Menstrual Changes After Emergency Contraceptive Use

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I took Postinor on June 24, and I experienced bleeding on June 30 that was similar in volume and duration to my regular menstruation.
Is it possible that this was indeed my period? My last menstrual period started on June 10, so could the Postinor have caused my period to come early? I went to the hospital on July 5 for a pregnancy test, and the result was negative.
How accurate is the pregnancy test at that time? My next period was expected on July 10, but it hasn’t arrived yet.
On July 8, I had unprotected intercourse and ejaculation occurred at the vaginal opening, but I rinsed immediately and took Postinor again.
On July 14, I experienced bleeding again, but it was less than the previous time.
After taking Postinor, I had intercourse on the day I stopped bleeding (July 19) without ejaculation.
Is there a chance of pregnancy? Does taking Postinor always result in bleeding? After taking Postinor twice, when can I expect my menstrual cycle to stabilize? Please respond, as I am very worried about the possibility of being pregnant! Thank you.

Xiao Mi, 20~29 year old female. Ask Date: 2004/07/19

Dr. Wu Linting reply Obstetrics and Gynecology

Taking postcoital contraceptive pills can lead to the shedding of the endometrium, resulting in a menstrual-like bleeding that serves as a method of emergency contraception.
However, this may cause menstrual irregularities, which could take one to two cycles to normalize.
Engaging in unprotected sexual intercourse, even without ejaculation, poses a risk since pre-ejaculatory fluid may contain sperm, leading to a high failure rate of the withdrawal method.
It is recommended to consider safer and more effective contraceptive methods that do not interfere with the normal menstrual cycle, such as 1.
consistent use of condoms, and 2.
oral contraceptive pills.

Reply Date: 2004/07/19

More Info

Emergency contraceptive pills (ECPs), such as the one you mentioned (commonly known as "Plan B" or "后安錠"), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. They primarily work by delaying ovulation, preventing fertilization, or inhibiting implantation of a fertilized egg. However, they can also cause changes in your menstrual cycle, which can lead to confusion regarding whether you are experiencing a normal menstrual period or side effects from the medication.

Based on your timeline, it appears that you took the emergency contraceptive on June 24, and then experienced bleeding on June 30. This bleeding could indeed be a result of the emergency contraceptive, as these medications can cause changes in the timing and flow of your menstrual cycle. It is not uncommon for women to experience bleeding that resembles a period after taking ECPs, and this can occur earlier or later than expected.
Your previous menstrual cycle began on June 10, and if your cycles are typically regular, the bleeding on June 30 could be interpreted as an early period due to the hormonal changes induced by the ECP. However, it is also possible that this bleeding is a side effect of the medication rather than a true menstrual period.
Regarding your pregnancy test on July 5, it is generally accurate if taken at least a week after the expected date of your period. Since you mentioned that you had bleeding on June 30, and the test was negative on July 5, it is likely that you were not pregnant at that time.
As for your subsequent sexual encounter on July 8, where you took another dose of the emergency contraceptive, the likelihood of pregnancy is low, especially since you mentioned that you washed immediately afterward and took the ECP. However, it is important to note that while ECPs are effective, they are not 100% guaranteed to prevent pregnancy.

You also asked whether taking emergency contraception always results in bleeding. While many women do experience some form of withdrawal bleeding after taking ECPs, it is not guaranteed. Some may not bleed at all, while others may have irregular bleeding patterns.
Regarding the regularity of your menstrual cycle after taking ECPs, it can take some time for your cycle to return to its normal rhythm. After using emergency contraception, it is common for the next period to be earlier, later, lighter, or heavier than usual. It may take one or two cycles for your menstrual cycle to stabilize.

In summary, your bleeding on June 30 could be a result of the emergency contraceptive, and the negative pregnancy test on July 5 suggests that you were not pregnant at that time. The subsequent bleeding after taking ECPs again on July 14 may also be related to the medication. If you continue to have concerns about your menstrual cycle or potential pregnancy, it is advisable to consult with a healthcare provider for personalized advice and guidance. They can help clarify any uncertainties and provide reassurance regarding your reproductive health.

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