Why Your Period Might Be Delayed After Taking Emergency Contraceptive

Taking emergency contraception but not getting your period?

Hello, doctor.
I started taking oral contraceptives on November 27th, which was the first day of my menstrual cycle.
During this time, I had one instance of unprotected intercourse, so I took emergency contraception as well.
My cycles have been quite regular, but now it is January 8th, and my period has not arrived yet.
I took two home pregnancy tests last week, both of which were negative.
Could this be due to the combination of taking both the regular and emergency contraceptives? Or is this situation common, and should I wait a few more days to test for pregnancy again?

H, 20~29 year old female. Ask Date: 2016/01/09

Dr. Tian Yiwen reply Obstetrics and Gynecology

Emergency contraceptive pills contain high doses of hormones, which can lead to menstrual irregularities.
It is advisable to wait and see; however, if your period is more than two months late, it is recommended to visit a gynecologist.
In theory, if oral contraceptives are taken consistently and on time, they can suppress ovulation, thereby preventing pregnancy with an effectiveness of over 98%.
However, since they are not 100% effective, it is still recommended to use condoms to enhance contraceptive effectiveness.
Condoms also help prevent sexually transmitted infections, providing additional protection.
If you are taking birth control pills correctly (emphasizing that proper usage is crucial as it affects contraceptive efficacy) along with the dual protection of condoms, there should be no need for emergency contraception to avoid hormonal imbalance.
Frequent use of emergency contraceptive pills can lead to menstrual irregularities and should only be considered as a last resort; regular use is not recommended.

Reply Date: 2016/01/09

More Info

The delay of your menstrual period after taking emergency contraceptive pills (ECPs) can be attributed to several factors, particularly hormonal fluctuations caused by the medications. ECPs, such as Plan B or Ella, are designed to prevent pregnancy after unprotected intercourse by altering hormonal levels to inhibit ovulation, fertilization, or implantation. However, these hormonal changes can also disrupt your regular menstrual cycle.

When you take ECPs, they can cause a temporary imbalance in your hormones, which may lead to changes in your menstrual cycle. This can manifest as a delay in your period, irregular bleeding, or even a lighter or heavier flow than usual. In your case, since you have been on a regular contraceptive regimen and then took ECPs, it is possible that the combination of these hormonal influences is causing your delayed period.

Moreover, stress, changes in weight, and other lifestyle factors can also contribute to menstrual irregularities. If you have experienced any significant stress or lifestyle changes recently, these could further exacerbate the delay in your menstrual cycle.
Given that you have already taken two pregnancy tests that returned negative results, it is less likely that you are pregnant, especially if you took the tests after the expected date of your period. However, it is important to note that ECPs can sometimes delay your period by a week or more, so it might be beneficial to wait a few more days before testing again. If your period does not arrive within a week or if you experience any unusual symptoms, it would be advisable to consult a healthcare provider for further evaluation.

In summary, the delay in your period could be due to the hormonal effects of the emergency contraceptive pills you took, combined with any other stressors or changes in your life. It is not uncommon for menstrual cycles to be disrupted after taking ECPs, and while it can be concerning, it is often a temporary situation. If you continue to have concerns or if your period does not arrive, seeking medical advice would be a prudent step to ensure there are no underlying issues that need to be addressed.

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