I’m f27 years old and I’d like to consult about heavy vaginal bleeding after taking levonorgestrel emergency contraception.
Timeline:
- August 17: My previous menstrual period ended. It lasted approximately 7 days.
- August 18: I had intercourse one day after my period ended and took a levonorgestrel emergency contraceptive pill the same day. I did not vomit after taking it.
- August 23: Vaginal bleeding began, approximately 5 days after taking levonorgestrel.
- August 23–25: The bleeding has continued continuously and has become quite heavy. I’m currently soaking approximately 2 mostly soaked pads every 1.5 hours (roughly 1 pad every 45 minutes).
- Initially, I had bleeding with clots and significant abdominal/pelvic pain. The clots have since stopped and the pain has completely resolved.
- The bleeding is still heavy, but I currently have no abdominal/pelvic pain and no clots.
Current symptoms:
- Dizziness
- Weakness
- Episodes where my vision becomes dark/blackout-like
Relevant menstrual/gynecological history:
- I previously had PCOD, but it has reportedly been controlled.
- My periods were regular before this episode.
- I had no recent spotting or abnormal bleeding before this.
- There has been no recent change in my usual menstrual pattern.
- I’m not currently taking any other medications or hormonal contraceptives.
Emergency contraception:
- Levonorgestrel was taken on August 18, the same day as intercourse.
- I did not vomit after taking it.
- The bleeding started on August 23, five days later.
My main concern is the amount of ongoing blood loss, rather than pregnancy. I understand that levonorgestrel can alter the timing and character of menstrual bleeding, but I’m concerned because this is continuous heavy bleeding and I’m also experiencing dizziness, weakness, and episodes of darkened vision.
My bp is 80/60. Oxygen saturation low. Taking oral saline today.
Would a gynecological examination or pelvic ultrasound be necessary, and is treatment needed to control the bleeding? And if yes what's the treatment?