Pregnancy Concerns: Symptoms After Unprotected Intercourse

Is it pregnancy?

Hello doctor, I apologize for bothering you again.
Regarding the situation from yesterday, my girlfriend and I had sexual intercourse on July 18th.
We used a condom, but it accidentally broke at the end (although I did not ejaculate).
We did not continue afterward, and I took emergency contraception (Ella) within an hour.
My girlfriend's last menstrual period was from July 8th to July 13th, with an average cycle of 28 to 33 days.
On the evening of the 23rd, she experienced abdominal pain (suspected ovulation pain), and that night she noticed clear, stretchy cervical mucus, which peaked on the 25th (the app also predicted ovulation on the 25th).
Then, on the 27th, she began to experience breast swelling and pain on the outer upper side, which has persisted until now, but her period has not arrived yet.
Last night, she felt a dull ache in her abdomen, and the breast tenderness remains the same (which usually occurs before her period).
I would like to ask if this is premenstrual syndrome (PMS) or signs of pregnancy?

P, 10~19 year old female. Ask Date: 2024/07/30

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you should not be pregnant.
Wishing you good health.

Reply Date: 2024/07/30

More Info

When it comes to concerns about pregnancy symptoms after unprotected intercourse, especially following a situation where a condom broke, it’s important to consider several factors. In your case, you mentioned that your girlfriend took emergency contraception (Plan B) shortly after the incident, which is a responsible step to prevent unintended pregnancy. However, it’s essential to understand how emergency contraception works and the potential symptoms that may arise afterward.

Emergency contraception is most effective when taken as soon as possible after unprotected intercourse. It works primarily by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus. Since your girlfriend took the pill within an hour of the incident, she maximized her chances of preventing pregnancy.

Regarding the symptoms your girlfriend is experiencing, such as abdominal pain, breast tenderness, and changes in vaginal discharge, these can be attributed to several factors:
1. Hormonal Changes: Emergency contraception can cause hormonal fluctuations that may lead to symptoms similar to those experienced during the menstrual cycle. Breast tenderness and abdominal discomfort can be common side effects of hormonal changes.

2. Ovulation: You mentioned that your girlfriend experienced symptoms resembling ovulation pain around the expected ovulation date. This could indicate that her body is responding to the hormonal changes or that she is indeed ovulating, which can happen even after taking emergency contraception.

3. Premenstrual Syndrome (PMS): The symptoms of breast tenderness and abdominal discomfort can also be indicative of PMS, which occurs in the days leading up to menstruation. If her menstrual cycle is typically around 28 to 33 days, she may be approaching her expected period, which could explain the symptoms.

4. Pregnancy Symptoms: While it’s less likely given the timely use of emergency contraception, some early pregnancy symptoms can mimic PMS. These include breast tenderness, nausea, and abdominal cramping. However, since she took the emergency contraceptive, the likelihood of pregnancy is reduced.

Given these considerations, it’s important for your girlfriend to monitor her symptoms and menstrual cycle. If her period does not arrive within a week of its expected date, it would be advisable for her to take a pregnancy test for confirmation. Additionally, if she experiences severe pain, heavy bleeding, or any other concerning symptoms, seeking medical attention is crucial.

In summary, the symptoms your girlfriend is experiencing could be attributed to hormonal changes from the emergency contraception, ovulation, or premenstrual syndrome. It’s essential to remain calm and allow her body some time to adjust. If there are any uncertainties or if her symptoms worsen, consulting with a healthcare provider would be the best course of action. They can provide personalized advice and support based on her specific situation.

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