Delayed Menstruation After Emergency Contraceptive Use

I'm not sure if the delayed menstruation is related to the emergency contraceptive pill?

Hello Doctor, on November 14, 2015, I had sexual intercourse with my boyfriend, and we used a condom.
However, on the morning of November 15, we discovered that the condom had multiple holes.
That morning, we immediately bought emergency contraception and took it.
My period came on November 22, but since then, up until today, January 11, 2016, my period has not returned.
Could this be due to the emergency contraception causing a disruption in my menstrual cycle? My boyfriend believes that since my period came after taking the emergency contraception, I should not be pregnant, but I am very anxious because my menstrual cycle is usually very regular, around 28 days.

YJ, 20~29 year old female. Ask Date: 2016/01/11

Dr. Tian Yiwen reply Obstetrics and Gynecology

Emergency contraceptive pills contain high doses of hormones, which can cause menstrual irregularities in some individuals.
It is advisable to purchase a home pregnancy test from a pharmacy to check for pregnancy.
If there is no pregnancy and menstruation has not occurred for over two months, please consult a gynecologist.
Additionally, for those who frequently engage in sexual activity, it is recommended that women consider long-term use of regular contraceptive pills (which provide optimal contraceptive effectiveness) along with male partners using condoms (to prevent sexually transmitted infections).
This approach protects both partners.
Frequent use of emergency contraceptive pills can lead to menstrual irregularities and should only be used as a last resort for contraception; regular use is not recommended.
By practicing effective preemptive contraception, there is no need to feel anxious after each sexual encounter.

Reply Date: 2016/01/11

More Info

Understanding delayed menstruation after the use of emergency contraceptives can be a source of anxiety for many individuals. In your case, you experienced a situation where the condom broke during intercourse, prompting you to take emergency contraception the following day. This is a common scenario, and many people turn to emergency contraceptives (EC) like Plan B (levonorgestrel) or Ella (ulipristal acetate) to prevent unintended pregnancy.

Emergency contraceptives work primarily by delaying ovulation. If taken before ovulation, they can effectively prevent the egg from being released, thus reducing the chances of fertilization. However, if ovulation has already occurred, EC may not be effective. After taking the emergency contraceptive, you reported that your period arrived on November 22, which is a positive sign indicating that the medication likely worked to prevent pregnancy.

However, it is not uncommon for menstrual cycles to be disrupted after taking emergency contraception. The hormones in these medications can cause temporary changes in your menstrual cycle, leading to irregularities such as delayed periods, heavier or lighter bleeding, or changes in the duration of your cycle. Since you mentioned that your menstrual cycle is typically regular, the hormonal changes induced by the emergency contraceptive could be the reason for your delayed menstruation.

It is important to note that while emergency contraceptives are effective, they can cause side effects, including changes in menstrual patterns. The delay you are experiencing could be attributed to the hormonal fluctuations caused by the emergency contraceptive. Stress and anxiety about the possibility of pregnancy can also impact your menstrual cycle, leading to further delays.

If your period does not arrive within a week or two, it is advisable to take a home pregnancy test to rule out pregnancy. If the test is negative and your period still does not come, it would be wise to consult with a healthcare provider. They can assess your situation more thoroughly and provide guidance on what steps to take next.

In summary, the delayed menstruation you are experiencing could very well be a result of the emergency contraceptive you took. Hormonal fluctuations are common after using EC, and while it is concerning to have a delayed period, it does not necessarily indicate pregnancy, especially since you had a withdrawal bleed after taking the medication. However, if you remain anxious or if your period does not return, seeking medical advice is the best course of action. Your healthcare provider can offer reassurance and help determine if further evaluation is needed.

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