Impact of Taking Emergency Contraceptive Pills During Menstruation

Taking emergency contraceptive pills during menstruation?

On August 25, I had unprotected sexual intercourse with my boyfriend on the second day of my menstrual period.
Although the chances of getting pregnant during menstruation are low, I still bought emergency contraception out of concern for any possibility.
After taking the pill, starting on August 27, my menstrual flow became very light, but there was still some spotting.
After my period ended, I had sexual intercourse twice, both times using condoms.
As of today, September 29, my period has not arrived.
Is there a possibility that I could be pregnant? What effects does taking emergency contraception during my menstrual period have?

Miss Chen, 10~19 year old female. Ask Date: 2021/09/29

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
Please wait another week, and if there is still no change, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2021/09/29

More Info

Taking emergency contraceptive pills (ECPs) during menstruation can have various effects, and it's important to understand how these medications work and their potential impact on your menstrual cycle.
Firstly, it's essential to clarify that ECPs, such as levonorgestrel (Plan B) or ulipristal acetate (Ella), are designed to prevent pregnancy after unprotected intercourse. They work primarily by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. When taken during menstruation, the likelihood of pregnancy is already low, as ovulation typically occurs in the middle of the menstrual cycle, and sperm can survive in the female reproductive tract for up to five days. Therefore, the risk of pregnancy from intercourse during menstruation is minimal.

However, taking ECPs can lead to changes in your menstrual cycle. It is not uncommon for individuals to experience alterations in their next period after taking ECPs. These changes can include:
1. Timing of the Next Period: Your next period may come earlier or later than expected. Some individuals report a delay in their menstrual cycle after taking ECPs, while others may experience an earlier onset.

2. Flow Changes: The flow of your menstrual period may also be affected. Some people experience lighter or heavier bleeding than usual, and spotting may occur. The slight bleeding you mentioned after taking the ECP could be a result of hormonal changes induced by the medication.

3. Pregnancy Concerns: If your period is significantly delayed (more than a week), it is advisable to take a pregnancy test to rule out pregnancy. While the chances of pregnancy are low after taking ECPs during menstruation, they are not zero, especially if ovulation occurs earlier than expected in your cycle.

4. Hormonal Effects: ECPs contain hormones that can disrupt your normal hormonal balance temporarily. This disruption can lead to symptoms such as breast tenderness, nausea, fatigue, or mood changes, which are common side effects of hormonal contraceptives.

In your case, since you had unprotected intercourse during your period and subsequently took ECPs, the likelihood of pregnancy is low. However, the changes in your menstrual cycle, such as the reduced blood flow and the delay in your next period, could be attributed to the ECPs.
If you continue to experience irregularities in your menstrual cycle or have concerns about potential pregnancy, it is essential to consult a healthcare provider. They can provide guidance, perform a pregnancy test if necessary, and discuss any further contraceptive options that may be suitable for you.

In summary, taking emergency contraceptive pills during menstruation can lead to changes in your menstrual cycle, including timing and flow. While the risk of pregnancy is low, it is advisable to monitor your cycle and consult a healthcare professional if you have concerns or if your period is significantly delayed.

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