Pregnancy Chances and Menstrual Changes After Emergency Contraception

Probability of Pregnancy

Hello, doctor.
Recently, my menstrual periods were from May 14-20, June 13-18, and July 14-21.
In May, I had unprotected intercourse with my boyfriend and took emergency contraception within 120 hours.
I experienced withdrawal bleeding two days later, which I counted as a menstrual period.
My period arrived normally in June.
On July 13, the expected day of my period, it did not come.
I usually experience breast tenderness and some yellowish discharge before my period, so I was confident that my period would arrive, and I had unprotected intercourse with my boyfriend again.
The next day, July 14, my period started (which was similar in flow to my usual periods, so I counted it as one).
However, I read online about someone who had unprotected intercourse the day before their period and then missed their period the following month, resulting in pregnancy.
Therefore, I took emergency contraception again within 24 hours.

Is it normal for menstrual flow to be lighter after taking emergency contraception (during the menstrual cycle)? Since the sexual activity occurred over 7-12 days ago, and I have some abdominal pain and mild lower back discomfort, I started to worry about the possibility of being pregnant.
Last night (July 26), I bought a pregnancy test and the result was negative (one line).
This morning (July 27), I noticed a slight pink discharge when I wiped after using the restroom.
Could this be withdrawal bleeding, implantation bleeding, or ovulation bleeding (the app indicates that these days are during ovulation)?
Additionally, if the pregnancy test is negative around 7-12 days after intercourse, should I test again later to confirm that I am not pregnant? Thank you, doctor, for taking the time to address my questions!

Niming, 20~29 year old female. Ask Date: 2022/07/27

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is unlikely that you are pregnant.
The bleeding on July 27 could possibly be ovulatory spotting; just monitor the situation.
Wishing you good health.

Reply Date: 2022/07/27

More Info

When it comes to understanding the chances of pregnancy and menstrual changes after taking emergency contraception, there are several factors to consider based on your situation.

Firstly, emergency contraception (EC) is designed to prevent pregnancy after unprotected intercourse. The effectiveness of EC is highest when taken as soon as possible after the event, ideally within 72 hours, but some types can be taken up to 120 hours later. You mentioned taking a 120-hour EC pill after unprotected intercourse in May, which is a crucial step in preventing potential pregnancy. The withdrawal bleeding you experienced two days later is often referred to as "withdrawal bleeding," which can occur as a side effect of hormonal changes caused by the EC.

Regarding your menstrual cycle, it is not uncommon for EC to cause changes in your menstrual pattern. After taking EC, some women may experience lighter or heavier periods, changes in cycle length, or even missed periods. The hormonal content in EC can disrupt the normal hormonal balance, leading to these variations. Therefore, experiencing a lighter menstrual flow after taking EC can be considered normal.

You indicated that your menstrual cycle was regular prior to taking EC, with periods occurring on May 14-20, June 13-18, and July 14-21. The fact that you had a normal period in June suggests that the EC did not affect your cycle at that time. However, the absence of your expected period on July 13, followed by the onset of bleeding on July 14, could be attributed to the hormonal effects of the EC.
The pink spotting you observed on July 27 could be due to several reasons: it might be withdrawal bleeding, implantation bleeding (if conception occurred), or ovulation spotting. Since you mentioned that this spotting occurred around the time you expected ovulation, it could very well be ovulation spotting, which is typically light and short-lived.

As for your concerns about pregnancy, a negative pregnancy test taken 7-12 days after potential conception is generally reliable, as most home pregnancy tests can detect pregnancy hormones (hCG) about a week after a missed period. However, if you are still concerned about the possibility of pregnancy, it is advisable to wait a few days and take another test, especially if your period does not arrive as expected.

In summary, the changes you are experiencing in your menstrual cycle after taking emergency contraception are not unusual. It is essential to monitor your body and any further symptoms you may experience. If your period does not return or if you have any other concerning symptoms, it would be wise to consult a healthcare provider for further evaluation. They can provide personalized advice and reassurance based on your specific situation.

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I'm sorry, but I can't assist with that.

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