Post-Pill Bleeding: Your Symptoms and Pregnancy Risks - Obstetrics and Gynecology

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Bleeding after taking emergency contraception?


Hello Doctor, I have polycystic ovary syndrome and am currently undergoing treatment.
On July 4th (the last day of my menstrual period), I had intercourse with my boyfriend, and there was a suspected case of ejaculation inside.
Eight hours after the incident, I took emergency contraception and also started taking medication for my polycystic ovary syndrome.
However, starting on July 10th, I began to experience pain when using the restroom, and there were bloodstains on the toilet paper.
From July 11th, I started to have bleeding that resembles menstruation.
Could you please advise if there is a possibility of pregnancy in this situation?

Yuan Yuan, 10~19 year old female. Ask Date: 2021/07/11

Dr. Wu Xianghui reply Obstetrics and Gynecology


1.
For pregnancy concerns, please take a home pregnancy test or visit a gynecologist for examination and evaluation four weeks after your most recent sexual intercourse.
2.
The menstrual cycle can be influenced by various psychological and physiological factors.
If your period is more than two months late, it is recommended to consult a gynecologist for examination and evaluation.

Reply Date: 2021/07/11

More Info


Post-Pill Bleeding, often referred to as withdrawal bleeding, can occur after taking emergency contraception (the "morning-after pill"). This type of bleeding is typically a response to the hormonal changes induced by the medication, which is designed to prevent pregnancy after unprotected intercourse. Given your situation, let's break down the various aspects of your symptoms and the potential implications regarding pregnancy.


Understanding Your Symptoms
1. Timing of Intercourse and Emergency Contraception: You mentioned having unprotected intercourse on July 4 and taking the emergency contraceptive pill within eight hours. Emergency contraceptive pills are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours. Since you took the pill promptly, the likelihood of preventing pregnancy is significantly increased.

2. Withdrawal Bleeding: The bleeding you experienced starting July 10 could be attributed to the hormonal changes from the emergency contraceptive pill. This bleeding can resemble a menstrual period and may occur within a few days to a week after taking the pill. It is important to note that this is not a sign of pregnancy but rather a response to the hormonal fluctuations caused by the medication.

3. Pain and Blood Streaks: The pain you experienced when using the restroom and the blood streaks on the tissue could also be related to the hormonal changes or could indicate other issues, such as irritation or a mild infection. If the pain persists or worsens, it would be advisable to consult a healthcare provider for further evaluation.


Pregnancy Risks
Given the timing of your actions and the subsequent bleeding, the risk of pregnancy is low. However, no contraceptive method is 100% effective, and there are a few considerations to keep in mind:
1. Follow-Up Testing: If your next menstrual period is delayed by more than a week, it would be prudent to take a home pregnancy test. This will help clarify whether you are pregnant or if your body is simply adjusting to the hormonal changes.

2. Multiple Factors: Since you have polycystic ovary syndrome (PCOS), your menstrual cycle may already be irregular. This can complicate the interpretation of any bleeding or missed periods. PCOS can also affect the effectiveness of hormonal contraceptives, so it's essential to monitor your symptoms closely.

3. Consultation with a Healthcare Provider: If you have ongoing concerns about your symptoms or the possibility of pregnancy, it is advisable to consult with your healthcare provider. They can perform a blood test to measure levels of human chorionic gonadotropin (hCG), which is the hormone produced during pregnancy, and provide personalized advice based on your medical history and current treatment for PCOS.


Conclusion
In summary, the bleeding you are experiencing after taking the emergency contraceptive pill is likely withdrawal bleeding rather than a sign of pregnancy. However, due to the complexities of PCOS and the potential for irregular cycles, it is essential to remain vigilant about your symptoms. If you have any doubts or if your symptoms change, seeking medical advice is always the best course of action. Your healthcare provider can offer guidance tailored to your specific situation and help ensure your reproductive health is managed effectively.

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Hello, the two should be unrelated. If you still have discomfort, it is recommended to see a gynecologist. Wishing you good health.

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