Impact of Acute Gastroenteritis on Emergency Contraceptive Effectiveness

Gastroenteritis and Emergency Contraceptive Pills

Hello, doctor.
I am on the fifth day of my period this month and was planning to take my first oral contraceptive pill of the month (I have been taking them for six months already) when I developed acute gastroenteritis.
After experiencing diarrhea, I went to see a doctor and then took my first pill of the month.
I did not have a bowel movement for the next three days.
Later, on the fifth day after taking the pill, I had unprotected intercourse with my boyfriend, but he did not ejaculate inside.

I would like to ask:
1.
What is the likelihood of pregnancy from the unprotected intercourse on the fifth day?
2.
Will the effectiveness of the oral contraceptive be affected by this situation? Do I need additional protection?

Ji Wa Wa, 20~29 year old female. Ask Date: 2022/03/16

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it should still be safe.
Do not take emergency contraception.
Wishing you good health.

Reply Date: 2022/03/16

More Info

Acute gastroenteritis can significantly impact various aspects of health, including the effectiveness of emergency contraceptive pills (ECPs). In your case, you experienced acute gastroenteritis just before taking your scheduled oral contraceptive, which raises important considerations regarding the timing and absorption of the medication.

1. Risk of Pregnancy After Unprotected Intercourse: The risk of pregnancy from unprotected intercourse largely depends on the timing of ovulation in your menstrual cycle. If you were on the fifth day of your menstrual cycle, it is generally considered a low-risk time for pregnancy, as ovulation typically occurs around the middle of the cycle (approximately day 14 in a standard 28-day cycle). However, sperm can survive in the female reproductive tract for up to five days, so if you were close to ovulating, there could still be a risk of pregnancy.

2. Effectiveness of Emergency Contraceptive Pills: The effectiveness of ECPs can be influenced by gastrointestinal issues such as vomiting or diarrhea. If you had significant diarrhea shortly after taking the contraceptive pill, it could potentially affect the absorption of the medication. Most ECPs are designed to be effective when taken as directed, but if gastrointestinal symptoms occur within two hours of ingestion, the pill may not be fully absorbed. Since you mentioned that you did not have any bowel movements for three days after taking the pill, it is likely that the medication was absorbed properly. However, if you experienced severe diarrhea shortly after taking the pill, it would be prudent to consult with a healthcare provider for further advice.

3. Additional Protective Measures: Given the circumstances, it is advisable to consider additional protective measures. If you are concerned about the effectiveness of the ECP due to your recent gastrointestinal illness, using a backup method of contraception, such as condoms, until your next period can provide extra reassurance. Additionally, if you experience any unusual symptoms or have concerns about potential pregnancy, taking a home pregnancy test after a missed period or consulting with a healthcare provider would be wise.

In summary, while the risk of pregnancy may be lower during the early days of your cycle, the effectiveness of the emergency contraceptive could be compromised if gastrointestinal symptoms affected absorption. It is always best to err on the side of caution and consult with a healthcare professional for personalized advice based on your specific situation. They can provide guidance on the best course of action moving forward, including whether additional contraceptive measures are necessary.

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