I had a medical abortion on 6/16 The Sunday following

Patient

Q: I had a medical abortion on 6/16. The Sunday following that I started chateal as a form of birth control . For the most part I took it regularly around 3pm everyday , some days were delayed but never did I totally skip a pill or have to take two doses in a day . I abstained from any sexual activity until 7/18 . This was after taking the last placebo pill of Chateal and having a period . We used withdraw and from what I witnessed it seemed like no ejaculation happened inside the vagina . On 7/18 at 3pm I took Altavera which is now the pill my pcp wants me to stay with . Since 7/18 I've taken my pills exactly at 3pm on the dot and plan to continue doing so. With this info , is there any concern here regarding a pregnancy occurring from any pre ejaculation , will those delayed pills make a difference in protection even if it was weeks prior to when I had sex ?
Today I am beginning to have very mild cramps similar to menstural cramps - I have not had sex since 7/18, there's very mild nipple sensitivity as well but I have not missed a pill . Is this most likely pms? My calendar predicts a period in 9 days

Doctor

A:   Hello,
Thanks for the query to ATD for an opinion,

The fact that you had sex after your periods ended before day 10 of your fresh cycle on 7/18, you were already in your safe period and even if there would have been a chance of pre ejaculation entering, still you wouldn't have become pregnant in the absence of ovulation. The Altavera pill pack which was started on the day of sex is not going to be protective anyhow. So the best would be to get a serum beta hcg test done to rule out any chance of early ovulation if at all. If the hcg levels are less than 3mIU, then you are surely not pregnant and the symptoms that you are experiencing are more likely to be PMS.

I hope i have unasserted your query in detail,
Wishing you good health,
Regards

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