Emergency Contraceptive Pills: Timing and Pregnancy Risks

Taking emergency contraceptive pills twice in one cycle?

Hello, on March 22, I took emergency contraception within thirty minutes after unprotected intercourse during the fertile window.
On March 31 (according to the app, this was a safe period), we were halfway through intercourse when the condom broke.
My boyfriend immediately withdrew and changed to a new condom.
He said that pre-ejaculate had not come out, and although there were a few instances of sliding to the front, there was no penetration.
Today, April 5 (also a safe period according to the app), we had unprotected ejaculation, and I took emergency contraception within two hours.
The app indicates that I should get my period tomorrow, April 6.
However, given my situation, will my period definitely be late? How many days late would be considered normal? What is the likelihood of pregnancy? Is it possible that I won't get my period in April and it will come in May instead?

Hjs, 10~19 year old female. Ask Date: 2024/04/05

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if you still haven't received it after another week, I recommend seeing a gynecologist.
Wishing you good health.

Reply Date: 2024/04/05

More Info

Emergency contraceptive pills (ECPs) are a form of birth control that can be used after unprotected intercourse or contraceptive failure (such as a broken condom) to prevent pregnancy. Understanding how these pills work, their timing, and their effectiveness is crucial for anyone who may find themselves in a situation where they need to use them.

ECPs are most effective when taken as soon as possible after unprotected sex. There are two main types of ECPs: those containing levonorgestrel (Plan B One-Step and others) and those containing ulipristal acetate (Ella). Levonorgestrel is most effective when taken within 72 hours (3 days) after unprotected intercourse, while ulipristal can be effective up to 120 hours (5 days) after. However, the sooner you take them, the better the chances of preventing ovulation and, consequently, pregnancy.

In your situation, you mentioned taking ECPs after a condom failure and also after unprotected intercourse. This is a proactive approach, and it is good that you are aware of the timing. However, it is essential to understand that while ECPs significantly reduce the risk of pregnancy, they are not 100% effective. The effectiveness can be influenced by several factors, including where you are in your menstrual cycle at the time of unprotected intercourse.

Regarding your concerns about your menstrual cycle, it is common for ECPs to cause some changes in your menstrual cycle. After taking ECPs, some women may experience their next period earlier or later than expected. It is not unusual for periods to be delayed by a few days or even a week after taking ECPs. If your period is more than a week late, it is advisable to take a pregnancy test to confirm whether or not you are pregnant.

As for the likelihood of pregnancy, if you took the ECPs within the recommended time frame after the incidents of unprotected sex, the chances of pregnancy are significantly reduced. However, since you had multiple instances of unprotected intercourse, it is difficult to provide a precise assessment of your pregnancy risk without knowing the exact timing of ovulation and other factors.

In summary, while ECPs are an effective method to prevent pregnancy after unprotected intercourse, they are not foolproof. It is normal for your menstrual cycle to be affected after taking them, and a delay in your period can occur. If your period does not arrive within a week of when it is expected, taking a pregnancy test is a prudent step. Always consult with a healthcare provider for personalized advice and to discuss any further concerns regarding your reproductive health.

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