Post-Pill Bleeding: Side Effects or Early Menstruation? - Obstetrics and Gynecology

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Postcoital bleeding after taking emergency contraception?


Hello doctor, my last menstrual period was from September 5 to September 11.
I had intercourse with my boyfriend on the 18th, and the condom broke, but there was no ejaculation.
Since my menstrual cycle has been irregular last month, my ovulation period was also uncertain, so I took emergency contraception (Plan B) 5 hours after the incident.
On the 25th, I experienced bleeding, and it has continued until today, with a flow similar to my menstrual period.
I would like to know if this is a side effect of the emergency contraception or if my period has come early.
If it is a side effect, when can I expect my next period? Thank you for your response.

Niming, 20~29 year old female. Ask Date: 2021/09/30

Dr. Cao Guotao reply Obstetrics and Gynecology


Hello, it may be related to taking the emergency contraceptive pill.
If the pregnancy test is negative, you can just monitor the situation.
Wishing you good health.

Reply Date: 2021/09/30

More Info


When it comes to understanding post-pill bleeding, it's essential to differentiate between side effects of the emergency contraceptive pill (ECP) and the onset of menstruation. Based on your situation, you took the ECP five hours after an incident where the condom broke, which is a responsible action to prevent unintended pregnancy.
The bleeding you are experiencing after taking the ECP can be attributed to several factors. First, it is important to note that ECPs, such as the one you took, can cause changes in your menstrual cycle. These changes may include spotting or bleeding that can occur shortly after taking the pill. This is often referred to as "breakthrough bleeding" and is a common side effect of hormonal contraceptives, including ECPs.
In your case, since you experienced bleeding starting on the 25th, which is about a week after taking the ECP, it could be a side effect of the medication. ECPs can cause your next period to arrive earlier or later than expected, and the bleeding may not necessarily indicate that your menstrual cycle is returning to its regular pattern. Instead, it could be a response to the hormonal changes induced by the ECP.
Regarding the volume of bleeding, if it resembles your typical menstrual flow, it is possible that this is an early onset of your period. However, the timing of your menstrual cycle can be unpredictable, especially after taking hormonal medications. Generally, if the bleeding is similar to your regular menstrual flow and lasts for several days, it could indicate that your period has arrived early.

As for when your next period will come, it can be difficult to predict after taking an ECP. Hormonal fluctuations can cause your cycle to be irregular for a month or two following the use of emergency contraception. If the bleeding you are experiencing is indeed your period, you can expect your next cycle to follow the usual pattern, but it may take some time to stabilize.

If you are concerned about the nature of the bleeding or if it continues beyond a week, it is advisable to consult with a healthcare provider. They can provide a more personalized assessment based on your medical history and current symptoms. Additionally, if you experience any severe pain, heavy bleeding, or other concerning symptoms, seek medical attention promptly.

In summary, the bleeding you are experiencing could be a side effect of the ECP or an early period. It's common for hormonal contraceptives to cause changes in your menstrual cycle, including breakthrough bleeding. If the bleeding resembles your normal menstrual flow and lasts for several days, it may be your period. However, if you have any concerns or if the bleeding persists, consulting a healthcare provider is the best course of action.

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