Pregnancy Risks with Withdrawal and Emergency Contraceptives

Q: Pregnancy Risks with Withdrawal and Emergency Contraceptives

Hello, the questioner： There is a possibility of pregnancy even if ejaculation does not occur during intercourse, as pre-ejaculatory fluid may contain sperm. <br>The effectiveness of emergency contraception is not 100%, with a failure rate of about 3%. <br>Many factors can influe

The probability of pregnancy after external ejaculation combined with emergency contraception?

Hello, I had sexual intercourse on September 25th with withdrawal method and took emergency contraception (Plan B) about an hour later.
I took the pill again 12 hours after the first dose, using (Levonorgestrel).
The day before the intercourse, I noticed brown discharge, and as of today, October 1st, my period has not arrived.
However, I have had poor sleep habits and have been staying up late for over a month, which could cause a delay in my menstruation.
What could be the cause of the brown discharge? If I happened to be ovulating when I took the emergency contraception, would it still be effective? The withdrawal method was used for the third time; the first two times were just manual stimulation, and before the third time, I think I went to the bathroom, and then I used withdrawal.
What is the likelihood of pregnancy in this situation? (My period usually arrives at the beginning or end of the month.) Thank you, doctor.

Fu Fu, 10~19 year old female. Ask Date: 2021/10/01

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the questioner: There is a possibility of pregnancy even if ejaculation does not occur during intercourse, as pre-ejaculatory fluid may contain sperm.
The effectiveness of emergency contraception is not 100%, with a failure rate of about 3%.
Many factors can influence the menstrual cycle or cause irregular bleeding, such as age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraception, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, ovulation, pregnancy, and breastfeeding.
The impact of emergency contraception on menstruation can vary, and it may not necessarily cause periods to come early or late, and its contraceptive effectiveness is not absolute.
It is advisable to check for pregnancy if menstruation is more than a week late.
If bleeding symptoms persist or worsen, it is important to consult a gynecologist to investigate potential hormonal imbalances or other causes.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2021/10/01

More Info

When it comes to understanding pregnancy risks associated with withdrawal methods and emergency contraceptives, it is essential to consider several factors, including the timing of sexual intercourse, the effectiveness of the contraceptive method used, and individual physiological responses.

Firstly, the withdrawal method, also known as coitus interruptus, involves the male partner withdrawing before ejaculation to prevent sperm from entering the vagina. While this method can reduce the risk of pregnancy, it is not highly reliable. Pre-ejaculate fluid (pre-cum) can contain sperm, and if the withdrawal is not perfectly timed, there is still a risk of pregnancy. The effectiveness of this method varies widely, with typical use resulting in a failure rate of about 20% per year.

In your case, you mentioned that you had sexual intercourse on September 25 and used emergency contraception (the "morning-after pill") shortly after. Emergency contraceptives, such as Levonorgestrel (often referred to as Plan B or similar brands), are most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours. However, they can be effective up to 5 days after intercourse, with efficacy decreasing over time. Taking the pill within an hour of intercourse and again 12 hours later is a proactive approach and should significantly reduce the risk of pregnancy.

Regarding the brown discharge you observed before your sexual encounter, this can be attributed to several factors. Brown discharge often indicates old blood that is being expelled from the body, which can occur at various times in the menstrual cycle. It may be related to ovulation, hormonal fluctuations, or even the onset of menstruation. If your menstrual cycle is irregular or if you have been experiencing stress or changes in your routine (such as staying up late), these factors can also contribute to delayed menstruation.

As for the timing of your emergency contraception in relation to ovulation, it is important to note that emergency contraceptives work primarily by delaying ovulation. If you took the emergency contraceptive during your fertile window (the days leading up to and including ovulation), there is still a chance of pregnancy, albeit reduced. However, if ovulation has already occurred, the effectiveness of the emergency contraceptive diminishes.

In summary, while the combination of withdrawal and emergency contraception significantly lowers the risk of pregnancy, no method is foolproof. The brown discharge you experienced could be related to hormonal changes or the onset of your period, and stress or lifestyle factors can indeed delay menstruation. If your period does not arrive within a week of the expected date, it would be advisable to take a pregnancy test for confirmation. If you have further concerns or experience unusual symptoms, consulting a healthcare provider would be beneficial for personalized advice and support.

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