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In postpartum period. Had sexual intercourse and semen dripped down to vagina. Pots syndrome with chest pain. Solution to avoid pregnancy?

DOCTOR OF THE MONTH - Apr 2013
Apr 2013
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General Surgeon
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Hello I was wondering if I should take an emergency contraceptive pill or not. I am 4 months postpartum with 2nd child and on Thursday night my husband and I were having sexual intercourse and after pulling out he ejaculated on my lower back area and upon getting up some semen dripped down to my vaginal opening which I wiped away with toilet paper and I rinsed off in the shower immediately. I am very hesitant to take plan b because since giving birth 4 months ago I have had very bad health issues and feel terrible on a daily basis with a feeling of persistent flu and palpitations among many other things I also had extremely high blood pressure the first 2 months post partum. Upon numerous tests and doctors they say I have fibromyalgia. I had carcinoid cancer in 2008 and a carcinoid specialist doesn't believe my carcinoid is back even though I'm exhibiting symptoms as urine and bloodwork and scans are ok but believes I have pots syndrome( I do get abnormally high heart rate upon standing) along with chest pain and excercise intolerance and dizziness. I know pulling out is not a smart birth control method but condoms irritate me and I have been advised not to take birth control because of cancer history. For the record we have successfully used the pull out method for 5 yrs and only got pregnant when actively trying. What are my chances of becoming pregnant with semen dripping from my back to vagina? And would I be a candidate for plan b? I am so worried to take it as I am exhibiting extreme symptoms of pots syndrome and fibro every day since giving birth 4 months ago to the point I cannot work but I also cannot become pregnant again. I should also mention I am very sensitive to medicines and since postpartum have suddenly contacted numerous food and environmental allergies. I had full cardiac work up structurally heart is fine and holter monitor ok. I should also mention we used lube and I know that can hinder sperm.
Posted Tue, 29 Oct 2013 in Women's Health
 
 
Answered by Dr. Ivan R. Rommstein 59 minutes later
Brief Answer:
Hi and welcome to XXXXXXX

Detailed Answer:
Considering your case and postpartum period, the chances that ejaculated sperm was in contact with female egg is very low,actually negligible and the risk is only theoretic,but also there are some sperms in pre-ejaculatory man's fluids so this is a cause of some pregnancies that occur without ejaculation. However,this scenario is also very very rare and I would say so rare that it doesnt require emergency contraception. Now,if you want to be 100%,not 99.5% for sure, you can take pill. There’s no some harm in using emergency contraceptive pills although considering your medical history it would not be advisable to use oral contraception for longer period but single dose of EM pill should not have some bad effects. However it may cause some hormonal imbalance especially in period of breast-feeding and it has certain risk of other mild side effects.

So this is your decision,I dont think you should take it but if you think that this minor possibility of pregnancy will make you anxious then take EM pills just to put your mind at ease.
WIsh you good health. Feel free to ask. Regards
Above answer was peer-reviewed by
 
Follow-up: In postpartum period. Had sexual intercourse and semen dripped down to vagina. Pots syndrome with chest pain. Solution to avoid pregnancy? 4 hours later
OK that makes me feel better this had never happened before. What do you recommend is a good form of birth control for someone like me?
 
 
Answered by Dr. Ivan R. Rommstein 3 hours later
Brief Answer:
Hi

Detailed Answer:
Well,first year after delivery it is not recommeded to use hormonal therapy,but all other methods of contraception are allowed. Actually you can use so called mini-pill which has only progesterone,not estrogens if this is available in your pharmacy.
Usually in first year after delivery, contraception can be succesful by natural methods(avoiding fertile days,pull out method) but you can always use condoms, diaphragms or IUDs.
After 1 year you can start with hormonal pills. Before it,you should just check your hormones related to carcinoid to rule out possiblity of recurence.
Regards
Above answer was peer-reviewed by
 
Follow-up: In postpartum period. Had sexual intercourse and semen dripped down to vagina. Pots syndrome with chest pain. Solution to avoid pregnancy? 7 minutes later
5hiaa and chromogranin were ok as well as colon and endoscopy pet scan had abnormality but follow up ct looked OK and could not detect cause of abnormality. I have had so many tests done in the last 4 months I don't know if my hormones are just crazy due to the pregnancy and postpartum I may have to follow up with an endocrinologist thank you for your help
 
 
Answered by Dr. Ivan R. Rommstein 7 hours later
Brief Answer:
Hi

Detailed Answer:
PET scan is very sensitive test,sometimes too sensitive and there are many false positive results. If your carcinoid specific hormones are fine as you said then you dont have to be worried.
Other female hormones are usually in certain kind imbalance during postpartum period and several months even up to year need to pass till periods stabilize. Especially if you have ovarian cysts that are functional and product estrogen. Also,if this is PCOS then hormonal imbalance is something expected.
But this is nothing serious, you just need to be patient few more months. Try to enjoy in your children and avoid stress and negative thinking. It will just make you anxious and it may worsen then all other organ functions.
Above answer was peer-reviewed by
 
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