Could an emergency pill cause a period delay at 19?

Question

Hello doctor,

I am 19 years old, and my last period started about seven weeks ago. I had unprotected intercourse around a week after that and took Unwanted 72 (Levonorgestrel) within 24 hours. About two weeks later, I experienced some brown spotting but have not had a proper period since.

I have done multiple pregnancy tests, all of which were negative, with the most recent one done about a week ago. My cycle has now been delayed for more than six weeks.

Could you please advise if this delay could be due to the emergency pill?
Whether I can take a short course of medicine to induce my period, such as progesterone withdrawal tablets?

I have no major health issues otherwise. Please suggest what I can safely do next.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Your period delay is most likely due to the emergency pill. Unwanted 72 (Levonorgestrel) contains a high dose of Levonorgestrel, which can disrupt the menstrual cycle for several weeks. The brown spotting you noticed a few weeks later was probably a withdrawal-type bleed rather than a whole period. Since your pregnancy tests are negative, that is reassuring, but the delay itself is likely related to the pill, stress, and hormonal changes. Your weight is also extremely low for your height, being around 30 kilograms (66 pounds) at 5 feet 6 inches, which can, by itself, cause irregular periods or stop them.

You should repeat a urine pregnancy test in about one week using the first morning sample. If your period still does not start after that, it would be advisable to get a pelvic ultrasound and basic hormone tests, including TSH (thyroid-stimulating hormone), prolactin, FSH (follicle-stimulating hormone), and LH (luteinizing hormone).

If pregnancy is ruled out, a short course of Medroxyprogesterone acetate 10 mg once daily for five days can be taken to induce a withdrawal bleed.
Stop the tablets if any bleeding starts earlier or if there is any suspicion of pregnancy.
Alongside this, focus on improving nutrition and gradually gaining weight, as maintaining a healthy weight is essential for regular cycles.
Continue to monitor for bleeding after taking the progesterone course. If your period does not occur within one to two weeks after completing it, you should have hormone tests and an ultrasound done.

For prevention,

Maintain a balanced diet.
Manage stress.
Avoid using emergency contraception repeatedly, and consider using regular birth control methods instead.

Follow up with an obstetrician-gynecologist to help regulate your cycle long term.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.