Prolonged Menstrual Bleeding After Emergency Contraception

Abnormal menstruation not stopping?

Hello doctor, my menstrual period was from July 1 to July 9, with a regular cycle of 26 days.
I had unprotected intercourse on July 17 and took emergency contraception immediately afterward.
My period was delayed by one day and started on July 28, but it has been ongoing and seems like it won't stop.
What could be the reason for this?

zero, 30~39 year old female. Ask Date: 2023/08/06

Dr. Chen Zhiyu reply Obstetrics and Gynecology

It is recommended to seek medical evaluation.
Thank you.

Reply Date: 2023/08/06

More Info

Prolonged menstrual bleeding after taking emergency contraception is a concern that many women may experience. Emergency contraceptive pills (ECPs), such as Plan B (levonorgestrel) or Ella (ulipristal acetate), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. While they are effective in preventing pregnancy, they can also cause changes in menstrual patterns, including prolonged bleeding.

When you take emergency contraception, it can disrupt your normal hormonal cycle. ECPs work primarily by delaying ovulation, but they can also affect the endometrial lining and alter the menstrual cycle. This disruption can lead to various outcomes, including irregular bleeding, spotting, or even a heavier than normal period. In your case, since you experienced a normal menstrual cycle prior to taking the emergency contraception, the prolonged bleeding you are experiencing could be a result of the hormonal changes induced by the medication.

It is important to note that while some women may experience heavier bleeding or prolonged periods after taking ECPs, this is generally not a cause for alarm. However, if the bleeding is excessively heavy (soaking through a pad or tampon every hour for several consecutive hours), or if you experience severe pain or other concerning symptoms, it is crucial to seek medical attention. These could be signs of complications such as an ectopic pregnancy or other underlying conditions that may require treatment.

In terms of management, if the bleeding is not excessively heavy and you are otherwise feeling well, it may be advisable to monitor the situation for a few days. The bleeding should gradually decrease as your body readjusts to its normal hormonal cycle. Staying hydrated, resting, and using over-the-counter pain relief if needed can help manage any discomfort associated with the bleeding.

If the bleeding persists beyond a week or if you have any concerns about your health, it is essential to consult with a healthcare provider. They may perform a physical examination, conduct blood tests, or perform an ultrasound to rule out any other potential issues. Additionally, they can provide guidance on what to expect in terms of your menstrual cycle moving forward and discuss any necessary follow-up care.

In summary, prolonged menstrual bleeding after taking emergency contraception can occur due to hormonal changes induced by the medication. While it is often not a cause for concern, it is essential to monitor the situation and seek medical advice if the bleeding is excessively heavy or accompanied by other worrying symptoms. Your healthcare provider can offer personalized advice and support to help you navigate this situation effectively.

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