pills, such as Ella (ulipristal acetate), can be taken up to 120 hours (5 days) after unprotected sex and are effective at preventing pregnancy primarily by delaying ovulation. Since you had unprotected sex on February 20, you are still within the window to take Ella. The sooner you take it after unprotected intercourse, the more effective it will be.

It's important to note that while ECPs are effective, they are not 100% guaranteed to prevent pregnancy. Factors such as your body’s hormonal response and the timing of ovulation can influence the effectiveness. If you are concerned about the possibility of pregnancy, taking the emergency contraceptive as soon as possible is advisable.

In addition to taking emergency contraception, if you find that your menstrual cycle continues to be irregular or if you have any concerns about your reproductive health, it would be wise to consult with a healthcare provider. They can offer personalized advice, help you understand your cycle better, and discuss long-term contraceptive options that may suit your needs.

Lastly, if you experience any unusual symptoms or if your period is significantly delayed after taking the emergency contraceptive, consider taking a pregnancy test or consulting with a healthcare professional for further evaluation.

In summary, it is not too late to take emergency contraceptive pills after unprotected sex, especially since you are within the recommended time frame for Ella. Taking action promptly can help mitigate the risk of unintended pregnancy, and seeking further medical advice can provide you with additional support and information regarding your reproductive health.

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