Delayed Period After Emergency Contraceptive: Am I Pregnant?

Emergency contraceptive pills and delayed menstruation?

Hello, doctor.
On February 10th, I had unprotected intercourse with my boyfriend, but I took the emergency contraceptive pill, Ella, within one hour.
My period was expected on February 20th, but it is now three days late.
Additionally, I fell ill and experienced general weakness on February 21st, and I usually have irregular sleep patterns.
What is the likelihood that I am pregnant, or could this just be due to my irregular lifestyle causing the delay in my period?

Xiao Yue, 10~19 year old female. Ask Date: 2016/02/23

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy are low.
If your period does not arrive within another week, it is advisable to see a gynecologist.
Wishing you good health.

Reply Date: 2016/02/23

More Info

When it comes to a delayed period after having unprotected intercourse, especially following the use of emergency contraception like Ella (ulipristal acetate), there are several factors to consider regarding the possibility of pregnancy and the reasons for a delayed menstrual cycle.

Firstly, it is important to understand how emergency contraceptive pills (ECPs) work. Ella is designed to prevent pregnancy primarily by delaying ovulation. If taken within the recommended time frame after unprotected intercourse, it can be effective in preventing ovulation and thus reducing the likelihood of pregnancy. However, if ovulation has already occurred, the effectiveness of the pill diminishes.
In your case, you mentioned that you had unprotected intercourse on February 10 and took Ella within an hour. Since your expected period was around February 20 and it is now delayed by three days, there are a few possibilities to consider:
1. Effect of Emergency Contraception: ECPs can cause changes in your menstrual cycle. It is not uncommon for women to experience a delay in their period after taking emergency contraception. This can be due to hormonal fluctuations caused by the medication. Some women may experience their period earlier, while others may have a delayed period.
2. Stress and Lifestyle Factors: You mentioned feeling unwell and experiencing general fatigue around the time your period was due. Stress, illness, and changes in your daily routine (such as sleep patterns) can significantly impact your menstrual cycle. If you are accustomed to irregular cycles or have a history of delayed periods, these factors could also contribute to the delay.

3. Pregnancy Testing: If your period does not arrive within a week of its expected date, 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, you should follow up with a healthcare provider for further evaluation. If the test is negative and your period still does not arrive, it may be worth consulting a healthcare professional to rule out other underlying issues.

4. Other Considerations: If you experience any unusual symptoms, such as severe abdominal pain, heavy bleeding, or any signs of pregnancy (such as nausea or breast tenderness), it is important to seek medical attention. These could indicate other medical conditions that may need to be addressed.

In summary, while there is a possibility of pregnancy given the circumstances, the delay in your period could also be attributed to the effects of the emergency contraceptive pill, stress, or lifestyle changes. It is essential to monitor your symptoms and consider taking a pregnancy test if your period does not arrive soon. If you have ongoing concerns, consulting with a healthcare provider would be the best course of action to ensure your health and well-being.

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