Irregular Menstrual Bleeding After Emergency Contraception - Obstetrics and Gynecology

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Menstruation occurs afterward, but the duration is shorter?


On December 21, I had intercourse with my girlfriend, who has polycystic ovary syndrome and had more regular menstrual cycles after taking medication two months ago.
We did not use a condom, and there was no ejaculation inside, but I was concerned, so I took emergency contraception that same day, which did not cause any side effects.
Based on her normal cycle, her period was expected around January 3.
However, her period started on January 1, with a heavier flow than usual on the first day, normal flow on the second day, but by January 3, the flow had significantly decreased and was almost stopping.
Is it possible that this is abnormal bleeding, and could there be a chance of pregnancy?

Mr. Lan, 20~29 year old female. Ask Date: 2016/01/03

Dr. Tian Yiwen reply Obstetrics and Gynecology


Emergency contraception contains high doses of hormones that may affect the amount and timing of menstrual bleeding.
Most of these changes are normal, but it does not completely eliminate the possibility of pregnancy.
It is recommended to take a home pregnancy test two weeks after sexual intercourse.

Reply Date: 2016/01/03

More Info


Irregular menstrual bleeding after taking emergency contraception is a common concern for many individuals. In your case, it seems that you and your girlfriend engaged in unprotected sexual intercourse on December 21, and she took emergency contraception the same day. Given her history of polycystic ovary syndrome (PCOS), which can already cause irregular menstrual cycles, it's important to consider how emergency contraception may affect her menstrual pattern.

Emergency contraception, such as the morning-after pill, can lead to changes in the menstrual cycle. It is designed to prevent pregnancy after unprotected intercourse by delaying ovulation, preventing fertilization, or inhibiting implantation. However, the hormonal changes introduced by these medications can also lead to irregular bleeding or changes in the timing and flow of the next menstrual period.

In your girlfriend's case, the bleeding that started on January 1, which was heavier than usual for the first day and then returned to normal, could be attributed to the effects of the emergency contraception. It is not uncommon for individuals to experience a heavier flow or spotting after taking these pills. The fact that the bleeding decreased significantly by January 3 could indicate that this was a response to the hormonal changes rather than a typical menstrual cycle.

Regarding the possibility of pregnancy, while emergency contraception is effective, it is not 100% guaranteed. If she took the pill within the recommended time frame after unprotected intercourse, the likelihood of pregnancy is reduced, but not eliminated. If her menstrual cycle does not return to normal in the following weeks, or if she experiences any unusual symptoms (such as severe cramping or persistent bleeding), it would be wise for her to take a pregnancy test or consult a healthcare provider for further evaluation.

In summary, irregular bleeding after taking emergency contraception can be a normal side effect, especially in someone with a history of PCOS. However, if there are concerns about pregnancy or if the bleeding pattern continues to be irregular, it is advisable to seek medical advice. Regular follow-ups with a healthcare provider can help manage her PCOS and any menstrual irregularities that may arise in the future.

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