Can frequent emergency contraception delay my period?

Question

Hello doctor,

My last menstrual period started about one and a half months ago. I had intercourse about five weeks ago and again about four weeks ago, and I took the iPill on the same day on both occasions. I experienced withdrawal bleeding after taking the iPill.

I had intercourse again about ten days ago; there was no ejaculation inside, and I did not take the iPill after this. My periods have not started yet, and I am concerned about the delay after repeated use of emergency contraception.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Based on the history provided, your last menstrual period occurred about one and a half months ago. You had unprotected intercourse on two occasions about five and four weeks ago, for which you appropriately took emergency contraception within the recommended time. You also experienced withdrawal bleeding (menstrual-like bleeding that occurs due to a drop in hormones), which is a common side effect of emergency contraception and often suggests that the pill worked.

However, about ten days ago, you had another episode of unprotected intercourse, although withdrawal was practiced, and you did not take emergency contraception. At present, you have not had a proper menstrual period since your last cycle, which suggests a delay or disruption of your cycle, most likely due to hormonal fluctuations from repeated use of emergency contraception.

At this point, you should take a urine pregnancy test immediately to rule out pregnancy, as emergency contraception is not 100 percent effective, especially when used multiple times in one cycle. If the test is negative and your period does not start within a week, the test should be repeated, and a short course of progesterone, such as Norethisterone, may be considered to induce withdrawal bleeding.

For future contraception, it is strongly advised that you switch to a reliable, regular method such as oral contraceptive pills, an intrauterine device, or an implant, as repeated use of emergency contraception is not suitable for routine use.

You should also be assessed for menstrual irregularities, with evaluation for conditions such as PCOS (polycystic ovarian syndrome, a hormonal reproductive disorder, if clinically indicated, along with appropriate reproductive health counseling.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.