Brief Answer:
Proper birth control methods should be used regularly.

Detailed Answer:
Hi Dear,

I have gone through your nicely narrated detail history about your menstrual cycle and unprotected intercourses. Let me discuss the issue one by one as per your narration:

1. You had started your period on 12th XXXXXXX and had unprotected intercourse on 13th of July. This intercourse is most unlikely to cause any pregnancy since the egg release takes place 14 days prior to the next expected menses. In your case, since you were expecting your menses on 12th July, your egg release day comes to be 29th XXXXXXX Hence the intercourse on 13th XXXXXXX was safe as far as the risk of pregnancy is considered and you need not have taken Postinor2 next morning. However, this intercourse carries a great risk of infection to your reproductory organs since you had performed it during your menses. Blood is a very good medium for bacteria to grow. Please avoid having sex during menstrual bleeding.

2. The unprotected intercourse on 27th XXXXXXX is carrying a high possibility of pregnancy since the days of ovulation (egg release) happens to be 29th XXXXXXX Considering the life of egg and sperms, a period of one week around this date is fertile window. In second round of intercourse, you had initially unprotected intercourse. Though he had not ejaculated without condom, there is always a possibility of pre-ejaculation secretion dropping into the vagina unknowingly. It does contain some sperms which are capable of impregnating the woman.

3. Again the intercourse you had a day before the expected menses; i.e. on 11th July is very unlikely to cause pregnancy.

4. The spotting you noticed around 23rd XXXXXXX was probably the break-through bleeding due to Postinor 2 which you can safely ignore.

Now considering all these facts, first priority is to rule out the pregnancy for which please wait expectantly for another week or little more. If you do not get menses within that period, you may get urine pregnancy test and/or ultrasonography performed for diagnosis of pregnancy after 8-10 days of missed period. These tests are not conclusive before this period. Beta hCG test done may be conclusive 2-3 days after missed period due to its specificity and sensitivity. However, it is costly.

After any of these tests, there are two possibilities of result : either pregnancy or no pregnancy.

If you happen to be pregnant and you do not want this pregnancy, you may go for Medical Termination of Pregnancy effected by Mifepristone and Misoprostol. These medicines are not over the counter and have to be taken by prescription and under the observation of Obstetrician only to avoid complications.

If you are not pregnant, you may ask your doctor to give you progesterone or oestrogen + progesterone tablets. About 4-8 days after these tablets you will get your period in the form of withdrawal bleeding.

And now apart from this advise on your priority query, I have to advise you on some other issues which are of importance from medical angle.

1. Please avoid intercourse during the menstruation as mentioned earlier.

2. If you are having a regular sexual life, please switch over to the regular birth control methods instead of relying up on emergency (next morning or plan 2) contraceptive pills. Repeated next morning pills may disturb the regularity of menstrual cycle and also give you stress of pregnancy every cycle (as you are having now). The reliable, suitable and convenient regular methods of birth control are birth control pills, intrauterine device and Condom. Condom can give you some amount of protection against many sexually transmitted infections (including HIV) in addition to safeguarding from the pregnancy. If you are interested in knowing details of the use of these methods, you may ask me.

I feel I have given you clear and sufficient detailed advice on your queries.

Please let me know the results of your pregnancy tests if need to be done. You can upload them for my review. Whatever is the result, or if you start your menses, please keep me informed. I am keen on knowing it.

For any further explanation of information, I am always available for you.

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