Emergency Contraception: When and How to Use It - Obstetrics and Gynecology

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Emergency contraception (EC) is a critical option for preventing unintended pregnancies after unprotected sexual intercourse or contraceptive failure. Understanding when and how to use it is essential for reproductive health.

In your case, you had your menstrual period from May 14 to May 18, and you engaged in unprotected sexual intercourse on the evening of May 18, after which ejaculation occurred inside you. Given that sperm can survive in the female reproductive tract for up to five days, there is a possibility of pregnancy if ovulation occurs shortly after intercourse. Typically, ovulation occurs about 14 days before the next expected period, but this can vary based on individual cycles. If your cycle is regular and you ovulate around the midpoint, there is a chance that you could become pregnant from this encounter.

Regarding the use of emergency contraception, it is most effective when taken as soon as possible after unprotected intercourse. There are two main types of emergency contraceptive pills (ECPs): levonorgestrel (Plan B One-Step and others) and ulipristal acetate (Ella). Levonorgestrel is most effective within 72 hours (3 days), while ulipristal acetate can be effective up to 120 hours (5 days) after unprotected intercourse. If you are within this time frame, it is advisable to take an emergency contraceptive pill.

If you decide to take an emergency contraceptive pill, it is important to note that the bleeding you may experience afterward can vary. Some women experience withdrawal bleeding, which can be similar to a menstrual period, while others may have lighter or irregular bleeding. This bleeding is typically not considered a new menstrual period but rather a side effect of the hormonal changes induced by the emergency contraceptive. If you take the pill and experience bleeding within a few days, it may indicate that the pill has worked, but it is not a definitive sign of pregnancy or non-pregnancy.

If your next period is delayed by more than a week after the expected date, it is recommended to take a pregnancy test to confirm whether or not you are pregnant. Additionally, if you have any concerns or experience unusual symptoms, consulting a healthcare provider is advisable for personalized guidance.

In summary, based on your timeline, there is a possibility of pregnancy, and using emergency contraception is a prudent option if you wish to prevent it. The bleeding following the use of emergency contraception can be a side effect and may not necessarily indicate the start of a new menstrual cycle. Always consult with a healthcare professional for tailored advice and support regarding reproductive health and contraception.