Emergency Contraception: FAQs on Menstrual Irregularities and Health

Emergency contraceptive pill

1.
Irregular menstruation; menstruation occurred from April 20 to April 25.
On April 26, I had unprotected intercourse with my boyfriend, and due to concerns about pregnancy, I took emergency contraception (Plan B).
I experienced bleeding from April 30 to May 5.
Is this considered a menstrual period? In retrospect, if it is a menstrual period, could it harm the uterus, as the endometrium has just shed and then is forced to shed again? In this situation, is it advisable to take emergency contraception?
2.
After having intercourse on May 27, I discovered that the condom had broken, and I had unprotected intercourse again.
I took emergency contraception three hours later.
The previous week, I noticed thick yellow discharge, which I learned in biology class is post-ovulatory discharge.
What is the likelihood of pregnancy in this case? If I want to start taking regular birth control pills, when should I begin? Should I take a pregnancy test on the eleventh day?
3.
I have a history of menstrual irregularities and was diagnosed with polycystic ovary syndrome (PCOS).
I often experience dark blood during ovulation.
After taking two boxes of a menstrual regulation medication, my periods became regular.
One of my parents is a doctor (not an OB-GYN) and believes that taking too many birth control pills can affect endocrine function, causing the body to become reliant on medication to maintain hormone levels.
After stopping the medication, my periods became irregular again after six months, and I took two more boxes to regulate them, but they became irregular again with dark blood.
What is the impact of taking birth control pills? If my periods have become regular, should I continue taking them?
4.
For menstrual irregularities, should I consult a Western medicine doctor or a Traditional Chinese Medicine practitioner? Is the only solution in Western medicine to prescribe birth control pills? It seems that Traditional Chinese Medicine can improve physical constitution.
5.
I want to consult an OB-GYN regarding issues after sexual activity, but one of my parents is a doctor.
I am concerned that my medical records will be seen.
My parents have conservative views and oppose premarital sexual activity.
Is there a way to visit an OB-GYN without my records being accessible to them?
6.
In the past, my mother took me to see an OB-GYN, and I was always asked if I had engaged in sexual activity.
If I want to regulate my menstrual cycle and my mother takes me to the OB-GYN, I will inevitably be asked this question.
However, I am hesitant to tell the truth in her presence.
Is the question of whether I have had sexual activity important for regulating my menstrual cycle? Thank you!

Hao, 20~29 year old female. Ask Date: 2022/05/27

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effects of emergency contraceptive pills on menstruation can vary; they may not necessarily cause periods to come early or late.
Additionally, their contraceptive effectiveness is not 100%, with a failure rate of about 3%.
Early pregnancy may not present specific symptoms, and subjective symptoms cannot be relied upon for diagnosis.
It is recommended to take a pregnancy test if menstruation is more than a week late.
For first-time users of contraceptive pills, it is advisable to start taking them on the first day of the menstrual cycle.
If you begin taking the pill after the second day of your period, it is recommended to use additional contraceptive measures for the first seven days of pill use.
Oral contraceptives are effective not only for preventing pregnancy but also for regulating menstrual cycles, reducing menstrual flow, and shortening the duration of menstrual bleeding, all of which contribute positively to women's health.
Due to these benefits, some clinicians may prescribe combined oral contraceptives to treat and alleviate menstrual issues such as dysmenorrhea and heavy menstrual bleeding caused by uterine fibroids or endometriosis, as well as to address endocrine disorders.
There are various methods and medications available for regulating menstruation, which can include traditional Chinese medicine, Western medicine, or a combination of both.
Medical records must be kept according to regulations, and inquiries should be assessed at the physician's discretion.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2022/05/27

More Info

Understanding emergency contraception and its implications on menstrual health is crucial, especially for individuals who may experience irregularities or have concerns about their reproductive health. Here’s a comprehensive response to your questions:
1. Menstrual Irregularities and Emergency Contraception: After taking emergency contraception (EC), it’s common to experience changes in your menstrual cycle. The bleeding you experienced from April 30 to May 5 could be a side effect of the EC, often referred to as withdrawal bleeding, rather than a regular menstrual period. EC can cause your next period to come earlier or later than expected, and it may also be lighter or heavier than usual. Regarding your concern about the uterine lining, while it’s true that EC can affect the endometrial lining, it is generally considered safe for occasional use. However, frequent use of EC is not recommended as a regular contraceptive method. If you find yourself needing EC often, it may be worthwhile to discuss more reliable contraceptive options with a healthcare provider.

2. Risk of Pregnancy After Contraceptive Failure: If you had unprotected intercourse after a condom broke and took EC within three hours, you have taken the appropriate steps to reduce the risk of pregnancy. The yellowish discharge you mentioned could be related to ovulation or hormonal changes, but it does not necessarily indicate a high risk of pregnancy. If you plan to start a regular contraceptive method (like the pill), it’s best to begin taking it at least a week before you expect your next period for optimal effectiveness. As for pregnancy testing, the best time to take a home pregnancy test is about 14 days after potential conception for the most accurate result.

3. Impact of Contraceptive Pills on Hormonal Balance: It’s understandable to be concerned about the long-term effects of hormonal contraceptives, especially if you have a history of irregular periods and polycystic ovary syndrome (PCOS). While hormonal contraceptives can help regulate your cycle, they may also mask underlying issues. If you find that your menstrual cycle normalizes with the use of contraceptives, it may be beneficial to continue under the guidance of a healthcare provider. However, if you experience adverse effects or have concerns about dependency on medication, discussing alternative treatments with a healthcare provider is advisable.

4. Consulting Healthcare Providers for Menstrual Irregularities: When it comes to menstrual irregularities, both Western and Traditional Chinese Medicine (TCM) can offer valuable insights. Western medicine often focuses on hormonal treatments, including birth control pills, while TCM may emphasize lifestyle changes, herbal remedies, and acupuncture to improve overall health and balance. It may be beneficial to explore both options and see which aligns better with your health philosophy and needs.

5. Confidentiality in Healthcare: If you are concerned about confidentiality when visiting a gynecologist, it’s important to know that healthcare providers are bound by patient confidentiality laws. You can express your concerns about privacy to your doctor, and they can take steps to ensure your records are kept confidential. If you are uncomfortable discussing certain topics in front of your parents, consider scheduling an appointment on your own or seeking a provider who understands your need for privacy.

6. Importance of Sexual History in Menstrual Health: Questions about sexual history can be sensitive, but they are often relevant in understanding menstrual irregularities. If you feel uncomfortable discussing this in front of your mother, you might consider speaking to the healthcare provider privately. You can request a moment alone with the doctor to discuss your concerns without your parent present. Being honest about your sexual history can help the doctor provide the best care tailored to your needs.

In summary, understanding the implications of emergency contraception and maintaining open communication with healthcare providers is essential for managing menstrual health. If you have ongoing concerns or irregularities, seeking professional advice tailored to your specific situation is always a good step.

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