Emergency Contraceptive Pills: Side Effects and Pregnancy Concerns

Emergency contraceptive pill

Hello, Doctor.
I had unprotected intercourse with my boyfriend on October 27, and about four hours later, I took emergency contraception.
I was already feeling unwell, so I wasn't sure if my discomfort that day was a side effect of the medication.
The next morning, I used an ovulation test, which indicated that I was not ovulating.
Since then, I've occasionally experienced lower abdominal pain similar to menstrual cramps, but it would go away after a while.
On the evening of November 3, around 7:25 PM, I noticed dark brown spotting and thought my period had started, but after about three hours, I found that it had stopped.
However, when I wiped after using the restroom, there was still some red discharge, similar to what I experience during my period.
Later that night, around 11 PM, I used a sanitary pad, and by about 3:30 AM, I checked and saw only a small amount of dark brown blood, resembling the end of my period.
Since I noticed the spotting, I have continued to experience lower abdominal pain.
I would like to know if this could be a side effect of the emergency contraception.
My last period started on October 11 and ended around the 17th or 18th, and I expect my next period around November 10 or 11.
Is there a possibility that I could be pregnant? If I want to take a pregnancy test, when would be the best time to do so? I apologize for asking so many questions, but I am really worried and scared, so I appreciate any help you can provide.
Thank you.

Niming, 20~29 year old female. Ask Date: 2021/11/04

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, bleeding may be related to taking emergency contraceptive pills.
Generally, a pregnancy test can be taken 12 days after sexual intercourse.
Please wait a bit longer, and if you still experience discomfort in the lower abdomen, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2021/11/04

More Info

Emergency contraceptive pills (ECPs) are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They are most effective when taken as soon as possible after the incident, ideally within 72 hours, but some types can be taken up to 5 days later. The most common ECPs contain either levonorgestrel or ulipristal acetate. While these pills are generally safe, they can cause side effects, which may lead to confusion about whether one is experiencing normal reactions to the medication or symptoms of early pregnancy.

In your case, you took the emergency contraceptive pill approximately four hours after unprotected intercourse. This timing is favorable for the effectiveness of the pill. Common side effects of ECPs include nausea, fatigue, headache, dizziness, breast tenderness, and changes in menstrual bleeding patterns. The abdominal pain you are experiencing could be related to the hormonal changes induced by the ECP, as they can cause your body to react similarly to what it would during a menstrual cycle.
The bleeding you described—dark brown discharge followed by a lighter flow—could be a side effect of the emergency contraceptive pill. This type of bleeding is often referred to as "breakthrough bleeding," which can occur when the hormonal levels in your body are altered. It is also possible that this bleeding is an early indication of your upcoming menstrual cycle, especially since your last period was on October 11, and you expect your next one around November 10-11.

Regarding your concerns about pregnancy, the fact that you took the ECP shortly after the incident significantly reduces the likelihood of pregnancy. However, no contraceptive method is 100% effective. If you are still concerned about the possibility of being pregnant, the best time to take a pregnancy test is after your expected period date. This is typically around two weeks after potential conception, as this allows enough time for the hormone hCG (human chorionic gonadotropin) to build up in your urine if you are pregnant.

If your period does not arrive as expected, or if you experience any unusual symptoms, it would be wise to consult with a healthcare provider. They can provide further guidance and may recommend a blood test for pregnancy, which is more sensitive than a urine test and can detect pregnancy earlier.

In summary, the symptoms you are experiencing are likely side effects of the emergency contraceptive pill rather than signs of pregnancy. Monitor your symptoms, and if you have any concerns or if your bleeding pattern changes significantly, do not hesitate to reach out to a healthcare professional for personalized advice.

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