Emergency contraception, better known by its brand name, Plan B, can be taken after unprotected sex to prevent pregnancy. It can be purchased over the counter at your local pharmacy. However, on social media, there is some sense of worry that emergency contraception will affect future fertility, especially if taken repeatedly. Let’s think twice: does emergency contraception affect fertility?

Emergency contraception typically consists of the hormone levonorgestrel, which is a synthetic form of the hormone progesterone (1). Progesterone is a natural hormone in the body that helps regulate the menstrual cycle and increases during pregnancy (2). Levonorgestrel delays ovulation to prevent pregnancy (3).

A 2022 systematic review of levonorgestrel emergency contraception analyzed 33 studies and found that it did not affect fallopian tube mobility, ectopic pregnancy, miscarriage, stillbirth, or subsequent menstruations (3). Another systematic review of 47 studies found that adverse outcomes like ectopic pregnancy and miscarriage were not significantly associated with taking levonorgestrel emergency contraception (4). Researchers reported that “the most common adverse effects of levonorgestrel were not serious.” Temporary side effects reported after emergency contraception use include nausea and vomiting, vaginal bleeding, and fatigue (7). In one observational study of 232 participants reported transient changes in their menstruation (6).

A 2014 systematic review of 22 studies evaluated the repeated use of emergency contraception as the primary source of contraception and reported that the most common side effect was menstrual irregularities (5). The researchers concluded that more investigation is required since the existing studies on repeated usage were not methodologically sound. Also, many menstrual cycles are irregular and pregnancy alone might alter them, making objective measurement of the cycle for several months before and after important, which is difficult and perhaps impossible.

Emergency contraception can reduce the probability of conception after unprotected sex (8) and is a safe and effective medication that does not impact future fertility.

Sources

Gillson, George. “Clarifying hormone terminology.” Canadian family physician Medecin de famille canadien vol. 53,1 (2007): 29-30.

Cable JK, Grider MH. Physiology, Progesterone. [Updated 2023 May 1]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK558960/

Endler, M et al. “Effect of levonorgestrel emergency contraception on implantation and fertility: A review.” Contraception vol. 109 (2022): 8-18. doi:10.1016/j.contraception.2022.01.006

Leelakanok, Nattawut, and Janthima Methaneethorn. “A Systematic Review and Meta-analysis of the Adverse Effects of Levonorgestrel Emergency Oral Contraceptive.” Clinical drug investigation vol. 40,5 (2020): 395-420. doi:10.1007/s40261-020-00901-x

Halpern, Vera et al. “Repeated use of pre- and postcoital hormonal contraception for prevention of pregnancy.” The Cochrane database of systematic reviews vol. 2014,9 CD007595. 26 Sep. 2014, doi:10.1002/14651858.CD007595.pub3

Gainer, Erin et al. “Menstrual bleeding patterns following levonorgestrel emergency contraception.” Contraception vol. 74,2 (2006): 118-24. doi:10.1016/j.contraception.2006.02.009

World Health Organization. “Emergency Contraception.” (2021). https://www.who.int/news-room/fact-sheets/detail/emergency-contraception#:~:text=Emergency%20contraception%20(EC)%20can%20prevent,assault%20if%20without%20contraception%20coverage.

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Prachi Shah

It’s a story passed from word of mouth, across households, generations and countries. Young people, often young women with an important event coming up, are told to eat certain foods to induce or delay their menstrual period in order to make sure that it doesn’t coincide with a birthday, religious occasion, or other event. Plants and herbs such as turmeric, mangoes, pineapple, and papaya have been touted for centuries as natural ways to encourage the early onset of a menstrual period. However, the evidence regarding these herbal treatments, known as emmenagogues, is often strictly anecdotal, and is often contradictory. 

A menstrual period is the culmination of the body’s roughly 28 day reproductive cycle. The cycle begins with the maturation of an ovum, or egg, which is then released into the body. Over the next few weeks, the endometrium (thick lining of the uterus) thickens. The cycle culminates with the shedding of this lining through the vagina, which is known as the menstrual period. The menstrual period is regulated largely by hormones such as estrogen and progesterone, among others. When these hormones are not present in the correct ratios, it can result in irregular periods, which may lead someone to seek out natural remedies to induce it. 

Anecdotes claim that foods such as citrus, berries, spinach, and tomatoes bring on a period through the increased intake of vitamin C (ascorbic acid), based on the rationale that this will have a hormone-like action that induces uterine contraction and a subsequent shedding of uterine lining. There are several hypotheses that need testing in theories like this. Other foods such as turmeric or pineapple supposedly induce periods by affecting levels of estrogen and progesterone (hormones that regulate the menstrual cycle) in the body. Unfortunately, there is little scientific evidence to support these concepts. Additionally, a few of these recommended herbal remedies, such as dong quai and parsley, can be toxic in high quantities or when children are exposed; therefore, they should be used in moderation. 

Aside from eating particular foods, there are some other suggested methods to help relieve irregular or painful periods. Exercise has been proved to help relieve menstrual pain. However, excessive exercise can delay or temporarily stop one’s menstrual cycle as can eating disorders or prolonged stress. People who seek regular periods may choose to participate in light/moderate exercise and relaxation techniques.

At the end of the day, the only reliable, scientifically proven method to fully control one’s period is hormonal birth control, which needs to be prescribed by a medical professional. 

https://www.healthline.com/health/womens-health/induce-period#natural-treatments

https://www.mountsinai.org/health-library/herb/dong-quai

https://www.sciencedirect.com/topics/medicine-and-dentistry/apiol

https://www.sciencedirect.com/topics/neuroscience/abortifacients

https://www.medicalnewstoday.com/articles/324830#inducing-a-period

https://www.sciencedirect.com/science/article/abs/pii/S2095496417603480