Withdrawal Bleeding After Taking Emergency Contraceptive Pills

Withdrawal bleeding after taking emergency contraception?

Hello, doctor.
My girlfriend and I had intimate contact without protection on the afternoon of December 31st.
There was no penetration or friction, but there was brief contact between our genitals.
On January 1st at 7:30 AM, I gave her emergency contraception (Plan B).
She started bleeding on January 7th and 8th, with a flow similar to menstruation, and she is experiencing lower back pain and fatigue.
I would like to know if this could be withdrawal bleeding.
If so, what is the likelihood of pregnancy?

Niming, 20~29 year old female. Ask Date: 2023/01/08

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the effects of emergency contraceptive pills on menstruation can vary; they may cause your period to come earlier or later.
Additionally, their contraceptive effectiveness is not 100%, with a failure rate of about 3%.
If you are uncertain whether the bleeding is your period, it is advisable to consult a physician to check for pregnancy.
Thank you! Wishing you safety and health.
Dr.
Chang

Reply Date: 2023/01/08

More Info

Withdrawal bleeding after taking emergency contraceptive pills (ECPs) is a common occurrence and can often be mistaken for a menstrual period. In your case, since your girlfriend took the emergency contraceptive pill (commonly known as Plan B or "morning-after pill") shortly after the intimate encounter, the bleeding she experienced on January 7 and 8 could indeed be classified as withdrawal bleeding.

ECPs work primarily by preventing ovulation. If taken within a certain timeframe after unprotected intercourse, they can significantly reduce the chances of pregnancy. The bleeding that occurs after taking ECPs is a result of the hormonal changes induced by the medication. It typically occurs within a week or two after taking the pill and can vary in flow and duration. The symptoms of cramping, fatigue, and lower back pain that your girlfriend is experiencing are also common side effects of ECPs and can mimic premenstrual symptoms.

To address your concerns regarding the likelihood of pregnancy: since the emergency contraceptive pill was taken shortly after the exposure, and considering that there was no penetration or significant friction, the chances of pregnancy are quite low. The withdrawal bleeding is a good indication that the body is responding to the hormonal changes, and it suggests that ovulation was likely prevented.

However, it is important to note that while ECPs are effective, they are not 100% guaranteed to prevent pregnancy. If your girlfriend's period is significantly delayed beyond the expected time frame (usually within 3 weeks after taking the pill), it would be advisable for her to take a pregnancy test to confirm whether or not she is pregnant.

In terms of follow-up care, if the withdrawal bleeding is heavy or accompanied by severe pain, it would be prudent for her to consult a healthcare provider. They can provide further evaluation and reassurance, as well as discuss any ongoing concerns regarding menstrual irregularities or side effects from the ECP.

In summary, the bleeding your girlfriend is experiencing is likely withdrawal bleeding due to the emergency contraceptive pill, and the chances of pregnancy are low given the circumstances. Monitoring her menstrual cycle in the coming weeks will be important, and if there are any concerns, seeking medical advice is always a good step.

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