Bleeding after taking the drug, how to stop them correctly. Postinor: instructions for use The principle of operation of postinor

One tablet contains

active substance - levonogrestrel 0.75 mg,

excipients: anhydrous colloidal silicon dioxide, potato starch, magnesium stearate, talc, corn starch, lactose monohydrate.

Description

Round, flat surface, white or off-white, beveled tablets, marked "INOR" on one side

Pharmacotherapeutic group

Sex hormones and modulators of the reproductive system. Hormonal contraceptives for systemic use. Progestogens. Levonorgestrel

ATX code G03AC03

Pharmacological properties

Pharmacokinetics

When taken orally, levonorgestrel is rapidly and almost completely absorbed. 1.6 hours after taking one Postinor® tablet, the maximum concentration of the drug in the blood serum reaches 14.1 ng / ml. After that, a two-stage decrease in the concentration of the drug occurs, the half-life ranges from 9 to 14.5 hours.

Levonorgestrel is equally excreted in the urine and feces exclusively in the form of metabolites. Biotransformation of levonorgestrel corresponds to the metabolism of steroids. Levonorgestrel is hydroxylated in the liver and metabolites are excreted in the form of conjugated glucuronates. Pharmacologically active metabolites of levonorgestrel are unknown. Levonorgestrel binds to serum albumin and to sex hormone-binding globulin (SHBG). Only 1.5% of the total dose is in free form, and 65% is associated with SHBG. Absolute bioavailability is almost 100% of the total dose.

About 0.1% of the dose enters the child's body with mother's milk.

Pharmacodynamics

Levonorgestrel at the recommended dose prevents ovulation and fertilization if sexual intercourse occurred before ovulation (at this time the likelihood of fertilization is higher). In addition, changes in the endometrium caused by levonorgestrel prevent the implantation of a fertilized egg. If the implantation process has already begun, then the drug will be ineffective.

Efficiency: using Postinor® tablets, pregnancy can be prevented in about 85% of cases. The more time passed between sexual intercourse and taking the drug, the lower its effectiveness (95% during the first 24 hours, 85% - from 24 to 48 hours, and 58% - from 48 to 72 hours). Thus, it is recommended to start taking Postinor® tablets as soon as possible (but no later than 72 hours) after sexual intercourse, if no protective measures have been taken. At the recommended dose, levonorgestrel does not have a significant effect on the coagulation system and on the metabolism of lipids and carbohydrates.

Indications for use

Emergency contraception to prevent pregnancy (in the first 72 hours after intercourse) in the absence of contraception or insufficient reliability of the method used

Dosage and administration

The drug is administered orally. You need to take 2 tablets. To achieve a more reliable effect, the first tablet should be taken as soon as possible after sexual intercourse (no later than 72 hours later). The second tablet should be taken 12 hours (but not later than 16 hours) after taking the first tablet.

If vomiting occurs within three hours of taking any tablet, another tablet should be taken.

Postinor® tablets can be used on any day of the menstrual cycle, but only if the previous menstruation was normal.

After taking emergency contraceptive, local barrier methods (such as a condom) should be used until the next menstrual period. After using Postinor® tablets, continuous use of oral contraceptives is not contraindicated.

Side effects

Very often (>1/10)

Nausea, pain in the lower abdomen

Bleeding not related to menstruation

Fatigue

Often (>1/100 to<1/10)

Headache, dizziness

Vomiting, diarrhea

Pain on palpation of the mammary glands

Delayed menstruation more than 7 days

Irregular bleeding and spotting

The nature of menstruation can change temporarily, but for most women, the next period comes on time, within 7 days of the expected time. If menstruation is delayed by more than 5 days, then it is necessary to exclude the possibility of pregnancy.

Contraindications

Hypersensitivity to the components of the drug

Girls before puberty

Patients with rare hereditary diseases of galactose intolerance, Lapp lactase deficiency or glucose-galactose malabsorption syndrome

Drug Interactions

With the simultaneous administration of drugs-inducers of liver enzymes, the metabolism of levonorgestrel is accelerated

Reduce the effectiveness of levonorgestrel: barbiturates, including primidone, phenytoin and carbamazepine, preparations containing St. John's wort (Hypericum perforatum), as well as rifampicin, ritonavir, rifabutin, griseofulvin. Women taking these drugs should contact their doctor

Preparations containing levonorgestrel may increase the risk of cyclosporine toxicity due to the suppression of its metabolism.

special instructions

The contraceptive should only be used in "emergency" situations. The drug does not replace regularly used contraceptives.

Emergency contraception may not always prevent pregnancy.

The effectiveness of Postinor® tablets after sexual intercourse, during which contraceptives were not used, decreases over time:

If there is any doubt about the timing of unprotected intercourse, or if unprotected intercourse occurred more than 72 hours during the same menstrual cycle, then there is a possibility that conception has already occurred. In this regard, the use of the drug Postinor during repeated sexual contact may be ineffective in preventing pregnancy. If the menstrual cycle is delayed by more than 5 days, or if there is unusual bleeding on the day of the expected period, or if there is other reason to suspect pregnancy, pregnancy should be excluded.

If pregnancy occurs after the use of Postinor®, the possibility of an ectopic pregnancy must be considered. Especially, the presence of an ectopic pregnancy may be suspected in women who report severe abdominal pain or fainting, as well as in the presence of a history of ectopic pregnancy, fallopian tube surgery, or pelvic inflammatory disease.

The effectiveness of Postinor® may be adversely affected by severe forms of malabsorption syndrome (for example, Crohn's disease). Women suffering from these conditions should consult a doctor if emergency contraception is needed.

