Emergency Contraception: Your Questions Answered on Effectiveness and Symptoms

Some questions about emergency contraceptive pills?

Hello, doctor.
I would like to ask some questions.
My boyfriend and I had sexual intercourse on the 5th day after my menstrual period ended.
We used a condom, but it seemed to have broken, so I bought and took the emergency contraceptive pill three hours later.
A few hours after taking it, we had sexual intercourse again without a condom, but there was no ejaculation.
What is the likelihood of pregnancy in this situation? Do I need to take another emergency contraceptive pill? Also, after taking the emergency contraceptive pill, I haven't experienced any bleeding, but I have had symptoms of headache and nausea.
Does this indicate that the contraception was successful?

Chen Yu-Ting, 20~29 year old female. Ask Date: 2016/02/23

Dr. Zhang Kunmin reply Obstetrics and Gynecology

What you need is not medical advice but a remedial course in sexual education.
For such inquiries, it is recommended to refer to the National Health Administration's "Sexual Well-being e-Learning" or the Obstetrics and Gynecology Society's "Consultation Guide for Adolescent Contraception" at http://goo.gl/dc6PfW.

Hello, the effectiveness of emergency contraception remains valid after a single or multiple instances of sexual intercourse, provided that all sexual activities occurred within 72 hours prior to taking the medication.
Thank you! Wishing you peace and health.
Dr.
Chang

Reply Date: 2016/02/23

More Info

Emergency contraception (EC) is a crucial option for individuals who may have had unprotected intercourse or experienced contraceptive failure, such as a broken condom. Your situation raises several important points regarding the effectiveness of emergency contraception, potential symptoms, and the likelihood of pregnancy.

Firstly, it's essential to understand that emergency contraception is most effective when taken as soon as possible after unprotected intercourse. The two most common types of emergency contraceptive pills (ECPs) are levonorgestrel (Plan B One-Step) and ulipristal acetate (ella). Levonorgestrel is effective up to 72 hours after unprotected sex, while ulipristal can be taken up to 120 hours after. Since you took the emergency contraception within three hours of the incident, you maximized your chances of preventing pregnancy.

Regarding your second sexual encounter after taking the emergency contraception, since you did not have internal ejaculation, the risk of pregnancy is significantly lower. However, it’s important to note that pre-ejaculate fluid can contain sperm, and thus, there is still a small risk of pregnancy. If you are concerned about this risk, taking another dose of emergency contraception is generally not necessary, especially since you have already taken it within the appropriate timeframe for the first incident. However, if you are unsure or feel anxious about the situation, consulting with a healthcare provider for personalized advice is always a good idea.

As for the symptoms you are experiencing after taking the emergency contraception, such as headaches and nausea, these can be common side effects of hormonal contraceptives. It’s not unusual for individuals to experience some degree of discomfort after taking ECPs. The absence of bleeding does not necessarily indicate that the emergency contraception has failed; many women do not experience withdrawal bleeding after taking ECPs. However, if your period is significantly delayed (more than a week), it would be advisable to take a pregnancy test to confirm whether or not you are pregnant.

In summary, while there is a small risk of pregnancy due to the second sexual encounter, the likelihood is low, especially since you used emergency contraception promptly after the first incident. The symptoms you are experiencing are likely side effects of the emergency contraception, and the absence of bleeding does not automatically indicate failure. If you have further concerns or if your symptoms worsen, please seek medical advice from a healthcare professional. They can provide you with the most accurate information and support tailored to your specific situation.

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