Emergency Contraceptive Pills: Timing and Effectiveness

Issues with the use of emergency contraceptive pills?

On January 29th in the afternoon, I started my menstrual period.
Five days later, on the evening of February 2nd, I took the first pill of a 21-pill pack of contraceptive pills.
At this point, it was the fifth day of my period, and the bleeding was almost gone, with only a drop or two.
I would like to know if taking the first contraceptive pill at this time (considered the sixth day of my menstrual cycle) will have contraceptive effects.
If it does have contraceptive effects, how many pills should I take to ensure effectiveness? Thank you for your response!

Miss Chen, 20~29 year old female. Ask Date: 2023/02/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you can start taking birth control pills on the fifth day of your menstrual period, and they will be effective as long as you take them.
Wishing you good health!

Reply Date: 2023/02/08

More Info

Emergency contraceptive pills (ECPs) are a crucial option for preventing unintended pregnancies after unprotected intercourse or contraceptive failure. Understanding their timing and effectiveness is essential for making informed decisions about reproductive health.

ECPs are most effective when taken as soon as possible after unprotected sex. There are two main types of emergency contraceptive pills: those containing levonorgestrel (Plan B One-Step and others) and those containing ulipristal acetate (ella). Levonorgestrel is effective when taken within 72 hours (3 days) after unprotected intercourse, while ulipristal acetate can be taken up to 120 hours (5 days) after.

In your case, you mentioned that you started your menstrual cycle on January 29 and took the emergency contraceptive pill on February 2, which is approximately five days later. Since you were near the end of your menstrual period when you took the pill, it is important to note that the effectiveness of ECPs is not significantly impacted by the timing within your menstrual cycle, as long as you are not already pregnant.
The effectiveness of ECPs can be influenced by several factors, including the timing of administration relative to ovulation. If you had unprotected intercourse during your fertile window (typically around the time of ovulation, which occurs about 14 days before your next expected period), taking the ECP can help prevent ovulation and thus reduce the risk of pregnancy. However, if ovulation has already occurred, ECPs may be less effective.

Regarding the dosage, most ECPs are designed to be taken as a single dose. For example, if you are using a levonorgestrel-based pill, you typically take one pill (1.5 mg) as soon as possible after unprotected intercourse. If you are using ulipristal acetate, you would take one pill (30 mg) as a single dose. It is crucial not to exceed the recommended dosage, as taking more than the prescribed amount does not increase effectiveness and may lead to increased side effects.

In your situation, since you took the ECP on the sixth day of your menstrual cycle, it is likely that you still have some level of protection against pregnancy, especially if you were not in your fertile window. However, if you have any concerns about the possibility of pregnancy or if your menstrual cycle is irregular, it is advisable to take a pregnancy test if your next period is delayed by more than a week.

In conclusion, taking emergency contraceptive pills shortly after unprotected intercourse is a responsible choice to prevent unintended pregnancy. The timing of your pill intake, being near the end of your menstrual period, should not significantly hinder its effectiveness. Always follow the instructions provided with the medication and consult with a healthcare professional if you have further questions or concerns about your reproductive health.

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