Why do bleeding and cramps occur after taking Unwanted 72?

Question

Hello doctor,

My fiancee is a 28 years old and weighs 94 lbs. We had unprotected sex on the 10th day of her menstrual cycle, and I am sure I did not ejaculate. But, I am worried about her getting pregnant. She took Unwanted 72 tablet 12 hours later. A week later, she had cramps and menses-like bleeding, which lasted for three days. The color and flow were like normal menses. Today is the 25th day of her cycle.

Her BP is 95/63 mmHg, and she has general tiredness. I do not know if these are early pregnancy symptoms. Does bleeding, a week after taking Unwanted 72, mean, pregnancy is possible? Does she need to test for pregnancy? What is the best time to test with a home pregnancy kit? When can we expect her next period?

Answer 1

Hello,

Welcome to icliniq.com.

If she had withdrawal bleeding seven days after taking Unwanted 72, which lasted for three days, then she is unlikely to be pregnant.
The pregnancy can be conclusively ruled out with a serum beta hCG test, as home pregnancy test may provide false negative results. If the test shows her hCG levels to be less than 3 mIU/mL, then she is surely not pregnant.
The commencement of bleeding seven days after the pill intake marks the start of a new cycle. That is considered as the day one of the next cycle. And, her menses should be expected only a month after the start of the withdrawal bleeding.

Answer 2

Hello,

Welcome back to icliniq.com.

You have calculated it right. The date of commencement of her period will be changed. Withdrawal bleeding is often heavier, lasts longer, and happens 7 to 10 days after taking an emergency contraceptive pill.

Implantation bleeding is seen in the form of spotting, and it occurs about three days after the last intercourse. Implantation occurs after fertilization. However, implantation bleeding is a diagnosis made after confirmation of pregnancy.

Answer 3

Hello,

Welcome back to icliniq.com.

As she had her withdrawal bleeding on time, followed by four negative pregnancy tests and the arrival of her menses, pregnancy is unlikely.

However, the hCG test is confirmatory. If the hCG levels are less than 3 mIU/mL, then she is definitely not pregnant and if levels are more than 5mIU/mL, then she was pregnant and is having a threatened miscarriage. But as she was completely asymptomatic post her withdrawal bleeding and no pregnancy symptoms were observed till today, it is unlikely she was pregnant.

There is nothing to worry at all if hCG test is negative as the bleeding can often be heavy after taking an emergency contraceptive pill like Unwanted 72, even up to the next two cycles in some women and it is an expected side effect. She can be given an antispasmodic like Meftal Spas (combination ofDicyclomine and Mefenamic acid) for controlling cramps and pain if pregnancy is ruled out.

Answer 4

Hello,

Welcome back to icliniq.com.

You are right about that. Urine pregnancy test is sensitive to hCG levels above 1500 mIU/mL. So, by the fifth or sixth week of pregnancy, a home test pregnancy kit would have detected it.

But considering the variations in the results, serum beta hCG test is more conclusive. In my opinion, she is not pregnant.