Menstrual Delays After Taking Emergency Contraceptive Pills

Delayed menstruation after taking emergency contraceptive pills?

On January 27, menstruation started, and on February 7, sexual intercourse occurred.
The condom broke, but ejaculation was outside.
On February 8, emergency contraception was taken.
On February 15, there was some bleeding, but since then, as of March 25, menstruation has not occurred, although there are feelings of impending menstruation (such as abdominal discomfort, discharge, bloating, and constipation).
Could this be due to irregularities caused by the emergency contraception?

Wi, 10~19 year old female. Ask Date: 2023/03/25

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Hello! It is recommended to practice safe sex to reduce the risk of sexually transmitted infections, as well as to avoid unintended pregnancies.
Please monitor your menstrual cycle, and if there is a delay, you can take a home pregnancy test or visit a gynecologist for confirmation.
Thank you!

Reply Date: 2023/03/25

More Info

Emergency contraceptive pills (ECPs), commonly referred to as "morning-after pills," are designed to prevent pregnancy after unprotected intercourse or contraceptive failure, such as a broken condom. The most commonly used ECPs contain either levonorgestrel or ulipristal acetate. These medications work primarily by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. However, they can also cause temporary changes in the menstrual cycle.

In your case, you took an emergency contraceptive pill on February 8 after experiencing a contraceptive failure on February 7. Following this, you experienced some bleeding on February 15, which is not uncommon after taking ECPs. This bleeding can be a side effect of the medication and may not necessarily indicate the onset of your regular menstrual cycle.
The delay in your menstrual period until March 25, combined with the symptoms you describe—such as abdominal discomfort, changes in discharge, bloating, and constipation—can indeed be attributed to the hormonal effects of the emergency contraceptive pill. ECPs can disrupt the normal hormonal balance in the body, leading to irregularities in the menstrual cycle. It is not unusual for women to experience delayed periods, lighter or heavier bleeding, or even missed periods after taking ECPs.

It is important to note that while ECPs are effective in preventing pregnancy, they are not 100% guaranteed. If you have had unprotected intercourse and are concerned about the possibility of pregnancy, it is advisable to take a home pregnancy test if your period is more than a week late. These tests are generally reliable and can provide peace of mind.

If the pregnancy test is negative and your period still does not arrive, it may be beneficial to consult with a healthcare provider. They can help determine if there are other underlying issues affecting your menstrual cycle, such as stress, hormonal imbalances, or other medical conditions.
Additionally, if you experience severe abdominal pain, heavy bleeding, or other concerning symptoms, it is crucial to seek medical attention promptly. These could be signs of complications that require further evaluation.

In summary, the irregularities in your menstrual cycle following the use of emergency contraceptive pills are likely due to the hormonal changes induced by the medication. While this can be concerning, it is a common side effect. Monitoring your symptoms and taking a pregnancy test if your period does not arrive can help clarify your situation. If you have further concerns, do not hesitate to reach out to a healthcare professional for personalized advice and support.

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