A Woman with Vaginal Bleeding After Starting a New Oral Contraceptive
Abstract
A 19-year-old female presented to the emergency department with vaginal bleeding for 1 day and passage of what she believed to be fetal tissue due to possible miscarriage (Fig. 1). She endorsed initial abdominal cramping and lower back discomfort. She reported being sexually active and recent placement on a combined oral contraceptive (OCP), levonorgestrel and ethinyl estradiol (Simpesse), 2 months prior to presentation. She denied menses since starting the OCP. Her vitals were stable; abdominal and pelvic exams were unremarkable.
Fields of Study & Subjects
Reproductive Health and Contraception
Maternal and fetal healthcare
Reproductive tract infections research
Publication details
- Journal / source
- Journal of the American College of Emergency Physicians Open
- Publisher
- Elsevier BV
- Volume
- 7
- Issue
- 2
- Pages
- 100323–100323
- Publication date
- 21 January 2026
- Language
- EN