Abdominal Pain and Missed Period After Emergency Contraception

I have a slight stomach ache, but there is no menstruation or bleeding?

I had sexual intercourse with my girlfriend on February 11, and she took the emergency contraceptive pill 8 hours later.
Two days later, on February 13, she mentioned having abdominal pain similar to menstrual cramps, but there was no bleeding.
She was supposed to get her period on February 13, but as of now, February 22, she still hasn't gotten it and has no significant symptoms.
Today, she said she feels some cramping similar to menstrual pain.
Is there a chance she could be pregnant? Is this normal? Should she take a pregnancy test? If she is indeed pregnant, is it safe to take abortion pills? Please advise on what steps to take.
Thank you.

Li, 10~19 year old female. Ask Date: 2016/02/22

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy are low.
It's better to take preventive measures for contraception before engaging in sexual activity.
If your period does not arrive within another week, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2016/02/22

More Info

When it comes to understanding abdominal pain and a missed period after taking emergency contraception, there are several factors to consider. Your girlfriend's experience of abdominal pain resembling menstrual cramps after taking the emergency contraceptive pill (ECP) is not uncommon. ECPs, such as Plan B or Ella, contain hormones that can affect the menstrual cycle and may lead to symptoms similar to premenstrual syndrome (PMS), including cramping and discomfort.

Possible Causes of Abdominal Pain and Missed Period
1. Hormonal Changes: Emergency contraceptive pills work primarily by delaying ovulation. The hormones in these pills can cause temporary changes in the menstrual cycle, leading to symptoms like abdominal pain and a delayed period. It is not unusual for the next menstrual cycle to be irregular after taking ECPs.

2. Pregnancy: While the primary purpose of ECPs is to prevent pregnancy, no contraceptive method is 100% effective. If your girlfriend had unprotected intercourse and missed her period, there is a possibility of pregnancy. The timing of ovulation and the effectiveness of the ECP can influence this outcome.

3. Stress and Anxiety: Emotional factors such as stress and anxiety can also affect the menstrual cycle. If your girlfriend is feeling anxious about the possibility of being pregnant, this could contribute to her symptoms and missed period.

Recommendations
1. Pregnancy Test: Given that your girlfriend's period is late, it is advisable to take a home pregnancy test. These tests are most accurate when taken after a missed period. If the test is positive, it would indicate pregnancy, and she should consult a healthcare provider for further evaluation and options.

2. Monitoring Symptoms: If the abdominal pain persists or worsens, or if she experiences any other concerning symptoms (such as heavy bleeding, severe pain, or fever), it is essential to seek medical attention.
3. Consulting a Healthcare Provider: If pregnancy is confirmed and your girlfriend is considering medical abortion, it is crucial to consult a healthcare provider. They can provide guidance on the options available, including medication abortion, and ensure that it is done safely and legally.

4. Understanding the Effects of ECPs: It is important to understand that while ECPs are effective in preventing pregnancy, they can cause side effects such as nausea, fatigue, and changes in the menstrual cycle. These effects are generally temporary.

Conclusion
In summary, your girlfriend's abdominal pain and missed period could be attributed to hormonal changes from the emergency contraceptive pill, the possibility of pregnancy, or emotional stress. Taking a pregnancy test is a prudent step to clarify the situation. If there are any signs of complications or if she has further concerns, consulting a healthcare provider is essential for appropriate care and guidance.

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