Is prolonged bleeding after taking the I-pill normal or serious?

Question

Hello doctor,

I took an emergency contraceptive pill (I-Pill) seven days ago, and I started experiencing bleeding five days later, which is still ongoing. Initially, the bleeding was light and brown, but it has now become thicker and red. I did not have cramps at first, but I have been experiencing them for the last two days.

Menstrual history: My last period was 24 days ago. Normally, I experience cramps one to two days before my period, but this time the pattern seems different.

Is this bleeding a side effect of the I-Pill, or could it be an early or irregular period? How long should I expect the bleeding to last? Should I be concerned about this prolonged bleeding, and when should I seek medical attention? Is there anything I can do to reduce the cramps and manage the bleeding?

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and can understand your concern.

Since you took the emergency contraceptive pill (I-Pill) containing Levonorgestrel 7 days ago and started bleeding 5 days later, which is still ongoing, this is likely withdrawal bleeding caused by the hormonal effect of the pill. However, since the bleeding has now become thicker and red with cramps, let us analyze the situation:

1. Emergency contraceptive effect (withdrawal bleeding)

The I-Pill contains a high dose of levonorgestrel, a synthetic progestin that can disrupt your normal hormonal balance, causing irregular bleeding within a week of taking it.

This bleeding is not a true period but rather your body's reaction to the hormonal shift.

It can last a few days to up to two weeks in some cases.

2. Early period or hormonal imbalance

Since your last menstrual period (LMP) was 24 days ago, this bleeding could be an early period triggered by the pill.

However, emergency contraceptives can make menstrual cycles irregular for one to two cycles, so your next period may also be delayed or different from usual.

3. Possible side effects of the I-Pill

a. Some common side effects include:

b. Heavy or prolonged bleeding.

c. Cramps and abdominal discomfort.

d. Nausea, fatigue, or mood swings.

What you can do:

a. Monitor the bleeding: If it lasts more than 14 days or becomes too heavy (soaking pads every one to two hours), consult a gynecologist (OB-GYN).

b. Take a home pregnancy test (just to be sure): If you had unprotected intercourse after taking the pill, a home pregnancy test (HPT) can confirm whether the emergency contraceptive worked.

c. Manage cramps and bleeding:

Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like Ibuprofen or Mefenamic acid can help relieve pain.

Stay hydrated and get adequate rest.

d. Expect menstrual irregularities in the next cycle:

e. Your next period may be early, delayed, or heavier/lighter than usual due to the hormonal effect of the I-Pill.

Seek medical attention if:

Bleeding lasts more than 14 days.
Very heavy bleeding (soaking through pads or tampons quickly).
Severe cramps or pain that does not improve with painkillers.
Other unusual symptoms, such as dizziness or fainting.

I hope this helps.

Kindly revert so I can assist you further.

Thank you.