Morning after pill should I or is it too,late

Patient

Q: I am 45 and due to an accident my husband and I have not had sex for 5 years (so no contraception) but we tried for the first time last week.....a spur of the moment thing we have penetrative intercourse but then we reached for a condom where he ejaculated inside the condom)

That was 5 days ago and since then (more recently today) I have had Cramping and feel sick. We had seX on day 9 of my cycle and I happe to know when we had our children this was my most fertile time....

I picked up an ella one today just in case but have so much tugging in my lower stomach I am petrified that if I take it I will,have an ectopic pregnancy!

I do to want another child (my husband has a rain injury with behavioural issues and life is tough enough.

Symptoms:  Pregnancy, ovulation, pre-cum
Doctor

A:   Hi.
Thanks for your query and an elucidate history.
I can understand the apprehension you might have.

Since you have said that there was ejaculation in the condom and if it was not ruptured, the chances of pregnancy are least in spite of 9 th and the most fertile day of your cycle.

The changes that you have might not be due to pregnancy.

The usual Morning after pill works the best when used within 72 hours of the sex.
But, ellaOne® 30mg tablet contains ulipristal acetate and is indicated for emergency contraception
within 120 hours (5 days) of unprotected sexual intercourse or contraceptive failure (From the product information. I think you can certainly take this immediately and be assured. This is in addition to the condom protection you already had. Tugging in my lower stomach is not confirmation of pregnancy.

I hope this answers your query,
please feel free to ask further if you feel that there is a gap of communication.

Comments / Follow Ups

Patient: When I collected ella one the pharmacist told me that pre-ejaculation can, it some cases, cause pregnancy. Is this your understanding?

I would,prefer not to,take the tablet if there is a no chance I may be pregnant. I do not want the unwanted side effects for nothing.

What is your opinion on this? Thank you
Doctor: Precum fluid does not contain sperm it can't by itself cause a pregnancy. However as the purpose of this fluid is to flush out the penis it will bring any sperm left in the penis from the last ejaculation to the tip of the penis (this seems to be not the case). If this happens that small amount of sperm could cause a pregnancy.
So what Pharmacist is saying is wrong unless there was ejaculation before the actual insertion and act.

Hence if there was no ejaculation in the vagina there can not be pregnancy as you say the ejaculation was in condom.

So you may hold on taking the tablet if you are certain about the two things mentioned above.

Patient: He may have ejaculated earlier that morning (several hours earlier) but showered afterwards. Does this make any difference ?
Doctor: He must have urinated in between flushing the sperms.
It does not make a difference.
He may have : you too are not sure.

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