Irregular Periods: Causes, Symptoms, and When to Test for Pregnancy

Irregular menstrual cycle?

Hello Doctor: I had sexual intercourse on February 25th, and since the app indicated a fertile window, I took emergency contraception (Postinor).
Additionally, due to significant psychological stress, my period was delayed.
My menstrual cycle in February was from February 7 to February 15, and I expected my period to start on March 7.
However, since it did not come, I went to the gynecologist on March 10 for a pregnancy test, which came back negative.
I was prescribed three days' worth of medication to induce menstruation.
On March 12, I noticed brown discharge, and on March 13, I experienced more noticeable bleeding, but the color was a dark brown and the amount was much less than usual.
I initially thought that on March 14 (today) the flow would return to normal and the color would also normalize, but it seems to remain light.
I do not have any significant discomfort, just a slight lower back ache.
I would like to ask: 1.
Does this count as menstrual irregularity? 2.
Should I take a pregnancy test again? Can this be considered a menstrual period? Thank you for your response, Doctor.

Niming, 20~29 year old female. Ask Date: 2021/03/14

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
For pregnancy concerns, please take a home pregnancy test or consult a gynecologist for evaluation four weeks after sexual intercourse.
2.
The use of emergency contraception may cause menstrual irregularities, and the duration varies from person to person.

Reply Date: 2021/03/14

More Info

Understanding irregular periods can be quite complex, especially when considering the various factors that can influence menstrual cycles, such as hormonal changes, stress, and potential pregnancy. Based on your situation, let's break down your concerns regarding your menstrual cycle, the use of emergency contraception, and the need for pregnancy testing.

1. Menstrual Irregularities: It sounds like you have experienced some irregularities in your menstrual cycle following the use of emergency contraception (Plan B). Emergency contraceptive pills can cause temporary changes in your menstrual cycle, including delays or alterations in flow. The psychological stress you mentioned can also significantly impact your cycle, as stress can lead to hormonal imbalances that affect ovulation and menstruation.
In your case, since you took the emergency contraceptive and are experiencing changes in your menstrual flow (such as lighter bleeding and a different color), it is not uncommon. The brownish discharge you observed could be old blood, which is often seen at the beginning or end of a menstrual period. However, if the bleeding is significantly lighter than your usual flow and is accompanied by other symptoms, it may be classified as a form of menstrual irregularity.

2. Pregnancy Testing: You mentioned that you took a pregnancy test on March 10, which was negative. Given that you had unprotected intercourse on February 25 and took emergency contraception shortly thereafter, the negative test result is reassuring. However, it is essential to note that pregnancy tests are most accurate when taken after a missed period. Since your period was expected around March 7 and you experienced some bleeding on March 12, it is likely that the test was accurate.
If you are still uncertain about the possibility of pregnancy, it may be worth waiting a few days and taking another test, especially if your bleeding does not progress to a normal menstrual flow. If you continue to experience irregularities or have concerns about your symptoms, consulting with a healthcare provider is advisable.

3. Can This Be Considered a Menstrual Period?: The bleeding you experienced on March 12 could potentially be considered a menstrual period, especially if it aligns with your typical cycle timing. However, since it was lighter and different in color, it may also be a withdrawal bleed due to the emergency contraception. If the bleeding continues to be light and does not resemble your usual menstrual flow, it might be worth discussing with your healthcare provider to rule out any underlying issues.

In summary, your situation reflects a common occurrence following the use of emergency contraception and the influence of stress on menstrual cycles. While it is likely that you are not pregnant based on your test results and the timing of your bleeding, monitoring your symptoms and consulting with a healthcare professional can provide clarity and peace of mind. If your menstrual irregularities persist or if you have any other concerning symptoms, seeking medical advice is always the best course of action.

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