Emergency Contraception: Success Rates and Menstrual Changes

Emergency contraceptive pill has been taken?

Hello doctor, I would like to ask the following: My girlfriend's menstrual cycle is 28-31 days.
On June 17, it was the 8th day of her cycle, and her period had already ended.
On June 17, we used a condom, but it broke, and I accidentally ejaculated inside her.
Within two hours, I bought and took an emergency contraceptive pill.
After taking the pill, she experienced occasional lower back pain for a day or two.
Then on June 23, she had a small amount of bleeding, but her ovulation period should be around the 24th.
Was the contraception successful? Could that small amount of bleeding (which should not be spotting) be considered an early onset of her period? When is her next period likely to arrive?

Xiao Zhan, 20~29 year old female. Ask Date: 2024/06/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, taking emergency contraceptive pills can sometimes cause irregular menstruation; just monitor the situation.
Wishing you good health.

Reply Date: 2024/06/24

More Info

Emergency contraception (EC) is a crucial option for preventing unintended pregnancies after unprotected intercourse or contraceptive failure, such as a broken condom. In your case, your girlfriend took emergency contraception within two hours of the incident, which is a positive step toward reducing the risk of pregnancy.
The effectiveness of emergency contraception, particularly the type you mentioned (commonly referred to as "Plan B" or levonorgestrel), is highest when taken as soon as possible after unprotected intercourse. Studies indicate that when taken within 72 hours, it can reduce the risk of pregnancy by up to 89%. However, its effectiveness diminishes the longer you wait, and it is most effective when taken within 24 hours. Since your girlfriend took it within two hours, she is likely to have a high chance of preventing pregnancy.

Regarding the symptoms she experienced after taking the emergency contraceptive, it is not uncommon for women to experience side effects such as abdominal pain, nausea, fatigue, or changes in their menstrual cycle. The mild lower back pain she reported could be a side effect of the hormonal changes induced by the emergency contraceptive.
The light bleeding she experienced on June 23 could be attributed to several factors. It may be a side effect of the emergency contraception, which can cause changes in menstrual bleeding patterns, including spotting or breakthrough bleeding. This bleeding is not necessarily indicative of an early period but rather a response to the hormonal influx from the emergency contraceptive.
Typically, emergency contraception can cause the next menstrual period to arrive earlier or later than expected. Since your girlfriend's cycle is usually between 28 to 31 days, if her last period started on June 17, she would expect her next period around July 15 to July 18. However, due to the hormonal effects of the emergency contraception, it is possible that her cycle may be disrupted, leading to an earlier or delayed period.
If her next period is more than a week late, it would be advisable for her to take a pregnancy test to confirm whether or not she is pregnant. Additionally, if she experiences any severe symptoms, such as heavy bleeding or severe abdominal pain, she should seek medical attention promptly.

In summary, based on the information provided, it appears that your girlfriend has taken the necessary steps to prevent pregnancy effectively. The symptoms she is experiencing are likely side effects of the emergency contraception, and the light bleeding could be a response to the hormonal changes. Monitoring her menstrual cycle over the next few weeks will provide further clarity on her situation. If there are any concerns or unusual symptoms, consulting with a healthcare provider is always a good idea.

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