Emergency Contraception: Effectiveness and What to Expect After Use

Emergency contraceptive pill

My period started on November 1 and ended completely on November 12.
On the night of the 12th, I had sexual intercourse and accidentally ejaculated inside.
That night, I went to the pharmacy and bought Plan B, which contains only one tablet of 1.5 mg.
Is it effective? Do I need to buy a second dose? Also, during this period, will I definitely experience bleeding? Does everyone experience this? What is the likelihood of pregnancy?

Xiao Zi, 20~29 year old female. Ask Date: 2015/11/14

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello,
There are mainly two types of emergency contraceptive pills.
The first category includes medications such as Postinor, Postinor-2, and Postinor-3, each containing 0.75 mg of levonorgestrel in two tablets.
The recommended usage is to take one tablet within 72 hours after unprotected intercourse and then take the second tablet 12 hours later.
Recent studies have shown that a single dose of 1.5 mg of levonorgestrel is also effective, which is why the second category of medications, such as EllaOne, Next Choice, and Plan B One-Step, contains only one 1.5 mg tablet to be taken within 72 hours after intercourse.
The effectiveness of emergency contraceptive pills is approximately 95% if taken within 24 hours, but the efficacy decreases over time, dropping to 58% by the third day.
If your period is delayed by a week, it is advisable to take a urine pregnancy test to confirm whether you are pregnant or consult a gynecologist.
Emergency contraceptive pills contain high doses of levonorgestrel, primarily working by inhibiting or delaying ovulation.
The dosage of one tablet is equivalent to taking eight regular oral contraceptive pills, making it a high-dose medication.
Frequent and long-term use may increase the risk of infertility, and it is not recommended as a regular contraceptive method.
Additionally, using emergency contraceptive pills more than once a month can lead to menstrual irregularities.
For those who are sexually active, the best contraceptive method is dual contraception, which involves the male partner using condoms while the female partner takes oral contraceptives, thus enhancing contraceptive safety.
The impact of emergency contraceptive pills on menstruation can vary, and it may not necessarily result in an earlier or delayed period.
If bleeding persists or if your period is more than a week late, it is still important to check for pregnancy.
Thank you! Wishing you safety and health.

Dr.
Zhang

Reply Date: 2015/11/14

More Info

Emergency contraception (EC) is a crucial option for individuals who have had unprotected intercourse and wish to prevent an unintended pregnancy. The effectiveness of emergency contraceptive pills (ECPs), such as Plan B (levonorgestrel) or Ella (ulipristal acetate), depends on several factors, including the timing of administration relative to ovulation and the type of emergency contraceptive used.

In your case, you mentioned taking a single dose of 1.5 mg of levonorgestrel (Plan B) after unprotected intercourse on December 12. This medication is most effective when taken as soon as possible after unprotected sex, ideally within 72 hours, but it can still be effective up to 5 days after intercourse, although the efficacy decreases the longer you wait. Since you took it the same night, you are within the optimal window for effectiveness.

Regarding your question about whether you need to buy a second dose: typically, a single dose of 1.5 mg is sufficient for one instance of unprotected intercourse. There is no need to take a second dose unless you have unprotected intercourse again after taking the first dose. However, if you are unsure or have concerns about the effectiveness, consulting with a healthcare provider can provide personalized guidance.

As for the side effects and what to expect after taking emergency contraception, it is common for individuals to experience some changes in their menstrual cycle. Some may have spotting or bleeding shortly after taking the pill, while others may experience a delay in their next period. It is important to note that not everyone will experience bleeding after taking EC, and the absence of bleeding does not necessarily indicate that the pill was ineffective.
Most individuals will have their next period within a week or so of the expected date, but variations can occur. If your period is more than a week late after taking the emergency contraceptive, it is advisable to take a pregnancy test to confirm whether or not you are pregnant.

In summary, taking the 1.5 mg of levonorgestrel after unprotected intercourse is a valid step for emergency contraception, and you should not need a second dose unless you have further unprotected intercourse. Expect some potential changes in your menstrual cycle, but remember that individual experiences can vary widely. If you have any concerns or unusual symptoms, reaching out to a healthcare provider is always a good idea for further evaluation and reassurance.

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