Changes in Menstrual Flow After Taking Emergency Contraceptive Pills

Postcoital contraceptive pills may result in decreased menstrual flow?

The app indicates that it was about three days after ovulation on June 1st when sexual intercourse occurred.
I penetrated for less than 20 seconds without a condom and did not ejaculate.
I'm unsure if pre-ejaculate fluid might contain residual sperm, so I took the emergency contraceptive pill Ella within 24 hours.
My last menstrual period was from May 13 to May 18, and the previous one was from April 14 to April 18.
According to the app, my next expected period is on June 11.
However, my girlfriend mentioned that this time it was much lighter and bright red.
Could this be an early sign of pregnancy, a normal period, a false period, or a side effect of the emergency contraceptive? When would be the best time to take a pregnancy test? I would appreciate your guidance, doctor.

Billy, 10~19 year old female. Ask Date: 2021/06/11

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
Although the chances are low, there can still be a small amount of sperm leakage before ejaculation, so it is important to take precautions throughout.
2.
Taking emergency contraception within 48 to 72 hours can generally prevent pregnancy; however, the subsequent menstrual cycle may be disrupted, which may require a pregnancy test or further observation.

Reply Date: 2021/06/11

More Info

When it comes to understanding changes in menstrual flow after taking emergency contraceptive pills, such as Ella (ulipristal acetate), it's important to consider several factors that can influence menstrual cycles and bleeding patterns.

Firstly, emergency contraceptive pills (ECPs) are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They work primarily by delaying ovulation, which means that if taken before ovulation, they can effectively prevent the release of an egg. However, if ovulation has already occurred, ECPs may not be effective. In your case, since you had unprotected intercourse on June 1st and took Ella within 24 hours, it is likely that the pill worked to prevent ovulation.

Regarding your menstrual cycle, you mentioned that your last period started on May 13th and ended on May 18th, with your next expected period around June 11th. After taking Ella, it is common for women to experience changes in their menstrual flow. This can include lighter bleeding, spotting, or even a delay in the onset of the next period. The fact that your girlfriend experienced a lighter and brighter red flow than usual could be attributed to the hormonal changes induced by the emergency contraceptive pill.
It's also important to note that some women may experience what is known as "withdrawal bleeding" after taking ECPs, which can mimic a period but is not the same as a regular menstrual cycle. This bleeding can be lighter or shorter than a typical period, and it may occur earlier or later than expected.
As for the timing of a pregnancy test, it is generally recommended to wait at least one week after the expected date of your period to take a home pregnancy test for the most accurate results. Since your expected period was around June 11th, you could consider taking a pregnancy test around June 18th or later. If the test is negative and your period does not arrive, it may be advisable to consult a healthcare provider for further evaluation.

In summary, the changes in menstrual flow after taking emergency contraceptive pills can be normal and are often a result of the hormonal effects of the medication. If there are any concerns about pregnancy or if the bleeding patterns continue to be unusual, it is always best to consult with a healthcare professional for personalized advice and guidance.

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