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Menstrual Irregularities & Pregnancy Concerns: A Consultation


Question
Hi
Brenda,
I was just waiting for you.
It is a bit long but I am suffering from lots of mental stress because of lots of nonavailabilities near to me. I hope, I will get a quick reply from you.

I am 22 years old and because of my menstrual irregularities I have been taking ovral G (Ethinylestradiol & Norgestrel Tablets I.P.) since September'08. My period was almost coming to be regular. I had the last irregular period on 1st September and started taking Ovral G as prescribed from September itself (I forgot the exact date from when did I start). Then I had the period on 10th October and then 8th November. I am completing the 3rd and final pack of Ovral G on 3rd December and my period should come around 6th to 10th December (as I am expecting). But I have had sex with my boy friend on 20th November (i.e on the 13th day from 8th Nov and if I was ovulating on that day!). I have used vaginal contraceptives and pull-out. But I am worried if all these fail because, I saw some red spotting on 25th November as I would have little bleeding on 24th Nov (could it be implantation bleeding?) without any pain. After that I am not experiencing any bleeding of that kind.
My period is now due already. I want to know the probable cause and consequences of my bleeding on 24th. Is it because of dryness by Ovral G or do I get pregnant? We are monogamous and hence there is no chance of STD as we feel. We had similar unprotected sex six months before. But that time I was in safe period. Moreover I have just come to know that the major compositions of Ovral G - Ethinylestradiol & Norgestrel, are used in almost all modern formulations of combined oral contraceptive pills. Does it mean that it worked effectively as emergency contraceptive and hence the bleeding on 24th?
Please say some words of relief to me prior that I may miss my period.
If I miss my period I want to terminate my pregnancy anyhow but not by surgical abortion. It is said that chemical abortions are effective within 49 days of LMP. So with this calculation I will be completing 49th day on 26th Dec. In between these 10-26 Dec I need to undergo chemical abortion. Is it safe without doing pregnancy test? And please inform me if I can do pregnancy test at home on my own with some alternatives without using the pregnancy test kit.

Answer
Dear Ruma,

The chemicals in Ovral G (Ethinyl estradiol and Norgestrel) are the same as those used in birth control pills and often (in high doses) for emergency contraception. I believe the dosage you were taking was smaller and may or may not have been enough to prevent conception. However, combined with the other methods you were using, I would suspect that your chances of pregnancy were actually fairly small with the contact on 11/20. The spotting you experienced on the 24th may simply have been brought on by a bit of a hormonal surge caused by the sexual activity. The increase in the hormone levels, combined with the the synthetic hormones you are taking may simply have caused the spotting.

IF you did happen to conceive a pregnancy despite the odds against it, you can typically get an accurate positive reading on a home pregnancy test approximately 3 weeks after a potential conception date. When/if you test make sure to use 1st morning urine to get a concentrated sample for the most accurate results.

I would not recommend a chemical abortion without a confirmed existing pregnancy and I cannot imagine a doctor ordering the necessary medication without confirming a pregnancy and performing all proper examinations and evaluations.

I hope this has helped you and answered your question. I wish you well.

Brenda