HomeAnswersFamily Physicianwithdrawal bleedingCan bleeding after seven days of taking Unwanted 72 indicate early pregnancy?

My fiancee has heavy bleeding and cramps after taking Unwanted 72. Could she be pregnant?

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The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Answered by

Dr. Sameer Kumar

Medically reviewed by

iCliniq medical review team

Published At October 6, 2017
Reviewed AtJanuary 5, 2024

Patient's Query

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?

Answered by Dr. Sameer Kumar

Hello,

Welcome to icliniq.com.

  1. If she had withdrawal bleeding seven days after taking Unwanted 72, which lasted for three days, then she is unlikely to be pregnant.
  2. 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.
  3. 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.

Patient's Query

Hello doctor,

Thanks for replying. I am relieved to hear that. But, will her period dates be changed from now? She used to have her periods on the first day of every month. Is it correct that from now, her period dates will be on the 20th of every month when calculated as a month from the last withdrawal bleeding? Also, how do we differentiate between withdrawal bleeding and implantation bleeding?

Answered by Dr. Sameer Kumar

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.

Patient's Query

Thank you doctor.

After withdrawal bleeding, my fiance, in the last two days took four home pregnancy tests. Three of the tests came back negative. But in one of them, a light pink line was visible which vanished soon. Today she got her period with heavy bleeding and cramping. She mentioned that the flow is similar to a regular period on the first day. I will take her for an hCG blood test soon. If this is a period bleeding, can pregnancy be a possibility?

Answered by Dr. Sameer Kumar

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 pilllike 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.

Patient's Query

Thank you doctor,

I will definitely get the test done in a few days. Would the hCG levels in the fifth week of pregnancy be detected by any home pregnancy test kit or can it be below 20 mIU/mL even in the fifth or sixth week? As I think the home test pregnancy kit can detect hCG levels only above this value.

Answered by Dr. Sameer Kumar

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.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sameer Kumar
Dr. Sameer Kumar

Obstetrics and Gynecology

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