Emergency Contraception: Symptoms and Pregnancy Concerns

Post-coital contraception-related issues?

Hello Doctor, my girlfriend had her period end on February 2nd and we had unprotected intercourse with ejaculation on February 4th.
She took the emergency contraceptive pill, Levonorgestrel, within 24 hours (on February 5th).
From February 8th to February 10th, she experienced bleeding that resembled her menstrual period.
Since then, her period has not arrived, and she has been experiencing symptoms such as drowsiness, breast pain, uterine pain, and abdominal discomfort.
I have read some information stating that emergency contraceptive pills can cause irregular menstrual cycles, and that if bleeding occurs 2-7 days after taking the pill, the next period should be calculated from the days of that bleeding as the start of a new cycle.
I would like to ask if this is accurate, whether she could be pregnant, when would be the best time to take a pregnancy test, and if there are any other possible conditions or things to watch out for.
I would appreciate your assessment, Doctor.

Xiao Ming, 20~29 year old female. Ask Date: 2023/03/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you should come around March 8th for observation; it is likely that you are not pregnant.
Wishing you good health.

Reply Date: 2023/03/06

More Info

Emergency contraception, such as the pill you mentioned (often referred to as Plan B or similar brands), is designed to prevent pregnancy after unprotected intercourse or contraceptive failure. It is most effective when taken as soon as possible after the event, ideally within 72 hours, but can be taken up to 5 days after. In your case, your girlfriend took the emergency contraceptive pill (ECP) within 24 hours, which is a good decision for reducing the risk of unintended pregnancy.

The symptoms you described—breast tenderness, abdominal discomfort, and changes in menstrual bleeding—are common side effects of emergency contraception. These side effects can occur due to the hormonal changes induced by the ECP. It is not unusual for the ECP to cause irregular bleeding or spotting, which can sometimes be mistaken for a menstrual period. The bleeding that occurred between February 8 and 10 could be a side effect of the ECP rather than a regular menstrual period.

Regarding your question about the timing of the next menstrual cycle, it is true that emergency contraception can disrupt the regular menstrual cycle. After taking the ECP, the next period may come earlier or later than expected. If the bleeding you observed was indeed a side effect of the ECP, it may not be counted as the start of a new cycle. Therefore, it is possible that the next period could be delayed.

As for the concern about pregnancy, if your girlfriend has not had her period by the expected date, it would be advisable to take a home pregnancy test. Most home pregnancy tests are accurate if taken at least one week after the missed period. If the test is positive, it is important to consult a healthcare provider for further evaluation and guidance.

In addition to pregnancy, other factors could contribute to the symptoms your girlfriend is experiencing. Stress, hormonal fluctuations, and other health conditions can also cause similar symptoms. If the symptoms persist or worsen, it would be wise for her to see a healthcare provider for a thorough evaluation.

In summary, while the symptoms your girlfriend is experiencing could be related to the emergency contraception, it is essential to monitor her menstrual cycle and take a pregnancy test if her period does not arrive as expected. If there are any concerns or if the symptoms are severe, seeking medical advice is always a prudent choice.

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