the Risks of Unprotected Sex During Menstruation

Menstrual intercourse with ejaculation inside?

Last month, my period lasted from January 14 to 15 for 4-5 days.
After having unprotected intercourse with my boyfriend in early February, I took emergency contraception.
This month, my period started on February 19, and after 4 days of bleeding, I had unprotected intercourse with my boyfriend again, and he ejaculated inside me.
Now my period is almost over, but I still notice some bleeding.
I would like to know if I should take emergency contraception again or if I am unlikely to be pregnant.

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

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the following are the precautions for emergency contraceptive pills:
1.
Regular use is not recommended, and it is especially advised against taking emergency contraceptive pills repeatedly within the same menstrual cycle, as the effectiveness may decrease.

2.
Emergency contraceptive pills remain effective after a single or multiple instances of sexual intercourse, provided that all sexual activities occurred within 72 hours prior to taking the medication.

3.
If you have unprotected intercourse after taking emergency contraceptive pills, it is advisable to take another dose of the emergency contraceptive pill.

4.
Emergency contraceptive pills can provide protection against pregnancy for the specific instance of sexual intercourse.
However, many people mistakenly believe that emergency contraceptive pills are a convenient and effective solution, leading to the poor habit of relying on them instead of using regular contraception.
Since emergency contraceptive pills primarily contain high doses of female hormones/progestins, they can cause side effects such as nausea, vomiting, and bloating.
Frequent use may not only lead to androgenic effects like oily skin and acne but also disrupt normal ovarian function, resulting in irregular menstrual cycles.
If sexual activity is frequent, it is recommended to adopt a regular contraceptive method.

Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2016/02/23

More Info

Engaging in unprotected sex during menstruation raises several concerns regarding the risk of pregnancy and sexually transmitted infections (STIs). To address your question, let's break down the key points regarding the risks involved and the potential need for emergency contraception.

Understanding the Risks of Unprotected Sex During Menstruation
1. Pregnancy Risk:
- While the likelihood of becoming pregnant during menstruation is generally lower, it is not impossible. Sperm can survive in the female reproductive tract for up to five days. If you have a shorter menstrual cycle (for example, 21 days), ovulation could occur shortly after your period ends. Therefore, if you have unprotected sex towards the end of your period, there is a possibility that sperm could still be viable when you ovulate, leading to a risk of pregnancy.

2. Emergency Contraception:
- If you had unprotected sex and are concerned about the possibility of pregnancy, taking emergency contraception (commonly known as the "morning-after pill") is advisable. Emergency contraception is most effective when taken as soon as possible after unprotected intercourse, ideally within 72 hours, but some types can be effective up to 5 days after. Since you mentioned that you had unprotected sex after your period and experienced bleeding afterward, it is crucial to consider whether this bleeding is a normal part of your menstrual cycle or a sign of implantation bleeding, which can occur if pregnancy has occurred.

3. Bleeding After Intercourse:
- The bleeding you observed after sexual intercourse could be due to various factors, including hormonal changes, cervical irritation, or even the onset of your menstrual cycle. If the bleeding is light and resembles your normal menstrual flow, it may not be a cause for concern. However, if it is unusual or accompanied by pain, it would be wise to consult a healthcare provider.

4. STI Risks:
- Unprotected sex, regardless of the timing in your menstrual cycle, increases the risk of STIs. Menstrual blood can potentially carry infections, and if either partner has an STI, the risk of transmission is heightened during this time. It is essential to consider getting tested for STIs if you have had unprotected sex, especially with new or multiple partners.

Recommendations
- Consider Taking Emergency Contraception: If you are within the time frame for emergency contraception and are concerned about pregnancy, it is advisable to take it. This can help reduce the risk of unintended pregnancy.

- Monitor Your Cycle: Keep track of your menstrual cycle and any unusual symptoms. If your next period is late or if you experience unusual symptoms, consider taking a pregnancy test.

- Get Tested for STIs: If you have had unprotected sex, it is a good practice to get tested for STIs, even if you do not have symptoms. Regular testing is an essential part of maintaining sexual health.

- Consult a Healthcare Provider: If you have any concerns about your menstrual cycle, the bleeding after intercourse, or the need for emergency contraception, it is best to consult a healthcare provider for personalized advice and care.

In conclusion, while the risk of pregnancy during menstruation is lower, it is not zero. Taking emergency contraception promptly can help mitigate this risk. Additionally, being proactive about STI testing and monitoring your reproductive health is crucial for your overall well-being.

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