the Effects of Emergency Contraceptive Pills on Menstrual Cycles

Effects of emergency contraception?

Hello, Doctor.
My last menstrual period started on December 3rd, and my cycle length has consistently been around 28-30 days.
However, on December 14th, during intercourse, the condom slipped off, which I calculated to be during my fertile window, so I took the emergency contraceptive pill Ella.
As of today, January 12th, I have not had my period, and there has been no bleeding in between; however, I have been experiencing bloating and discomfort in my abdomen for the past few days.

I visited a gynecologist yesterday and mentioned my delayed period, but I was so anxious and uncomfortable that I forgot to tell the doctor that I took Ella.
The doctor performed an ultrasound and noted that my endometrium is quite thick, but it appears that I am not pregnant.
The doctor prescribed me Medroxyprogesterone to induce my period.

I would like to ask the doctor if my anxiety and discomfort caused me to forget to mention taking Ella, would that affect the timing of a pregnancy test result and the ultrasound findings? Also, since I have taken Ella, is it still safe to take the medication to induce my period? Is it okay to take Ella and Medroxyprogesterone in a short time frame? Could this lead to an excessive amount of progesterone or hormonal imbalance in my body? I apologize for having so many questions, but I am quite worried, so I would appreciate your help in answering them.
Thank you.

Gillian, 20~29 year old female. Ask Date: 2016/01/12

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, menstrual induction medications are not related to emergency contraceptive pills.
If you are sure you are not pregnant, take the menstrual induction medication and wait for about one week.
If your period still does not arrive, please return to the obstetrics and gynecology department.
Wishing you good health.

Reply Date: 2016/01/12

More Info

Emergency contraceptive pills (ECPs), such as Ella (ulipristal acetate), are designed to prevent pregnancy after unprotected intercourse or contraceptive failure. Understanding their effects on menstrual cycles is crucial, especially when experiencing delays or changes in menstrual patterns after taking them.

Effects of Ella on Menstrual Cycles
1. Menstrual Cycle Disruption: ECPs can cause temporary changes in your menstrual cycle. After taking Ella, some women may experience a delay in their next period, while others may have an earlier onset. The hormonal changes induced by the medication can affect the timing of ovulation and the subsequent menstrual cycle.

2. Thickening of the Endometrium: As noted in your ultrasound, a thickened endometrial lining can occur after taking ECPs. This is a result of hormonal fluctuations and is not uncommon. It does not necessarily indicate pregnancy, especially if a pregnancy test is negative.

3. Possible Side Effects: Common side effects of Ella include nausea, fatigue, headache, and abdominal discomfort. The bloating and discomfort you are experiencing could be related to the hormonal changes from the ECP.

Interaction with Medroxyprogesterone
Medroxyprogesterone is a progestin used to regulate menstrual cycles and can be prescribed to induce menstruation. Here are some considerations regarding the use of Medroxyprogesterone after taking Ella:
1. Timing and Safety: It is generally safe to take Medroxyprogesterone after using Ella. However, it is essential to inform your healthcare provider about your recent use of Ella, as this information can help them assess your situation more accurately.

2. Hormonal Effects: Taking both Ella and Medroxyprogesterone in a short timeframe may lead to fluctuations in hormone levels. While this is usually manageable, it can cause side effects such as mood changes, breast tenderness, or further menstrual irregularities.

3. Pregnancy Testing: If there is a concern about pregnancy, it is advisable to wait at least a week after the expected date of your period to take a pregnancy test for accurate results. Since you mentioned that your ultrasound indicated no signs of pregnancy, this is reassuring, but it is still wise to follow up with a pregnancy test if your period does not arrive.

Recommendations
- Follow-Up: Since you are experiencing a delay in your menstrual cycle and discomfort, it is essential to follow up with your healthcare provider. They can provide further evaluation and reassurance.

- Communication with Your Doctor: In future consultations, ensure to communicate all medications you are taking, including emergency contraceptives. This information is vital for your healthcare provider to make informed decisions about your treatment.

- Monitoring Symptoms: Keep track of any additional symptoms you may experience, such as changes in mood, further abdominal discomfort, or any unusual bleeding. This information will be helpful for your healthcare provider.

In summary, while Ella can affect your menstrual cycle, it is generally safe to take Medroxyprogesterone afterward. However, clear communication with your healthcare provider about all medications and symptoms is crucial for optimal care. If you have further concerns or if symptoms persist, do not hesitate to seek medical advice.

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