Hello. I understand your concern, but please be reassured. Since you have been consistently taking your daily combined oral contraceptive containing levonorgestrel and ethinylestradiol for 14 days, you are already fully protected against pregnancy. These daily pills become effective after 7 days of consistent use. Therefore, taking an emergency contraceptive pill like Unwanted 72 is not necessary. Taking extra hormones when you are already protected is not needed and might cause minor side effects like nausea or irregular spotting. Just continue taking your daily birth control pills on schedule.

Starting sertraline can sometimes cause a temporary wave of unsettling symptoms as your body adjusts, which is quite common. Feeling uneasy, dizzy, disconnected from yourself, or even slightly disoriented at night can happen in the first couple of weeks. These are typically transient startup side effects rather than a life-threatening reaction. However, because you are experiencing multiple intense symptoms like feeling close to fainting (presyncope), please contact your prescribing doctor right away to ensure your safety and comfort. They can help adjust your dose or offer guidance.

The symptoms you describe?unexplained crying, loss of interest, and trouble concentrating?are common signs of depression or anxiety. Anxiety itself can frequently cause physical symptoms like chest pain. Sometimes, underlying physical conditions like thyroid issues can also mimic these feelings. Because you are experiencing chest pain, it is very important to visit a healthcare provider for a thorough checkup to rule out physical causes. Please reach out to a professional; there are highly effective treatments and support available to help you feel like yourself again.

It is very common for your period to be delayed after taking an emergency contraceptive pill like Unwanted 72 (levonorgestrel). These pills contain hormones that temporarily disrupt your menstrual cycle, which can easily delay your period by a week or more. Since your pregnancy test is already negative, this is highly reassuring. Your body just needs a little time to reset. I recommend waiting a few more days. If your period is delayed by more than ten days, or if you feel anxious, you can take another test or consult a healthcare provider for peace of mind.

Washing hands with water removes almost all sperm, and digital penetration itself carries virtually no risk. Furthermore, taking levonorgestrel within 12 hours is highly effective at preventing pregnancy. Regarding the pregnancy test, six days is too early to show an accurate result. For complete peace of mind, she should take a home urine pregnancy test 14 to 21 days after the incident, or if her period is late.

Smoking a cigarette or having intercourse after taking Unwanted 72 (levonorgestrel) will not reduce the medication's effectiveness for your previous intercourse. However, please know that emergency contraception only protects you from intercourse that happened *before* taking the pill. It does not prevent pregnancy from any sex that occurs *after* you take it. Because you had intercourse four hours later, you may not be protected for that specific act. I highly recommend using a barrier method, like condoms, for any further intimate contact. Please consider speaking with a healthcare provider for personalized guidance.