Is Emergency Contraception Effective After Unprotected Intercourse? - Obstetrics and Gynecology

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Emergency contraception (EC) is a crucial option for preventing unintended pregnancies after unprotected intercourse. The effectiveness of emergency contraception, such as levonorgestrel (Plan B) or ulipristal acetate (ella), depends on several factors, including the timing of administration relative to the unprotected intercourse and the individual's menstrual cycle.

In your case, you mentioned that unprotected intercourse occurred on December 26, and your girlfriend took the emergency contraceptive pill within 24 hours. This is a positive step, as emergency contraception is most effective when taken as soon as possible after unprotected intercourse. Levonorgestrel is about 89% effective when taken within 72 hours, while ulipristal acetate can be effective up to 120 hours after intercourse. Therefore, taking the pill within 24 hours significantly increases the likelihood of preventing pregnancy.

Regarding your concern about the timing of her menstrual cycle, you noted that her period was expected around January 3 but is now late by two days. It's important to understand that menstrual cycles can vary for many reasons, including stress, hormonal fluctuations, and the use of hormonal contraceptives. While a late period can be an early sign of pregnancy, it is not definitive proof. The best course of action is to take a home pregnancy test if her period does not arrive soon. These tests are designed to detect the hormone hCG, which is produced during pregnancy, and they can provide accurate results if taken after a missed period.

You also mentioned having unprotected intercourse again on January 1, but with withdrawal (pull-out method). While this method can reduce the risk of pregnancy, it is not foolproof. Pre-ejaculate fluid can contain sperm, and if any sperm is present, there is still a risk of pregnancy. Since your girlfriend has already taken emergency contraception, it may provide some level of protection against this subsequent encounter, but it is not guaranteed.

In summary, emergency contraception is effective when taken promptly after unprotected intercourse, and while a late period can be concerning, it is not a definitive indicator of pregnancy. If your girlfriend's period does not arrive soon, taking a home pregnancy test will provide clarity. Additionally, if you are concerned about future instances of unprotected intercourse, consider discussing more reliable forms of contraception with your girlfriend, such as regular birth control pills, IUDs, or condoms, to better manage the risk of unintended pregnancy.