Concerns About Bleeding After Taking Emergency Contraceptive Pills

Questions related to bleeding after taking emergency contraceptive pills?

My partner has been taking Qlaira for about six months, but switched to EllaOne, recommended by the pharmacist, due to side effects last month.
During the course of taking EllaOne, she accidentally took two pills twice, which changed her original 24+4 cycle to 22+4.
She finished the last active pill on September 27, and had unprotected intercourse the following day.
A few days later, she experienced severe headaches followed by vaginal bleeding, which at first we thought was her period, but after a few days, we realized there was only bleeding that day.
Therefore, we are concerned about the possibility of pregnancy and plan to take a pregnancy test two weeks after the last intercourse.
What is the likelihood of pregnancy in this situation? Or could this just be a side effect of the medication causing minimal bleeding? Thank you.

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

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
You can wait for your period to arrive, which should happen within a week.
Wishing you good health.

Reply Date: 2023/10/03

More Info

When it comes to concerns about bleeding after taking emergency contraceptive pills, it is essential to understand the potential side effects of these medications and how they interact with the menstrual cycle. In your case, your partner has switched from one contraceptive pill to another and has experienced some unusual bleeding after a recent sexual encounter.
Firstly, it is important to note that hormonal contraceptives, including emergency contraceptive pills (ECPs), can cause changes in menstrual bleeding patterns. These changes may include spotting, lighter or heavier periods, or even missed periods. The bleeding your partner experienced could be a side effect of the hormonal changes induced by the switch from the original contraceptive pill (祈麗安) to the new one (愛莉莎), especially after the incident of taking two pills at once, which could have altered the expected hormonal balance.

The timing of the bleeding is also significant. If your partner took the last effective pill on September 27 and had unprotected intercourse the following day, it is crucial to consider the timing of ovulation. Emergency contraceptive pills are most effective when taken before ovulation occurs. If ovulation had already taken place, the likelihood of pregnancy increases. However, the bleeding that occurred shortly after could also be a withdrawal bleed due to the hormonal fluctuations from the contraceptive pills rather than an indication of pregnancy.

Regarding the concern about pregnancy, it is advisable to wait at least two weeks after the last unprotected intercourse to take a home pregnancy test. This waiting period allows enough time for the hormone hCG (human chorionic gonadotropin) to build up in the body if pregnancy has occurred, making the test more reliable.
If your partner continues to experience unusual bleeding, severe headaches, or any other concerning symptoms, it is essential to consult a healthcare provider. They can perform a thorough evaluation, including a pregnancy test and possibly an ultrasound, to rule out any complications or confirm pregnancy.

In summary, the bleeding your partner experienced could be due to the hormonal changes from switching contraceptive pills or a withdrawal bleed rather than a definitive sign of pregnancy. Monitoring her symptoms and waiting for the appropriate time to take a pregnancy test will provide clarity. If there are any doubts or persistent symptoms, seeking medical advice is always the best course of action.

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