Concerns About Post-Coital Contraceptive Use and Menstrual Irregularities

Inquiry about abnormalities after taking emergency contraceptive pills at the end of the ovulation period and before menstruation?

Hello Dr.
Lu, I would like to ask you a question.
The first day of my last menstrual period was on October 11, with ovulation around October 25, and my estimated menstrual date is November 9.
We had unprotected intercourse around 11 PM on November 5.
Due to concerns about the side effects of emergency contraception, I took the emergency contraceptive pill (single-dose) only on the morning of November 7.
As of now, November 20, my period has not arrived, but I have noticed a significant increase in discharge, to the point where it feels like I might be starting my period.
The discharge is yellowish-green in color.
I would like to know if this is a normal side effect of the medication, a sign that my period is approaching, or an indication of early pregnancy? If my period does not come, when should I take a pregnancy test? Is it still 18 days after the date of intercourse?

W, 20~29 year old female. Ask Date: 2015/11/20

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
The pregnancy test should be taken 18 days after sexual intercourse.
2.
The increased amount of discharge could be due to inflammation or possibly elevated hormone levels.
Please seek medical attention for confirmation.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/11/20

More Info

The concerns regarding post-coital contraceptive use and menstrual irregularities are quite common, especially among individuals who are navigating the complexities of reproductive health. In your case, you took a single-dose emergency contraceptive pill (ECP) on November 7, after having unprotected intercourse on November 5. Your last menstrual period started on October 11, and you expected your next period around November 9. Given this timeline, let's break down your situation.

Firstly, it's important to understand that emergency contraceptive pills, such as the one you took, are designed to prevent pregnancy after unprotected intercourse. They work primarily by delaying ovulation, preventing fertilization, or preventing a fertilized egg from implanting in the uterus. However, these pills can also cause temporary hormonal changes that may lead to menstrual irregularities.

The absence of your period since November 9 could be attributed to several factors:
1. Effect of Emergency Contraceptive: ECPs can disrupt your normal menstrual cycle. It's not uncommon for women to experience a delay in their period after taking these pills. Some may also experience changes in the flow, such as lighter or heavier bleeding, or even spotting.

2. Hormonal Fluctuations: The hormonal changes induced by the ECP can lead to increased vaginal discharge, which you described as yellow-green in color. This could be a side effect of the medication, but it’s also important to consider other factors, such as an infection. Yellow-green discharge can sometimes indicate a bacterial infection or sexually transmitted infection (STI), especially if accompanied by other symptoms like itching or a strong odor.

3. Pregnancy: While the ECP is effective, no contraceptive method is 100% foolproof. If your period does not arrive in the next few days, it would be prudent to take a pregnancy test. The best time to test is typically at least 14 days after unprotected intercourse for the most accurate result. In your case, that would be around November 19 or later.

4. When to Test: If you are concerned about the possibility of pregnancy, you can take a home pregnancy test after the expected date of your period. If your period is still absent after a week or so, it would be advisable to consult with a healthcare provider for further evaluation.

5. Consulting a Healthcare Provider: If you continue to experience unusual discharge or if your period does not arrive, it is essential to consult a healthcare professional. They can provide a thorough examination, rule out infections, and discuss your menstrual cycle and contraceptive options.

In summary, while the absence of your period and the changes in discharge can be side effects of the emergency contraceptive, they could also indicate other issues, including the possibility of pregnancy or an infection. Monitoring your symptoms and consulting with a healthcare provider will help clarify your situation and ensure your reproductive health is managed appropriately.

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