Abnormal Menstrual Bleeding After Emergency Contraception

Menstrual irregularities

Hello: I had unprotected sexual intercourse with my girlfriend on November 18 and 19, without ejaculation inside.
On November 22, she purchased and took a second-generation emergency contraceptive pill.
She started bleeding in the afternoon on December 5, which is around the time of her normal menstrual period.
However, this time the bleeding is noticeably less than usual and has a brownish color.
Typically, her menstrual periods are regular and last 6-7 days, but this time it has significantly decreased after just 4 days.
Additionally, she experienced very severe abdominal pain for the first two days, and while in the past, taking pain medication would help a lot, this time the medication did not improve her condition at all.
I found information online indicating that implantation can also cause bleeding.
I would like to ask if this situation is due to implantation bleeding from a possible pregnancy, or if it is a result of changes in her menstrual cycle due to taking the emergency contraceptive pill? Thank you.

Gan Gan, 20~29 year old female. Ask Date: 2023/12/08

Dr. Chen Zhiyu reply Obstetrics and Gynecology

Hello, it is recommended to practice safe behaviors to reduce the risk of sexually transmitted infections, while also preventing unintended pregnancies.
Based on the description, you can either take a home pregnancy test or visit a gynecologist for evaluation.
Thank you.

Reply Date: 2023/12/08

More Info

Abnormal menstrual bleeding after taking emergency contraception can be a source of concern for many individuals. In your case, the timeline and symptoms you described suggest a few possibilities that are worth exploring.

First, it's important to understand how emergency contraceptive pills (ECPs), such as the one you mentioned, work. ECPs primarily contain hormones that can prevent ovulation, inhibit fertilization, or prevent implantation of a fertilized egg. The most common side effects of taking ECPs include changes in menstrual bleeding patterns, which can manifest as earlier or later periods, lighter or heavier bleeding, or even spotting between periods.

In your situation, your girlfriend experienced bleeding starting on December 5, which aligns closely with her expected menstrual cycle. However, the characteristics of this bleeding—being lighter than usual and accompanied by severe abdominal pain—are noteworthy. The color of the blood being more brownish could indicate older blood, which is often seen in lighter periods or spotting.

The severe abdominal pain she experienced is also significant. While some discomfort can be normal during menstruation, if the pain is more intense than usual and not relieved by over-the-counter pain medications, it could indicate other issues, such as an ovarian cyst, ectopic pregnancy, or other gynecological concerns. It's essential to monitor these symptoms closely.

Regarding the possibility of implantation bleeding, it typically occurs around the time a woman would expect her period, which can lead to confusion. Implantation bleeding is usually lighter and shorter than a regular period, but given that your girlfriend took emergency contraception, it is more likely that the bleeding is a side effect of the medication rather than implantation bleeding.

Given the combination of lighter bleeding, severe abdominal pain, and the recent use of emergency contraception, it is advisable for your girlfriend to consult a healthcare provider. A medical professional can perform a thorough evaluation, which may include a pelvic exam, ultrasound, or blood tests to rule out pregnancy or other complications.
In summary, while the bleeding could be a result of the emergency contraception, the severity of the abdominal pain and the change in bleeding patterns warrant further investigation. It is always better to err on the side of caution when it comes to reproductive health. If your girlfriend's symptoms persist or worsen, seeking medical attention promptly is crucial.

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