Pre-Contraceptive Pill Bleeding: Causes and Concerns

Bleeding after taking emergency contraceptive pills?

Hello, doctor.
My period started on September 5th, and I went to the obstetrics and gynecology clinic to get emergency contraception.
The doctor advised me to start taking it on September 7th.
I had sexual intercourse before September 5th, and we used condoms throughout.
I took the pill every day, usually around 11 or 12 PM, but one day I took it later, around 2 AM.
By September 10th, my period seemed to have stopped.
On September 13th, when I wiped in the afternoon, I noticed a pinkish discharge about the size of a five-dollar coin, but I’m not sure if it was spotting since they seemed to stick together.
Then, on the evening of September 18th, my boyfriend inserted his finger, and I bled again, this time also pinkish.
The next day, when I wiped after using the restroom, there was a little bit of pink discharge, and this morning, September 19th, after using the restroom, there was a more noticeable amount of pink discharge, about the size of a panty liner.
(The emergency contraception I took was Ella, prescribed by the clinic.) I would like to ask: 1.
What does this bleeding mean? 2.
Is this related to sexual intercourse? 3.
What should I be aware of? 4.
Could this indicate pregnancy?

X, 10~19 year old female. Ask Date: 2022/09/20

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is possible that the dosage of the birth control pill is too low.
Finish this pack of birth control pills and try taking another one next month to see if there is any improvement.
If the same issue persists, I recommend trying a different brand of birth control pill.
Wishing you good health.

Reply Date: 2022/09/20

More Info

Understanding pre-contraceptive pill bleeding can be quite complex, especially when considering the various factors that can influence menstrual cycles and bleeding patterns. Based on the information provided, let's address your questions and concerns regarding the bleeding you experienced after starting the contraceptive pill.

1. What does this bleeding mean?
The bleeding you are experiencing, particularly the pinkish discharge, could be attributed to several factors. One common reason for light spotting or bleeding after starting a new contraceptive pill is hormonal adjustment. When you begin taking hormonal contraceptives, your body may take some time to adjust to the new hormone levels, which can lead to breakthrough bleeding or spotting. This is especially common in the first few months of starting a new contraceptive method. The pink color of the discharge suggests that it may be old blood mixed with cervical mucus, which is not uncommon.

2. Is this related to sexual activity?
While the timing of your bleeding coincides with sexual activity, it is essential to differentiate between bleeding caused by hormonal changes and bleeding due to physical irritation or trauma. If your partner used fingers during intercourse, it is possible that this could have caused minor irritation to the vaginal walls, leading to light bleeding. However, if the bleeding persists or is accompanied by pain, it would be prudent to consult a healthcare provider to rule out any injuries or infections.

3. What should I pay attention to?
It is important to monitor the bleeding pattern over the next few weeks. If the spotting continues beyond a few cycles or becomes heavier, you should consult your healthcare provider. Additionally, keep an eye out for any other symptoms such as severe abdominal pain, unusual discharge, or fever, which could indicate an infection or other complications. It is also essential to ensure that you are taking the contraceptive pill consistently and at the same time each day to maintain its effectiveness.

4. Does this indicate pregnancy?
The likelihood of pregnancy is low, especially since you have been using condoms consistently during sexual activity. However, no contraceptive method is 100% effective, and if you have concerns about potential pregnancy, consider taking a home pregnancy test if your next period is late or if you experience any other pregnancy symptoms. It is also worth noting that some women may experience light bleeding or spotting in early pregnancy, but this is typically different from the bleeding associated with starting a new contraceptive pill.

In summary, the pinkish discharge you are experiencing is likely a result of hormonal adjustments from starting the contraceptive pill. It is essential to monitor your symptoms and consult a healthcare provider if you have any concerns or if the bleeding persists. Remember that while hormonal contraceptives can regulate menstrual cycles, they can also lead to irregularities in the initial months of use. Maintaining open communication with your healthcare provider will help you navigate any concerns regarding your reproductive health.

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