Emergency Contraceptive Pills: Pregnancy Risk Assessment

Regarding the use of emergency contraceptive pills?

Hello, Dr.
Tsao.
I recently had sexual intercourse with my girlfriend during a trip on the night of February 26 and the morning of February 27.
On February 26, we used a condom and practiced withdrawal.
On February 27, we did not use a condom but still practiced withdrawal.
After the encounter on February 27, my girlfriend took emergency contraception.
Her expected next menstrual period is on March 10, and the app indicates that neither day was during her ovulation period.
What is the likelihood of pregnancy in this situation?

Guo Xiansheng, 20~29 year old female. Ask Date: 2021/03/05

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low; just monitor the situation.
Wishing you good health.

Reply Date: 2021/03/05

More Info

When it comes to understanding the risk of pregnancy after unprotected intercourse and the use of emergency contraceptive pills (ECPs), it's essential to consider several factors, including the timing of intercourse in relation to the menstrual cycle, the effectiveness of the contraceptive methods used, and the specific type of emergency contraceptive taken.

In your case, you mentioned that on February 26, you had sexual intercourse with a condom, which is a reliable method of contraception when used correctly. The fact that you also practiced withdrawal (pulling out) adds an additional layer of protection, although it is not foolproof. On February 27, you had unprotected intercourse without a condom but again used withdrawal. Since you took an emergency contraceptive pill shortly after this encounter, it is crucial to understand how these pills work.

Emergency contraceptive pills, such as Plan B (levonorgestrel) or Ella (ulipristal acetate), are designed to prevent ovulation or fertilization if taken within a specific time frame after unprotected intercourse. Plan B is most effective when taken within 72 hours, while Ella can be effective up to 120 hours after intercourse. The sooner you take the pill after unprotected sex, the more effective it is at preventing pregnancy.

Given that your girlfriend's expected menstrual period is on March 10, and considering that both instances of intercourse occurred before this date, it is important to note that if she was not ovulating during those days, the risk of pregnancy is significantly reduced. The menstrual cycle can vary, but if your girlfriend's app indicates that those days were not during her ovulation window, the likelihood of pregnancy is lower.

However, it is important to remember that no contraceptive method is 100% effective. The effectiveness of ECPs can also be influenced by factors such as body weight and the timing of administration. If your girlfriend experiences a delay in her period or has any symptoms of pregnancy (such as nausea, breast tenderness, or fatigue), it would be advisable for her to take a home pregnancy test or consult with a healthcare provider for further evaluation.

In summary, while the combination of condom use, withdrawal, and the timely administration of emergency contraception significantly reduces the risk of pregnancy, it is not entirely eliminated. The best course of action is to monitor her menstrual cycle and seek medical advice if there are any concerns about potential pregnancy. Additionally, discussing long-term contraceptive options with a healthcare provider can help prevent similar situations in the future.

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I'm sorry, but I can't assist with that.

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