Emergency Contraception: Effectiveness and Menstrual Irregularities

Emergency contraceptive pill

On July 5, 2022, I took emergency contraception, and my period started on July 10 and ended on July 16.
Then, I had my next period on August 6, which ended on August 12.
After that, on August 23, I had sexual intercourse using a condom, but after finishing, the male partner withdrew and I noticed a white chunk fell onto the bed.
I asked him if that chunk was his or mine, and after smelling it, I confirmed it was his.
I want to know if, after intercourse, if the semen inside the condom could overflow and leak out due to pressure, since a chunk fell on the bed.
I took emergency contraception once, but I still haven't gotten my period.
Was the emergency contraception effective? I also want to ask about my irregular menstrual cycle; I previously consulted a gynecologist and was diagnosed with polycystic ovary syndrome (PCOS).
When is my ovulation period? I'm being more detailed because I'm worried since my period hasn't come yet, and I have been experiencing some discharge.
Could you please help me with these questions? Thank you.

Zhuang Xiaojie, 20~29 year old female. Ask Date: 2022/09/08

Dr. Huang Yuande reply Obstetrics and Gynecology

From your description, it's difficult to determine what the "white lump" is; it could simply be vaginal discharge and not necessarily semen leakage.
Whether pregnancy has occurred can be confirmed with a pregnancy test.
If it's polycystic ovary syndrome (PCOS), using birth control pills can actually be a "two-for-one" solution.

Reply Date: 2022/09/08

More Info

Emergency contraception (EC) is a method used to prevent pregnancy after unprotected sexual intercourse or contraceptive failure, such as a broken condom. The effectiveness of EC, particularly hormonal options like levonorgestrel (Plan B) or ulipristal acetate (ella), is highest when taken as soon as possible after the incident, ideally within 72 to 120 hours, depending on the specific medication.
In your case, you mentioned taking an emergency contraceptive pill on July 5, and your menstrual cycle appeared to resume normally afterward, with your period starting on July 10 and ending on July 16. This suggests that the emergency contraception was effective in preventing pregnancy from the incident prior to your menstrual cycle.
Regarding your concern about the white substance that fell on the bed after intercourse, it is possible for semen to leak out of a condom if it is overfilled or if the condom is not fitted properly. However, if the condom was used correctly and there were no visible tears or breakage, the risk of pregnancy is significantly reduced. It is important to ensure that condoms are used properly to minimize the risk of leakage.

As for your menstrual irregularities, it is not uncommon for women to experience changes in their menstrual cycle after taking emergency contraception. Hormonal fluctuations can lead to delayed periods, lighter or heavier bleeding, or even spotting. Since you have a history of polycystic ovary syndrome (PCOS), this condition can also contribute to irregular menstrual cycles and make it more challenging to predict ovulation. Women with PCOS often experience anovulatory cycles, which can lead to missed periods or unpredictable cycles.

To determine your ovulation period, you can track your menstrual cycle over several months. Ovulation typically occurs about 14 days before your next expected period, but this can vary widely, especially in women with irregular cycles. Monitoring signs of ovulation, such as changes in cervical mucus or basal body temperature, can also help identify your fertile window.

If your period does not arrive within a week or two of when you expect it, consider taking a home pregnancy test to rule out pregnancy. If the test is negative and your period remains absent, it may be beneficial to consult with a healthcare provider for further evaluation, especially given your history of PCOS. They can provide guidance on managing your menstrual irregularities and discuss potential treatment options if necessary.

In summary, emergency contraception is effective, especially when taken promptly. Your menstrual irregularities may be influenced by both the emergency contraception and your underlying condition of PCOS. If you have ongoing concerns about your menstrual cycle or potential pregnancy, seeking medical advice is recommended for personalized care and management.

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