Pregnancy Tests and Emergency Contraception: Key Questions Answered

Pregnancy testing and contraceptive pill issues?

Hello Doctor, I am the person who asked question #170311.
After my last post, I have more information to add and some questions to ask, so I am reaching out again.
Thank you.

I stopped taking my preemptive medication on May 21.
My menstrual cycle usually starts around the 25th, but after having unprotected intercourse on June 24, when the condom broke (without ejaculation), I took an emergency contraceptive pill.
My period for June did not arrive until July 1.
On July 5, while I was still menstruating, I had intercourse again, and the condom broke on the side, with ejaculation occurring.
I immediately rinsed with water and took another emergency contraceptive pill within an hour, and used a vaginal douche.
I tested for ovulation with an ovulation test strip within three hours, which showed a negative result.
However, after four to five hours, I noticed egg white-like discharge with blood streaks.

Here are my questions:
Q1: What is the likelihood of pregnancy?
Q2: The ovulation test was negative, but I later had egg white discharge.
Could this be caused by the emergency contraceptive pill or is there another reason?
Q3: Are there any additional contraceptive measures I can take to mitigate this situation?
Q4: When is the best time to take a pregnancy test for reliable accuracy?
Q5: If my period arrives in July, can I resume taking the preemptive medication on the fifth day? (Could the bleeding be caused by the emergency contraceptive pill rather than my period?)
I have consistently used condoms, and I stopped the preemptive medication due to unavoidable circumstances.
I was very anxious when I saw what happened.
I hope the doctor can provide some advice.
Thank you for taking the time to respond.

Miss Wang, 10~19 year old female. Ask Date: 2021/07/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if your period started on July 1st, then July 5th is generally not considered the ovulation period, and pregnancy is unlikely.
If there was no prior contraception or if contraception failed, it is usually recommended to take emergency contraception.
If your period is late, then you should take a pregnancy test.
Birth control pills are typically started on the fifth day of your menstrual cycle.
Wishing you good health.

Reply Date: 2021/07/06

More Info

When it comes to understanding pregnancy tests and emergency contraception, there are several important factors to consider, especially in the context of your recent experiences. Let's address your questions one by one.

Q1: What is the likelihood of pregnancy?
Given that you experienced a condom failure during intercourse, there is a possibility of pregnancy, especially if ejaculation occurred. However, since you took emergency contraception (EC) shortly after the incident, it significantly reduces the chances of pregnancy. Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but it can be effective up to 5 days after. If your menstrual cycle is regular and you have taken the EC correctly, the likelihood of pregnancy is lower, but not zero.

Q2: The ovulation test was negative, but later I had egg white discharge with blood streaks. What could this mean?
A negative ovulation test indicates that you are not currently ovulating. However, the presence of egg white cervical mucus (EWCM) can occur at various times in your cycle, not just during ovulation. This type of discharge is typically associated with increased estrogen levels and can be a sign of approaching ovulation, but it can also occur due to hormonal fluctuations caused by the emergency contraception. The blood streaks may be a result of hormonal changes or breakthrough bleeding, which can happen after taking EC.

Q3: Are there any additional contraceptive measures I can take?
If you are concerned about the risk of pregnancy after the condom failure, you have already taken a significant step by using emergency contraception. For ongoing protection, consider discussing long-term contraceptive options with your healthcare provider. Options include hormonal birth control pills, intrauterine devices (IUDs), implants, or other barrier methods. It's crucial to find a method that suits your lifestyle and health needs.

Q4: When should I take a pregnancy test for reliable accuracy?
For the most accurate results, it is recommended to wait until at least the first day of your missed period to take a home pregnancy test. Since you mentioned that your menstrual cycle is usually around 25 days, if your period does not arrive as expected, you can test a few days after the missed period. Pregnancy tests are generally very reliable when used correctly and at the right time.

Q5: If I get my period in July, can I start taking the pill again on the fifth day?
If your period arrives, you can typically start taking hormonal contraceptives again, including the pill, on the first day of your period or the first Sunday after your period starts, depending on the specific instructions for the pill you are using. Starting on the fifth day may not provide immediate protection, so it's best to follow the guidelines provided with your contraceptive method. If you are unsure, consult your healthcare provider for personalized advice.

In summary, while the situation can be stressful, taking emergency contraception was a proactive step. Monitor your menstrual cycle closely, and if you have any unusual symptoms or concerns, do not hesitate to reach out to your healthcare provider for further evaluation and guidance. It's essential to have a reliable contraceptive plan in place to avoid similar situations in the future.

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