Menstrual Irregularities After Emergency Contraceptive Use

Delayed menstruation?

Taking emergency contraceptive pills for two consecutive weeks can potentially disrupt your menstrual cycle.
You mentioned that your last period started on the 18th and ended on the 23rd of last month, and you took the emergency contraceptive pill on the 29th after unprotected intercourse on the 28th.
This month, you took the pill again on the 7th after unprotected intercourse on the 4th, and you experienced bleeding that lasted until the 7th, but not on the 8th.
Your period is expected to arrive, but you noted that your cycle can sometimes be irregular, varying by a day or two.
On the 20th, you did not notice your period, but you observed a small amount of pink discharge for two days prior.
Given these circumstances, it may be advisable to take a pregnancy test.
Additionally, you mentioned experiencing emotional distress, irritability, palpitations, abdominal pain, difficulty sleeping until late at night, and a weight loss of one kilogram.
These symptoms could be related to premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD).
It’s important to consult with a healthcare provider for a comprehensive evaluation and appropriate guidance.

Niming, 10~19 year old female. Ask Date: 2015/08/20

Dr. Lü Lizheng reply Obstetrics and Gynecology

Indeed, the frequent use of emergency contraceptive pills may lead to menstrual irregularities.
Other causes of irregular menstruation include disrupted sleep patterns, stress, insomnia, and premenstrual syndrome, which can occur repeatedly every month.
Therefore, if this is only the case for this month, it cannot be considered definitive; it is necessary to observe for several more months.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/08/20

More Info

Understanding menstrual irregularities after the use of emergency contraceptives can be quite complex, as various factors can influence the menstrual cycle. Emergency contraceptive pills (ECPs), such as those containing levonorgestrel or ulipristal acetate, can cause hormonal fluctuations that may lead to changes in your menstrual cycle.
When you take ECPs, they can alter the timing of ovulation, which can subsequently affect when your period arrives. It's not uncommon for women to experience irregular bleeding or spotting after taking ECPs. This can manifest as light bleeding, spotting, or even a delay in the onset of the next menstrual period. In your case, taking the emergency contraceptive on the 29th and again on the 7th of the following month may have contributed to the irregularities you are experiencing.

Regarding your specific situation, you mentioned that your last menstrual period started on the 18th and ended on the 23rd, and you had unprotected intercourse on the 28th and 4th, followed by taking the emergency contraceptive. The spotting you experienced from the 4th to the 7th could be a side effect of the emergency contraceptive rather than your regular menstrual flow. The fact that you are now experiencing a delay in your expected period, along with the presence of pink discharge, could indicate that your body is still adjusting to the hormonal changes caused by the ECPs.

As for whether you should take a pregnancy test, it is advisable to do so if your period is significantly delayed (more than a week) or if you have any symptoms that could suggest pregnancy, such as nausea, breast tenderness, or fatigue. Given that you had unprotected intercourse, it is prudent to rule out pregnancy.

Your emotional symptoms, such as feeling low, experiencing mood swings, and having heart palpitations, could be related to premenstrual syndrome (PMS) or premenstrual dysphoric disorder (PMDD), especially if they coincide with your menstrual cycle. PMDD is a severe form of PMS that can cause significant emotional and physical symptoms, including anxiety, depression, and irritability. The abdominal pain and difficulty sleeping you mentioned could also be related to hormonal changes or stress.

Weight changes, such as the loss of one kilogram, can occur due to various reasons, including stress, changes in appetite, or hormonal fluctuations. It’s essential to monitor these symptoms and discuss them with a healthcare provider, especially if they persist or worsen.

In summary, the irregularities you are experiencing after taking emergency contraceptives are not uncommon and can be attributed to hormonal changes. It is advisable to take a pregnancy test if your period does not arrive soon. Additionally, if your emotional and physical symptoms continue to be concerning, consider consulting a healthcare professional for further evaluation and management. They can provide guidance on managing PMS or PMDD and help address any other underlying issues that may be contributing to your symptoms.

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