Emergency Contraceptive Pills: Delayed Period and Symptoms

Please ask any questions related to emergency contraceptive pills?

Hello Doctor, my last menstrual period ended on April 18.
I had unprotected intercourse with my boyfriend on May 2, and he ejaculated inside me.
Within 5 hours, I went to the gynecology clinic and took emergency contraceptive pills.
As of today (May 11), it has been 9 days, and my period is now 3 days late.
I have a history of anxiety disorder and had previously taken anti-anxiety medication.
After a period of discontinuation, I resumed taking the medication again in the last five days.
The delay in my period has caused me significant anxiety, and I am uncertain whether the symptoms I am experiencing are side effects of the emergency contraceptive, premenstrual syndrome, early signs of pregnancy, or simply due to excessive stress and anxiety.
The clinic I visited informed me that taking emergency contraceptive pills could potentially delay my period.
Currently, I am experiencing symptoms such as headaches, palpitations, nausea, mild lower back pain, slight cramping in the lower abdomen, minimal discharge, no breast or nipple tenderness, frequent urination at night, and excessive sleepiness.
Thank you, Doctor.

Su Hua, 10~19 year old female. Ask Date: 2021/05/11

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effects of emergency contraceptive pills on menstruation can vary; they may not necessarily cause your period to come early or late.
Additionally, early pregnancy may not present specific symptoms, and subjective symptoms are not reliable for making a judgment.
It is advisable to consult a physician if your period has not arrived by around 5-25 days.
Thank you! Wishing you safety and health.
Dr.
Chang

Reply Date: 2021/05/11

More Info

Understanding the effects of emergency contraceptive pills (ECPs) and their potential impact on menstrual cycles is crucial for individuals who have recently engaged in unprotected intercourse. In your case, you took ECPs shortly after unprotected intercourse on May 2nd, and now, as of May 11th, you are experiencing a delay in your menstrual period, which has understandably caused you anxiety.

ECPs, such as those containing levonorgestrel or ulipristal acetate, work primarily by preventing ovulation. If taken within a specific timeframe after unprotected intercourse, they can significantly reduce the risk of pregnancy. However, these pills can also cause temporary changes in your menstrual cycle. It is not uncommon for individuals to experience a delay in their period after taking ECPs, as hormonal fluctuations can disrupt the regularity of the menstrual cycle.
In your situation, the delay of three days in your menstrual period is within the range of what can be expected after taking ECPs. Many women report changes in their cycle, including delayed or early periods, heavier or lighter bleeding, and other symptoms that can mimic premenstrual syndrome (PMS) or early pregnancy symptoms. The symptoms you are experiencing—headaches, palpitations, nausea, mild lower back pain, and abdominal discomfort—can indeed be attributed to the hormonal effects of the ECPs, PMS, or even anxiety.

Your history of anxiety and the recent resumption of anti-anxiety medication may also contribute to your current symptoms. Anxiety can manifest physically, leading to symptoms such as palpitations, headaches, and gastrointestinal discomfort, which can further complicate the interpretation of your symptoms. It is essential to consider both the physiological effects of the ECPs and the psychological impact of anxiety on your body.

If your period does not arrive within a week or if you experience any unusual symptoms, it would be advisable to take a home pregnancy test to rule out pregnancy. These tests are generally reliable if taken after a missed period. If the test is negative and your period still does not arrive, or if you have any concerns about your symptoms, consulting with a healthcare provider is recommended. They can provide further evaluation and reassurance.

In summary, while the delay in your period and the symptoms you are experiencing can be concerning, they are not uncommon after taking emergency contraceptive pills. The hormonal changes induced by the ECPs, combined with your anxiety, may be contributing to your current state. Monitoring your symptoms and considering a pregnancy test if your period does not arrive soon will be important steps in managing your health and peace of mind. If you have further concerns or if symptoms worsen, seeking medical advice is always a prudent choice.

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