Emergency Contraception After RU486: Your Questions Answered - Obstetrics and Gynecology

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When it comes to understanding emergency contraception after taking RU486 (mifepristone), it's essential to clarify a few key points regarding the medication, its effects, and the implications for future pregnancies.

RU486 is primarily used for medical abortion, and it works by blocking the hormone progesterone, which is necessary for maintaining a pregnancy. After taking RU486, it is common for individuals to experience bleeding as the body expels the pregnancy tissue. This bleeding can vary in duration and intensity, and it may be accompanied by other symptoms such as cramping.

In your case, you mentioned that after taking RU486 on April 4 and confirming with your doctor that the embryo was expelled on April 9, you experienced a range of bleeding patterns, including the transition from yellowish discharge to brown and then to red blood, which you suspect might be your menstrual period starting on May 13. This is a crucial point because the bleeding following a medical abortion can sometimes be mistaken for a menstrual period.

On May 15, you took your first oral contraceptive pill (OCP) and had unprotected sexual intercourse. The concern here is whether you could become pregnant despite taking the OCP. Generally, if you take the OCP correctly (starting it as directed), it should provide effective contraception. However, if you had unprotected intercourse before the pill had a chance to take effect (which can take about 7 days for some formulations), there is a possibility of pregnancy.

If you are worried about the risk of pregnancy after unprotected intercourse, taking emergency contraception (EC) is an option. Emergency contraception is most effective when taken as soon as possible after unprotected sex, ideally within 72 hours, but some forms can be effective up to 5 days later. If you are within this timeframe, it would be advisable to consult with a healthcare provider about obtaining EC.

Additionally, it is important to note that after a medical abortion, it may take some time for your menstrual cycle to regulate. The first period after an abortion can be irregular, and it may not arrive on the expected date. If your menstrual cycle does not return to normal within a few weeks, or if you have any concerns about potential pregnancy, it is wise to take a home pregnancy test or consult with your healthcare provider for further evaluation.

In summary, after taking RU486, if you engage in unprotected sex, there is a risk of pregnancy, especially if the OCP has not yet taken effect. If you are concerned about this, consider taking emergency contraception and consult with a healthcare provider for personalized advice. It is also important to monitor your menstrual cycle and seek medical advice if you experience any unusual symptoms or prolonged irregularities.