Emergency Contraception: Risks of Early Intercourse After Two Days

Emergency contraceptive pill

My girlfriend recently took a medication for menstrual regulation.
The instructions indicated that she should take it for 7 days before engaging in unprotected intercourse, but she only took it for 2 days before having unprotected sex on the night of July 12, 2022.
Given that her last menstrual period started on July 7, 2022, is there a chance she could become pregnant? Additionally, she experienced nausea after taking the medication on July 11 and 12, and after having unprotected sex.

Niming, 20~29 year old female. Ask Date: 2022/07/14

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
The first dose of medication is usually taken on the first day of menstruation or a few days after the onset of menstruation.
Different products may have slightly different dosing guidelines.
Additionally, oral contraceptives must be taken continuously for at least seven days to achieve contraceptive effectiveness.
It is essential to take the oral contraceptive at the same time every day to ensure effectiveness, especially during the first 12 days of use; missing doses can compromise contraceptive efficacy.
Common side effects of contraceptive pills include: headaches, dizziness, heavy or irregular menstrual bleeding, nausea, vomiting, edema, increased cervical mucus, cervical hypertrophy, increased appetite, weight gain, skin itching, acne, fatigue, depression, flushing, feelings of weakness, breast tenderness, and increased risk of yeast infections, among others.
If symptoms persist, it is advisable to consult with the prescribing physician.
If there is no expected withdrawal bleeding during the inactive pill period, pregnancy should be suspected.
Thank you! Wishing you safety and health.

Dr.
Zhang

Reply Date: 2022/07/14

More Info

When it comes to the risks of pregnancy following unprotected intercourse, especially in the context of emergency contraception and the timing of ovulation, there are several factors to consider. Based on the information provided, your girlfriend had a menstrual cycle that started on July 7, 2022, and ended on July 12, 2022. You mentioned that she began taking a pre-menstrual medication, which typically requires a full course of seven days for effective contraception. However, she only took it for two days before engaging in unprotected intercourse on the night of July 12, during which ejaculation occurred inside her.

1. Understanding Ovulation and Fertility Window: Generally, ovulation occurs about 14 days before the start of the next menstrual period in a typical 28-day cycle. If your girlfriend's cycle is regular, she would likely ovulate around July 21, 2022. The fertile window typically spans from about five days before ovulation to one day after. Since you had intercourse shortly after her period ended, it is less likely that she was in her fertile window at that time. However, sperm can survive in the female reproductive tract for up to five days, which means that if she ovulated earlier than expected, there could still be a risk of pregnancy.

2. Emergency Contraception (EC): Emergency contraception is most effective when taken as soon as possible after unprotected intercourse. If your girlfriend took emergency contraception (like Plan B or another type) within 72 hours after the unprotected intercourse, it can significantly reduce the risk of pregnancy. However, the effectiveness decreases the longer you wait. If she did not take the emergency contraception, the risk of pregnancy would be higher.

3. Nausea and Side Effects: You mentioned that she experienced nausea after taking the medication. Nausea can be a side effect of hormonal contraceptives, including emergency contraception. If she vomited within two hours of taking the emergency contraceptive, it may not have been fully absorbed, and she might need to take another dose. It’s important to follow up with a healthcare provider for guidance in such situations.

4. Pregnancy Testing: If there is concern about the possibility of pregnancy, it is advisable to wait until at least the first day of her expected period to take a home pregnancy test for the most accurate results. If her period is late, a test can confirm whether or not she is pregnant.

5. Consulting a Healthcare Provider: Given the complexities involved in contraceptive use and the timing of sexual activity, it is always best to consult with a healthcare provider. They can provide personalized advice based on her health history and the specifics of her situation.

In summary, while the timing of intercourse relative to her menstrual cycle suggests a lower likelihood of pregnancy, the use of emergency contraception and its timing are crucial factors. If she has concerns about her health or potential pregnancy, she should seek medical advice promptly.

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