Emergency Contraceptive Pills and Menstrual Cycle: Your Questions Answered

Emergency contraceptive pills and menstruation?

Hello Doctor, I would like to ask about an incident that occurred on August 21, when I accidentally had unprotected intercourse and took the emergency contraceptive pill (Plan B) within two hours.
I started bleeding on August 27 for seven days (with heavier flow during the first two to three days).

1.
Does this count as my period? Should I start counting my cycle from this occurrence?
2.
I took pregnancy tests 12 days and 18 days after the intercourse, both of which were negative.
Is there still a possibility of pregnancy?
3.
Later, I went to a gynecologist on the 22nd day for an ultrasound and urine test, both of which were normal.
However, the doctor prescribed me medication to regulate my menstrual cycle for 10 days, stating that my period would come after finishing the medication.
Is it necessary to take the medication, or should I wait for my next period naturally? (I am unsure if my period is overdue; if my period is supposed to come but hasn't yet, is it okay to take the medication?) Additionally, this doctor advised me to return for a follow-up after my period, where he would prescribe me birth control pills for three months.
Is this approach correct? I am not questioning the doctor's skills, but I have some concerns.
Thank you for your response.
I apologize for having many questions as I am quite worried.
Thank you!

Feng Tang, 10~19 year old female. Ask Date: 2015/09/14

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
The menstrual bleeding that occurs after taking emergency contraceptive pills is considered irregular menstruation.
The next cycle may be on time or it may not be regular.

2.
Pregnancy tests taken 18 days and 22 days after intercourse both returned negative results, confirming that there is no pregnancy.

3.
Whether to take menstrual regulation medication is subjective; if medication is taken, it can ensure that the next menstrual period will arrive on time and not be significantly delayed.
If no medication is taken, the next menstrual period may be normal or it may be irregular.

Respectfully, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/09/14

More Info

When it comes to emergency contraceptive pills (ECPs) and their effects on the menstrual cycle, it's important to understand how they work and what to expect after taking them. Based on your situation, here are some insights and answers to your questions.

1. Is the bleeding after taking ECPs considered a period? Should I start counting my cycle from this?
The bleeding you experienced starting on August 27, which occurred six days after taking the emergency contraceptive pill (ECP), could be a side effect of the medication rather than a true menstrual period. ECPs can cause changes in your menstrual cycle, including breakthrough bleeding or changes in the timing of your next period. If the bleeding was similar to your normal period in terms of duration and flow, you might consider it as a period for the purpose of tracking your cycle. However, if it was significantly lighter or shorter, it may not be considered a true menstrual period. You should start counting your cycle from the first day of this bleeding if you consider it a period.

2. I took pregnancy tests 12 and 18 days after the incident, both negative. Is there still a chance of pregnancy?
If you took two pregnancy tests that were both negative, it is unlikely that you are pregnant, especially since these tests are generally reliable when taken at least a week after a missed period. ECPs are designed to prevent pregnancy effectively when taken within a specific time frame after unprotected intercourse. Given that you took the ECP within two hours of the incident, the likelihood of pregnancy is very low.

3. The doctor prescribed me medication to regulate my cycle. Is this necessary? Should I wait for my next period naturally?
The decision to take medication to regulate your cycle depends on your individual circumstances and the advice of your healthcare provider. If your doctor believes that the medication will help normalize your cycle after the hormonal changes caused by the ECP, it may be beneficial. However, if you feel comfortable waiting for your next period to see how your cycle regulates itself, that is also a valid option. It is important to communicate with your doctor about your concerns regarding the timing of your next period and the necessity of the medication.

4. The doctor suggested I return for a prescription for regular birth control pills after my next period. Is this a good approach?
Yes, starting a regular birth control method after your next period can be a good strategy for preventing unintended pregnancies in the future. Birth control pills can provide effective contraception when taken as directed. It’s important to discuss with your doctor which method is best for you, considering your health history and lifestyle.

In summary, the bleeding you experienced may not be a true menstrual period, but it can be counted as such if it resembles your normal cycle. The negative pregnancy tests suggest that you are likely not pregnant. Whether to take the prescribed medication to regulate your cycle is a personal decision, and you should feel free to discuss your concerns with your doctor. Finally, considering a regular birth control method after your next period is a proactive step in managing your reproductive health. Always feel free to ask your healthcare provider any questions you may have about your health and treatment options.

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