Emergency Contraception and Pregnancy Concerns

Q: Emergency Contraception and Pregnancy Concerns

Hello： <br>1. <br>Emergency contraception primarily works by preventing the implantation of a fertilized egg. <br>Therefore, medications or the insertion of an intrauterine device (IUD) are effective when used within 72 hours after intercourse. <br>Emergency contraceptive pills (

Contraceptive concerns?

1.
Hello, my girlfriend and I had intercourse, and on the same day, she took the emergency contraceptive pill.
Since there was only one pack with three pills, she took all three at once, less than an hour apart.
Is this effective? I heard that the pills should be taken at different intervals.
Now, her expected menstrual period is approaching, but it hasn't arrived yet.
I've heard that taking the pill can cause an earlier onset of menstruation.
Is there a possibility of pregnancy?
2.
Usually, during intercourse, I can feel when I'm about to ejaculate, but sometimes a little fluid leaks out just before ejaculation.
Does that count? I hope the doctor can provide some answers.
Thank you!

Xiao Han, 10~19 year old female. Ask Date: 2008/03/22

Dr. Yang Wangjun reply Obstetrics and Gynecology

Hello:
1.
Emergency contraception primarily works by preventing the implantation of a fertilized egg.
Therefore, medications or the insertion of an intrauterine device (IUD) are effective when used within 72 hours after intercourse.
Emergency contraceptive pills (ECPs) may contain high doses of progestin or a combination of estrogen and progestin; additionally, mifepristone (RU486) has recently been used as an emergency contraceptive, with an efficacy rate of nearly 100%.
Some medications require a second dose 12 hours after the first, while others can be taken as a single dose.
Generally, taking these emergency contraceptive pills may cause abnormal vaginal bleeding.
Therefore, if you do not have a normal menstrual period three weeks after taking the medication, it is necessary to take a pregnancy test to confirm whether it has failed.
2.
Normal ejaculation is divided into two phases.
The first phase often occurs without conscious awareness, and the semen in this phase has a high concentration of sperm and strong motility, making it more likely to result in pregnancy.
This is why withdrawal (coitus interruptus) is often ineffective.
According to your description, when you feel the urge to ejaculate, you have likely entered the second phase of ejaculation.
Thank you for your message!

Reply Date: 2008/03/22

More Info

Emergency contraception (EC) is a method used to prevent pregnancy after unprotected sexual intercourse or contraceptive failure, such as a broken condom. It is important to understand how it works, its effectiveness, and the implications for future pregnancy concerns.

1. Effectiveness of Emergency Contraception: The emergency contraceptive pill (ECP) is most effective when taken as soon as possible after unprotected intercourse. There are different types of ECPs, including those containing levonorgestrel (Plan B) and ulipristal acetate (Ella). The effectiveness decreases the longer you wait to take it, and it is generally recommended to take it within 72 to 120 hours after intercourse, depending on the type of pill. Taking all three pills at once, as your girlfriend did, may not be the recommended method for some ECPs, as they are often designed to be taken in separate doses. However, taking them all at once is unlikely to cause harm.

2. Menstrual Cycle Changes: After taking emergency contraception, it is common for women to experience changes in their menstrual cycle. This can include an earlier or later onset of menstruation, as well as changes in flow and duration. If your girlfriend's period is delayed, it could be due to the hormonal changes induced by the ECP. It is also important to note that while ECPs can delay ovulation, they do not terminate an existing pregnancy. If her period is significantly late (more than a week), it would be advisable for her to take a pregnancy test to confirm whether she is pregnant.

3. Pre-ejaculate Fluid: Regarding your concern about pre-ejaculate fluid (pre-cum), it is important to understand that this fluid can contain sperm, although typically in lower quantities than ejaculate. If you were close to ejaculation and some fluid was released, there is a possibility, albeit small, that it could lead to pregnancy, especially if it occurred during the fertile window of her menstrual cycle.
4. Next Steps: If your girlfriend's period does not arrive soon, taking a home pregnancy test is a prudent step. If the test is positive, she should consult a healthcare provider for further guidance. If the test is negative and her period still does not come, it may be worth discussing with a healthcare professional, as they can provide insights into her menstrual health and any potential need for further evaluation.

5. Future Considerations: If you and your girlfriend are considering becoming sexually active in the future, it may be beneficial to discuss regular contraceptive methods that can provide more reliable protection against unintended pregnancy. Options include hormonal birth control pills, intrauterine devices (IUDs), condoms, and other methods.
In summary, while emergency contraception can be effective in preventing pregnancy after unprotected intercourse, it is not 100% guaranteed. Changes in the menstrual cycle are common after taking ECPs, and if there are any concerns about pregnancy, taking a test and consulting a healthcare provider is the best course of action.

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