How Ella's Active Ingredient Affects Your Menstrual Cycle
Ella's active ingredient, ulipristal acetate, is a selective progesterone receptor modulator. This means it works by altering the body's progesterone levels, a crucial hormone for regulating the menstrual cycle. By delaying or inhibiting ovulation—the release of an egg from the ovary—Ella effectively prevents a potential pregnancy. Since ovulation is a key event that dictates when your period begins, altering its timing has a ripple effect on the rest of your cycle.
The Ovulation and Menstrual Link
Normally, after ovulation occurs, there is about a 14-day window before your period starts. When Ella delays ovulation, that 14-day countdown is pushed back, which can cause your period to be late. The extent of the delay depends on where you were in your cycle when you took the pill. For example, taking Ella just before the luteinizing hormone (LH) surge, which triggers ovulation, can significantly delay it.
Potential Changes to Your Menstrual Period After Taking Ella
For many women, the next period after taking Ella will arrive around the expected time, but it's very common to experience some changes. These effects are temporary and do not signal a long-term problem with your fertility.
- Delayed Period: A late period is one of the most common effects. Many users find their period is delayed by a few days, and a delay of up to one week is considered normal. This is a direct result of Ella's mechanism of action, as it successfully postpones ovulation. If your period is more than a week late, it is recommended to take a pregnancy test.
- Early Period: Less frequently, some women may experience their period arriving earlier than expected. This can also be attributed to the hormonal shifts caused by the medication. For instance, in one study, 7% of women taking Ella experienced their period up to 7 days early.
- Spotting or Breakthrough Bleeding: It is not uncommon to experience light bleeding or spotting in the days or weeks following Ella. This is a normal side effect of hormonal contraceptives and is not your actual period.
- Changes in Flow and Intensity: Your next period may also differ in flow and intensity compared to your usual cycle. It could be lighter, heavier, or more painful than you are accustomed to.
Comparison: Ella vs. Plan B
While both Ella (ulipristal acetate) and Plan B (levonorgestrel) are emergency contraceptives, they differ in their active ingredients, effectiveness windows, and potential side effects, including how they affect your period.
| Feature | Ella (Ulipristal Acetate) | Plan B (Levonorgestrel) |
|---|---|---|
| Active Ingredient | Ulipristal Acetate | Levonorgestrel |
| Mechanism | Delays or inhibits ovulation and affects the uterine lining; effective even when ovulation is imminent. | Delays or inhibits ovulation. |
| Effective Window | Up to 120 hours (5 days) after unprotected sex. | Up to 72 hours (3 days) after unprotected sex; less effective with time. |
| Prescription Status | Requires a prescription. | Available over-the-counter. |
| Weight Impact | Effective for people weighing up to 195 lbs; less effective beyond this point. | Less effective for people weighing over 165 lbs. |
| Effect on Period | Commonly delays period by a few days to a week. May also cause it to arrive early or trigger spotting. | May cause the next period to be earlier, later, or have a different flow. |
What to Do If Your Period is Late After Taking Ella
Waiting for your period after taking emergency contraception can be a stressful time. Here is a step-by-step guide on what to do:
- Be Patient: A delay of up to one week is normal due to Ella's hormonal effects. Try to manage your anxiety, as stress itself can also impact your cycle.
- Take a Pregnancy Test: If your period is more than 7 days late, take an at-home pregnancy test. This is the most reliable way to confirm if Ella was successful. It's also a good idea to take a test if your period is unusually light or short, or if you experience pregnancy symptoms.
- Use Backup Contraception: Fertility can return very quickly after taking Ella, so it is crucial to use a barrier method, such as condoms, for every instance of sex until your next period. You should also wait at least 5 days before resuming hormonal birth control to avoid reducing the effectiveness of both medications.
- Consult a Healthcare Provider: If your pregnancy test is positive, or if you have concerns about your menstrual cycle, contact a healthcare professional for guidance. They can provide advice and support, especially if you have been experiencing severe side effects or unusual bleeding.
When to Seek Medical Attention
While most side effects from Ella are mild and temporary, some symptoms require immediate medical attention. Seek help if you experience any of the following:
- Severe abdominal pain: This could be a sign of an ectopic pregnancy, a serious and life-threatening condition where a fertilized egg implants outside the uterus.
- Persistent or excessive bleeding: Soaking through multiple pads or tampons in a short period (e.g., two hours) or bleeding that lasts significantly longer than a typical period warrants medical advice.
- Allergic reaction symptoms: If you have difficulty breathing, swelling of the face or mouth, or a severe rash, seek emergency care immediately.
Conclusion
Ella is a highly effective emergency contraceptive that works by delaying or inhibiting ovulation, which can cause changes to your next period. It's common for your period to arrive a few days early or, more typically, to be delayed by up to a week. This variation is normal, and it is the most definitive sign that the medication has taken effect. If your period is delayed by more than seven days, it is important to take a pregnancy test to confirm that Ella was successful. In any case of severe pain, excessive bleeding, or if you are concerned, speaking with a healthcare professional can provide peace of mind and necessary medical guidance. You can learn more about emergency contraception and other sexual health resources from a reliable source such as Planned Parenthood.
