Emergency Contraceptives and Herpes Concerns: Expert Q&A

Inquiries about emergency contraceptive pills and herpes-related questions?

Hello, Dr.
Chang.

1.
I had my menstrual period from January 10 to January 14 this year, and on the third day, I took the emergency contraceptive pill (21 pills).
I took them at the same time every day without any issues until January 24, when I started noticing some dark brown spotting.
After researching online, I learned that it is okay to continue taking the pills, so I did.
However, starting January 28, the dark brown spotting was mixed with some bright red blood.
Although the amount is not significant, I am still very concerned.
I would like to ask the doctor if this situation indicates that my period has started or if my body is just still adjusting to the medication.
Should I continue taking the pills?
2.
I have previously had genital herpes and am aware of the risk of recurrence.
Recently, I have experienced some pain when urinating and slight itching at the vaginal opening.
Fearing a recurrence, I have started taking the medication (Acyclovir 400 mg) and have also applied Eclira cream (applied to the clitoris, where I mainly feel discomfort).
However, due to the itching at the vaginal opening, I have also applied a separate ointment (Clobetasol propionate).
I would like to know if I need to finish the 5-day course of the herpes medication before stopping.
Additionally, what are the distinguishing symptoms of a second recurrence of herpes? Lastly, should I avoid using both ointments simultaneously?

Rou, 20~29 year old female. Ask Date: 2024/01/29

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the contraceptive pill pack contains 21 tablets, which should be taken one tablet daily in the order of the pill dates for a continuous period of 21 days.
During the 7-day break from the medication, menstruation will typically occur between the 2nd and 4th day of the break.
If menstruation or any bleeding occurs during the usage period, there is no need to stop taking the pills; continue to take them according to the schedule.
Once the body adjusts to the contraceptive pills, any irregular bleeding should cease.
However, if irregular bleeding persists for more than three months or if there is heavy bleeding, it is advisable to consult a physician for further guidance.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2024/01/29

More Info

When it comes to understanding emergency contraceptives and concerns regarding herpes, it's essential to approach the situation with clarity and a solid understanding of the medications involved.
1. Regarding the Use of Emergency Contraceptives: You mentioned that you started taking the emergency contraceptive pill (ECP) after your menstrual cycle and experienced some unusual bleeding. It's not uncommon for individuals to experience spotting or breakthrough bleeding when starting hormonal contraceptives, including emergency contraceptives. This can happen as your body adjusts to the hormones. The brown discharge you observed is often old blood, which can occur when the uterine lining sheds. The presence of some red blood mixed in could indicate that your body is responding to the hormonal changes.
It's important to continue taking the ECP as directed unless advised otherwise by your healthcare provider. If the bleeding becomes heavy or is accompanied by severe pain, you should consult your doctor. Generally, spotting does not mean you should stop taking the medication, as it can be a normal side effect during the adjustment period.
2. Concerns About Herpes: You mentioned a history of genital herpes and are experiencing some discomfort and itching around the vaginal area. It's wise to be cautious, especially since herpes can recur. The medication you are taking, Acyclovir (the active ingredient in the medication you referred to as "敵疱治錠"), is an antiviral that helps manage herpes outbreaks.
You should indeed complete the full course of Acyclovir as prescribed, typically for five days, even if symptoms improve. Stopping the medication prematurely can lead to a resurgence of the virus.
As for the symptoms of a second outbreak, they can include tingling or itching in the genital area, pain during urination, and the appearance of blisters or sores. It’s crucial to monitor these symptoms closely. If you notice any new lesions or if the pain worsens, it would be advisable to consult your healthcare provider for further evaluation.

Regarding the use of multiple topical treatments, it’s generally not recommended to apply two different ointments simultaneously without consulting a healthcare professional. This is because the combination could potentially irritate the skin further or reduce the efficacy of one or both treatments. It would be best to discuss your symptoms with your doctor, who can provide guidance on the most appropriate treatment plan for your situation.

In conclusion, while it’s understandable to be concerned about the interactions and side effects of medications, it’s essential to communicate openly with your healthcare provider about any symptoms you experience. They can provide personalized advice based on your medical history and current medications. Always prioritize your health and well-being by seeking professional guidance when in doubt.

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