Is Post-Pill Bleeding a Period or Just Spotting?

Is the bleeding after taking emergency contraception considered a period?

Hello, doctor.
I inquired about emergency contraception on June 27, and my last menstrual period started on May 25.
I took the emergency contraceptive pill (Postinor) on June 27, and about four hours later, I noticed brown discharge.
On June 30, I experienced bright red bleeding (which didn't feel like the first day of my period, but the abdominal pain was similar to menstrual cramps).
From July 1 to July 3, I had dark red, thick blood (similar to my regular menstrual flow), requiring the use of sanitary pads, although the amount was less than usual.
The first day had a lighter flow, and the following 2-3 days had a heavier flow, resembling my typical menstrual pattern, but the overall volume was proportionally less than before.
I would like to know if this is considered bleeding from the emergency contraceptive or if it is my actual period.
Should I recalculate my menstrual cycle starting from June 30, or is this just bleeding, and I should wait for my next period? Thank you, doctor.

Nìmíng, 30~39 year old female. Ask Date: 2023/07/03

Dr. Huang Yuande reply Obstetrics and Gynecology

1.
The bleeding from June 30 to July 1 is likely a result of taking the emergency contraceptive pill, which is reasonable.
2.
It is difficult to confirm when the next period will occur; a general estimate would consider June 30 as the first day of the new cycle.

Reply Date: 2023/07/03

More Info

Post-pill bleeding can often be a source of confusion for many women, especially when trying to distinguish between a true menstrual period and withdrawal bleeding caused by emergency contraception. In your case, it appears that you experienced some bleeding after taking the emergency contraceptive pill (ECP) on June 27, following your last menstrual period on May 25.

When you take an emergency contraceptive pill, it works primarily by delaying ovulation and preventing fertilization. However, it can also lead to changes in your menstrual cycle. The bleeding you experienced on June 30, which started as brown discharge and then progressed to bright red blood, is likely a result of the hormonal changes induced by the ECP. This type of bleeding is often referred to as "withdrawal bleeding" and can mimic a menstrual period, but it is typically lighter and shorter in duration.

The characteristics of your bleeding—starting with a small amount of brown discharge, followed by bright red blood that was less than your usual menstrual flow—suggest that this is indeed withdrawal bleeding rather than a true menstrual period. It is common for women to experience changes in their menstrual cycle after taking emergency contraception, including lighter periods, irregular cycles, or even missed periods.

Regarding your question about when to expect your next menstrual period, it is generally recommended to start counting from the first day of withdrawal bleeding (in your case, June 30). However, since this bleeding may not be a true period, it is essential to monitor your cycle closely. If your next period does not arrive within a few weeks of the expected date, or if you experience any unusual symptoms, it would be wise to take a pregnancy test to rule out the possibility of pregnancy.

In summary, the bleeding you experienced after taking the emergency contraceptive pill is likely withdrawal bleeding rather than a true menstrual period. You should expect your next period to follow the cycle based on this bleeding, but keep in mind that hormonal fluctuations can lead to irregularities. If you have any further concerns or if your bleeding patterns continue to be irregular, consulting with a healthcare provider is advisable for personalized guidance and support.

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