Why Your Period Might Be Delayed After Taking Emergency Contraceptive

If your period hasn't arrived after taking the emergency contraceptive pill,

Hello, doctor.
I apologize for coming back to ask another question, but I am really anxious.
On the night of February 27, I had unprotected intercourse with my boyfriend (no condom and no ejaculation inside).
About four hours later, I took the second-generation emergency contraceptive pill (ella).
On March 1, I experienced symptoms such as fever, fatigue, and migraine, so I took a dose of acetaminophen, and then all these symptoms disappeared.
My last three menstrual periods were on December 5, December 26, and February 3.
Since taking the emergency contraceptive pill (about 7 days ago), I have not experienced the common side effect of bleeding.
Additionally, I would like to ask if the chances of pregnancy are high in this situation, or if my anxiety and unease might be causing my missed period.
Thank you, doctor, and I wish you a wonderful day!

Nìmíng, 10~19 year old female. Ask Date: 2023/03/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
Taking emergency contraceptive pills may not necessarily cause bleeding; just monitor the situation.
Wishing you good health.

Reply Date: 2023/03/06

More Info

The delay of your menstrual period after taking emergency contraception can be attributed to several factors, including hormonal changes induced by the medication, stress, and individual physiological responses. Emergency contraceptive pills (ECPs), like Ella, contain hormones that can disrupt your normal menstrual cycle. They work primarily by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. However, these hormonal changes can also lead to irregularities in your menstrual cycle, including delays.

In your case, you took Ella approximately four hours after unprotected intercourse. This timing is crucial because the sooner you take the emergency contraceptive after unprotected sex, the more effective it is at preventing pregnancy. Given that you have not experienced the common side effect of withdrawal bleeding after taking the ECP, it is understandable to feel anxious about the possibility of pregnancy. However, the absence of bleeding does not necessarily indicate pregnancy, especially since ECPs can cause changes in your cycle.

Your previous menstrual dates indicate a cycle that is somewhat regular, but it is important to note that stress and anxiety can significantly impact your menstrual cycle. The body’s response to stress can lead to hormonal fluctuations that may delay ovulation or menstruation. Symptoms like fever, fatigue, and headaches that you experienced after taking the medication could also contribute to your overall stress levels, potentially affecting your menstrual cycle.

Regarding the likelihood of pregnancy, since you took the emergency contraceptive pill shortly after unprotected intercourse, the chances of becoming pregnant are relatively low. However, no contraceptive method is 100% effective, and it is always wise to monitor your body for any changes. If your period does not arrive within a week or two of its expected date, it would be advisable to take a pregnancy test for peace of mind.

If you find that your period is delayed beyond a reasonable timeframe, or if you have any other concerning symptoms, it is important to consult with a healthcare provider. They can provide further evaluation and guidance on your situation. Additionally, if you are experiencing significant anxiety regarding your menstrual cycle or potential pregnancy, discussing these feelings with a healthcare professional can also be beneficial.

In summary, the delay in your period could be due to the hormonal effects of the emergency contraceptive, stress, or a combination of both. It is essential to give your body some time to adjust after taking the medication, and if your period does not arrive as expected, consider taking a pregnancy test and consulting with a healthcare provider for further advice.

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