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Is hormonal imbalance the cause of all of my symptoms after taking Plan B One-Step twice ? #116/12

I'm having quite a bit of a dilemma. My fiancé and I had sex on November 26th. After we finished, I noticed that the condom was inside me. I am not on regular birth control so out of fear, I went and bought the Plan B One-Step and took it 2 days after the incident. Everything seemed fine and I got a period about 5 days later (on my normal expected date). The period felt like my normal period and lasted about 6-7 days.


Well, on December 10th we had sex again and this time we noticed the condom broke after my fiancé ejaculated!!! Out of fear again, I went ahead and took another Plan B One-Step pill about 3 days after the incident. I got a period about 16 days after taking the pill. It was a normal period just like the previous.

My concern is that I now had 2 periods in one month. One on December 3rd and another on December 29th.  Ever since I took those pills I have been feeling nauseous, have sore breasts, am experiencing occasional vaginal dryness and I have constant hunger (where I never feel full, even right after eating) and I feel bloated. I have also been extremely tired lately. I used to be able to get up at 5-6AM and workout and now I can barely make it out of bed at 8.30AM to get ready for work. It has been over a month since I took the 2nd Plan B One-Step pill and I am still feeling these symptoms. I did have sex again on January 7th, but it was protected and the condom was good this time! It's definitely too soon for me to feel pregnancy symptoms. I really don't know what is happening to me. I feel lethargic, sick and overall plain miserable.


I went to my ObGyn on December 11th and had a Pap smear test done that came back normal. My guess is that those 2 doses of Plan B One-Step have caused me to have serious hormonal imbalance. I haven't done a pregnancy test yet because it's just way too soon. My ObGyn won't do one either until I miss my period, but my period is not due
until the end of January.


Please help!!!

Definitely do a sensitive urine pregnancy test now and definitely use abstinence or two (2) condoms until you know exactly where you stand.



Her email reply on 1-23: “Thank you for your response!  I took a home pregnancy text this morning and the results came back negative.  My nauseousness and hunger have subsided a bit, but my breasts are sill very sore.  I still feel a bit lethargic too.  I am also beginning to get acne around my chin area.  I also forgot to mention that my ObGyn prescribed some Ortho Tri-Cyclen 28 to use after I get my period, which is due at the end of this month.  If I am not pregnant and do end up getting my period, then I guess these symptoms are just a result of major hormonal imbalance due to the Plan B pills.  Now, do you think it is safe for me to begin taking these regular birth control pills after the effects those 2 doses of emergency contraceptive pills did to my body?  Do you think the pills are safe for me?”


I do think the pills are safe for you to begin using as your contraceptive.

Email on 1-27: “Thank you again for responding!  I am feeling a lot better.  I will definitely begin Ortho Tri-Cyclen as soon as my period arrives.  The nausea has almost disappeared and my energy is slowly coming back.  I still don’t fell like my normal self, but I think I’m getting there.  My breasts are still super sore and swollen.  I am due for my period in a few days.  Today I woke up feeling warm with cramps, which is the usual way I feel when my period is near.  “Knock on wood”, hopefully my period is on her way!”

Today, January 30th, did you get your period yet?


Her email reply on 2-1-2012: “Yes, I received my period on January 28th, one month minus a day from my last Plan B induced period.  The flow is a little heavier than my usual.  Most of my pregnancy symptoms have disappeared except for the sore and swollen breasts.  I must have gone up at least one cup size.  I still have a bigger than normal appetite.  It seems like the “pregnancy” symptoms are slowly diminishing.  I’m hoping they go away completely soon!  I started Ortho Tri-Cyclen 28 on Sunday, the day aft4r my period began.  I vow to never take Plan B again!  Progesterone just doesn’t sit well with my body.  I was so sick and lethargic for so long that I really thought I was pregnant.


Thank you for your concern, it’s truly appreciated!”  

Below is an extensive list of causes of breast tenderness or pain:

  1. Cyclic fluctuations in hormones can lead to pain in normal menstrual cycles
  2. Pregnancy
  3. Irritation of the nipples, from friction with clothing, rough handling
  4. Improperly fitting bra, particularly under wire designs
  5. Physical activity without adequate support/heavy lifting
  6. mastitis, an infection of the ducts of the breasts; not well-defined area of infection
  7. Breast abscess – well-defined area of infection
  8. Mondor’s disease (superficial thrombophlebitis of veins on upper, outer aspect of breast)
  9. Tietze’s syndrome/costochondral separation
  10. Dermal cysts
  11. Fibrocystic disease
  12. Excessive caffeine consumption
  13. Bruising from rough sex play
  14. Shingles
  15. Muscle pull (of pectoral muscles or possibly the neck)
  16. Arthritis
  17. Excess estrogen
  18. Menarche
  19. Breast cancer
  20. Breast papilloma
  21. Sclerosing adenosis
  22. Ductal ectasia (ectasis is an inflammation of the breast ducts that is not caused by bacteria.)
  23. Engorgement from lactation after birth
  24. Pinched nerve in the back or neck
  25. Medications
  26. Cycles where a woman does not ovulate – estrogen has a proliferative effect on tissues on the breast, and if she does not secrete testosterone to stop this effect it can cause pain.


To learn more about the advantages and disadvantages of emergency contraceptive pills, go to our website: www.managingcontraception.com and click on Choices.  You can also order this wonderful new educational book from our website or by calling 404-875-5001.  Do you have your copy yet?

Key Words:  sex, condom, inside vagina, Plan B One-Step emergency contraceptive pills, birth control, fear, period, condom broke, ejaculated, nauseous, sore breasts, tired, vaginal dryness, constant hunger, bloated, sleep, protected sex, pregnant, lethargic, sick, hormonal imbalance, pregnancy test, sensitive urine pregnancy text, negative, abstinence, Ortho Tri-Cyclen, safe

Posted 1-28-2012, Updated 2-1-2012, Updated 3-19-2012

Robert A. Hatcher MD, MPH
Emeritus Professor of Gynecology and Obstetrics
Emory University School of Medicine
Atlanta, GA

The directors and owners of this website and any publications and information concerning health matters offered here advise a person with a particular problem to consult a primary-care clinician or a specialist in obstetrics, gynecology, or urology (depending on the problem or the contraceptive) as well as the product package insert and other references before diagnosing, managing, or treating the problem.
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