Emergency Contraception and Its Impact on Irregular Cycles

Post-coital contraception issues

Hello Doctor: I have a history of infertility, irregular menstruation, and anovulation (all of which have been verified through hospital visits).
During sexual intercourse today, I was using a condom, but later discovered it had broken.
Within an hour, I took Ella (emergency contraception), and subsequently tested for ovulation with an ovulation test strip within four hours, which showed negative for ovulation.
Previously, I took Shiton for menstrual regulation from May 28 to June 3 and from June 27 to June 29, which resulted in my menstrual periods occurring from June 5 to June 10 and from July 1 to July 7 (I typically do not ovulate during my periods, as I have vaginal ultrasounds done at the gynecologist after my periods, and the doctor indicated that I do not ovulate and that the lack of ovulation has led to the presence of polyps in the endometrium).
I plan to take Shiton for the third time on July 19.
I would like to ask: 1.
What is the likelihood of pregnancy? 2.
Will this affect my future Shiton treatment and menstrual cycle? Thank you.

Māo māo, 30~39 year old female. Ask Date: 2021/07/12

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
For pregnancy concerns, please perform 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 advisable to consult a gynecologist for examination and evaluation.
3.
Hormonal medications vary in usage depending on their intended purpose, and their concurrent use can easily lead to menstrual cycle irregularities.

Reply Date: 2021/07/12

More Info

Emergency contraception, such as Ella (ulipristal acetate), is designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. It works primarily by delaying or inhibiting ovulation, which is crucial in preventing fertilization. Given your history of irregular cycles and anovulation, it’s essential to understand how this medication may interact with your existing conditions and treatment plans.

1. Pregnancy Probability: The likelihood of pregnancy after taking emergency contraception like Ella is generally low, especially when taken within the recommended time frame (up to 120 hours after unprotected intercourse). However, since you have a history of irregular cycles and anovulation, it is crucial to consider that your body may not respond predictably. If you had no ovulation detected via your ovulation test, the chances of pregnancy are significantly reduced. However, if you have irregular cycles, it’s possible that ovulation could occur later than expected, which might complicate the situation.
2. Impact on Future Treatment and Menstrual Cycle: Taking Ella can cause temporary changes in your menstrual cycle. Some women may experience a delay in their next period, while others might have it earlier than expected. Given that you are also planning to take Shiton (a medication used for regulating menstrual cycles), it’s important to note that emergency contraception can potentially alter the effectiveness of your ongoing treatment. The hormonal changes induced by Ella may lead to unexpected bleeding or changes in the timing of your menstrual cycle, which could affect how Shiton works for you.

In terms of your upcoming Shiton treatment, it is advisable to consult with your healthcare provider. They can provide personalized guidance based on your medical history and current situation. It’s essential to communicate openly about your recent use of emergency contraception and any changes you notice in your cycle or symptoms.
Additionally, since you have been diagnosed with conditions such as anovulation and endometrial polyps, it’s crucial to monitor your symptoms closely. If you experience significant changes in your menstrual cycle, unusual bleeding, or any other concerning symptoms, you should seek medical advice promptly.
In conclusion, while the immediate risk of pregnancy after taking Ella is low, your irregular cycles and ongoing treatment with Shiton warrant careful monitoring and communication with your healthcare provider. They can help you navigate any potential impacts on your menstrual cycle and overall reproductive health.

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