Delayed Periods After Emergency Contraception: What to Know

Menstruation is delayed by one month?

Hello, doctor.
I am feeling quite anxious, so I wanted to ask a question.
On September 14, I had intercourse with my girlfriend, but the condom broke.
There was no ejaculation inside, and she took emergency contraception.
Her estimated next menstrual period was on September 26, but she started her period early on September 23, which lasted for six days.
She mentioned that the flow, cycle, and duration were all normal for her period.
The app predicted her next period in October would start around October 21, but as of today, October 23, it is two days late, and she reports no discomfort or any signs of pregnancy.
I would like to ask the doctor if there is still a possibility of pregnancy in this situation.
Additionally, I would like to know if taking second-generation emergency contraception can cause menstrual irregularities afterward.
My girlfriend and I are feeling very anxious about this, and I would appreciate your opinion.
Thank you for your hard work, doctor.

CY, 20~29 year old female. Ask Date: 2023/10/23

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraceptive pills, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, ovulation, pregnancy, and breastfeeding, among others.
It is advisable to consult a gynecologist if symptoms persist or worsen to determine if there is a hormonal imbalance or other underlying causes.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2023/10/23

More Info

When it comes to understanding delayed periods after emergency contraception, it's important to consider several factors that can influence menstrual cycles and the potential for pregnancy. In your case, you mentioned that on September 14, you had sexual intercourse with your girlfriend, during which the condom broke, but there was no ejaculation inside her. Following this, she took emergency contraception (the "morning-after pill"). Her expected period was due on September 26, but she experienced bleeding starting on September 23, which lasted for six days and was described as normal in terms of flow and duration.

First and foremost, it’s crucial to understand how emergency contraception works. Emergency contraceptive pills (ECPs) are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They are most effective when taken as soon as possible after the incident, ideally within 72 hours, but can be taken up to 120 hours after. ECPs primarily work by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus.
The bleeding your girlfriend experienced starting on September 23 could be a side effect of the emergency contraception. It’s not uncommon for ECPs to cause changes in menstrual cycles, including earlier or later periods, as well as changes in flow and duration. The hormonal changes induced by the pill can lead to what is known as "withdrawal bleeding," which may resemble a period but is not necessarily a sign of a regular menstrual cycle.

Now, regarding the delayed period you mentioned, where her expected period for October was due on the 21st but has not yet arrived as of the 23rd, there are a few considerations:
1. Timing of Ovulation and Menstrual Cycle Variability: The use of emergency contraception can disrupt the normal hormonal balance, leading to irregularities in the menstrual cycle. If her cycle is typically regular, the hormonal changes from the ECP may have caused a delay in her next period. It’s also important to note that menstrual cycles can naturally vary from month to month due to stress, changes in weight, illness, or other factors.

2. Pregnancy Possibility: Given that there was no ejaculation and the emergency contraception was taken, the likelihood of pregnancy is quite low. However, no contraceptive method is 100% effective, and if there is still concern, it may be prudent for her to take a home pregnancy test. These tests are most reliable when taken after a missed period.

3. Consultation with a Healthcare Provider: If her period does not arrive within a week or if there are any other concerns, it would be advisable for her to consult with a healthcare provider. They can perform a pregnancy test and assess her overall reproductive health.

In summary, while the likelihood of pregnancy seems low given the circumstances, the use of emergency contraception can lead to temporary changes in menstrual cycles. It’s essential to monitor her cycle and take a pregnancy test if her period does not arrive soon. If there are any further concerns or symptoms arise, seeking medical advice is always the best course of action.

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