Delayed Menstruation After Emergency Contraceptive Use: What to Do Next? - Obstetrics and Gynecology

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Delayed menstruation after the use of emergency contraception can be concerning, especially when you have a regular menstrual cycle. Let's break down the situation and provide some insights into what might be happening and what steps you can take next.

First, it's important to understand how emergency contraceptive pills (ECPs) work. They are designed to prevent pregnancy after unprotected intercourse by delaying ovulation, inhibiting fertilization, or preventing implantation of a fertilized egg. Common ECPs include Levonorgestrel (Plan B) and Ulipristal Acetate (ella). While these medications are effective, they can also cause temporary hormonal changes that may affect your menstrual cycle.

In your case, you took the emergency contraceptive pill on February 7, and your expected period was on February 21. Since it is now February 28 and your period has not arrived, there are a few possibilities to consider:
1. Hormonal Disruption: ECPs can cause your menstrual cycle to be delayed or altered. It's not uncommon for women to experience changes in their cycle after taking emergency contraception, including delayed periods, spotting, or even heavier bleeding.

2. Negative Pregnancy Test: You mentioned that you tested negative for pregnancy. This is a good sign, but keep in mind that if you tested too early, it might not be conclusive. If your period does not arrive soon, consider retesting a week later.

3. Physical Symptoms: The symptoms you are experiencing, such as breast tenderness, bloating, and frequent urination, can be attributed to hormonal fluctuations caused by the emergency contraceptive pill. These symptoms can mimic early pregnancy signs, which can be confusing.

4. Stress and Lifestyle Factors: Stress, changes in weight, travel, or illness can also impact your menstrual cycle. If you've experienced any significant changes in your life recently, they could be contributing to the delay.

Regarding your question about taking regular birth control pills (the "前避孕藥") while waiting for your period, it is generally safe to start taking them even if your period is delayed. However, it's essential to consult with your healthcare provider before starting any new medication. They can provide personalized advice based on your health history and current situation.

If your period does not arrive within a week or if you continue to experience unusual symptoms, it would be wise to consult a healthcare professional. They may recommend a blood test to check for pregnancy or evaluate other potential causes for your delayed menstruation.

In summary, while a delayed period after taking emergency contraception can be concerning, it is often a temporary hormonal response. Monitoring your symptoms, retesting for pregnancy if necessary, and consulting with a healthcare provider will help you navigate this situation effectively. Remember, your health and well-being are paramount, so don't hesitate to seek professional advice if you have concerns.