This medicinal product contains lactose monohydrate and should not be used in patients with rare hereditary problems of galactose intolerance, the Lapp lactase deficiency or glucose-galactose malabsorption syndrome.

After taking the drug Postinor®, menstruation usually passes normally and comes on time. Sometimes menstruation can start a few days earlier or later. Women should be advised to visit a doctor in order to select and start using one of the methods of regular contraception. If in the next cycle after the use of the drug Postinor® and regular hormonal contraception, menstruation does not occur, then pregnancy should be excluded.

Repeated use of the drug during one menstrual cycle is not recommended due to the possibility of a violation of the cycle. Postinor® is not effective as a standard regular method of contraception and should only be used as an emergency measure. Women who present for repeated courses of emergency contraception should be advised to use long-term methods of contraception.

The use of emergency contraception does not replace the necessary precautions related to protection against sexually transmitted diseases.

No matter how sad it is to write about it, but postinor in Russia ranks second among contraceptive methods. On the first, as you know, is. And yet, many women, despite the large selection of contraceptives, use postinor to prevent unwanted pregnancy, forgetting or not knowing about the complications, and what danger the harmless 2 pills pose in the future.

Meet Postinor

Postinor is produced in a package in which there are only 2 tablets (only the number of tablets should suggest that this is not a drug for regular use). One tablet contains 750 mcg of levonorgestrel, which has an emergency contraceptive effect. Levonorgestrel has antiestrogenic and progestogenic properties.

Postinor refers to emergency or fire contraception, and should be used only in exceptional cases, and not constantly and regularly.

How does postinor work?

The contraceptive effect of the drug is in three points. Firstly, levonorgestrel prevents the release of the egg from the follicle, that is, it inhibits ovulation (this moment is especially relevant in the preovulatory and ovulatory phases). Secondly, levonorgestrel, as a progestogen, changes the structure of the uterine mucosa and causes "glandular regression" of the endometrium, which makes it impossible for a fertilized egg to penetrate into the uterine wall (violation of implantation). This mechanism is comparable to, that is, conception has already occurred, but the uterus expels the egg. And thirdly, levonorgestrel causes changes in the mucus in the cervical canal, making it viscous and thick. Such mucus plays the role of a barrier and makes it difficult for sperm to enter the uterine cavity.

From the described mechanisms of action of postinor, it becomes clear that the effectiveness of the drug is directly proportional to the time it is taken after unprotected sex. After using postinor 24 hours or less after sexual intercourse, it will protect against unwanted pregnancy in 95% of cases, when taking pills after 25-48 hours, the effectiveness is 85%, and if postinor was taken in the interval from 49 to 72 hours, its reliability decreases up to 58%.

Rules for accepting a postinor

Postinor can be taken on any day of the menstrual cycle. If a woman has an irregular menstrual cycle, the absence of pregnancy should be confirmed. The first tablet from the blister should be taken no later than 72 hours after intercourse. The second dose should be taken exactly 12 hours later (an interval of 4 hours is allowed, that is, no more than 16 hours later).

If a woman vomits within three hours after taking a postinor tablet (regardless of the first or second one), an additional tablet should be taken. Menstrual-like bleeding (withdrawal bleeding) can occur a few days after taking the drug (on average after 3 to 7 days) and about a month later (at the time of the expected period).

Postinor is not a means for regular contraception, if a woman has an active sex life, she should consult a doctor and choose the best method of contraception. It is believed that you can not use the drug more than once a month, and preferably no more than 4 times a year. In fact, it is better not to resort to postinor at all, but to use it only in an exceptional situation.

When is postinor justified?

Life is an unpredictable thing and there are situations when it is necessary to prevent pregnancy:

• rape;
• the condom broke;
• unprotected intercourse for various reasons;
• expulsion of the intrauterine device or shift of the vaginal diaphragm;
• missed taking a pill from a series of combined oral contraceptives.

Consequences after using postinor

Since the drug contains an "elephant" dose of the hormone, its use can adversely affect a woman's health. Firstly, there is a high probability of uterine bleeding, which can only be stopped surgically (that is, by curettage of the uterus). Secondly, taking postinor, especially more than once in a lifetime, hits the ovaries, which leads to menstrual irregularities, hormonal imbalance and anovulation. All of these effects are a direct path to infertility. Thirdly, a large dose of levonorgestrel cannot but cause side effects:

• nausea and vomiting, diarrhea;
• headache, dizziness;
• mood swings (emotional lability, panic fears);
• delay of menstruation;
• allergic reactions;
• pain in the lower abdomen, fatigue;
• pain and engorgement of the mammary glands.

Postinor is a postcoital hormonal emergency contraceptive that suppresses ovulation and fertilization during sexual intercourse in the preovulatory phase, in the case of the highest probability of fertilization, causing changes in the endometrium that prevent implantation.

Release form and composition

Postinor is produced in the form of tablets: disc-shaped, flat, almost white or white, with a chamfer and a circular engraving "INOR" on one side (2 or 4 pieces in blisters; 1 blister in a cardboard pack).

1 tablet contains:

• Active ingredient: levonorgestrel - 0.75 mg;
• Auxiliary components: lactose monohydrate, corn starch, talc, magnesium stearate, potato starch, colloidal silicon dioxide.

Indications for use

Postinor is used for emergency (postcoital) contraception in cases of unprotected intercourse or the unreliability of the contraceptive method used.

Contraindications

Absolute:

• severe liver failure;
• Hereditary diseases: glucose-galactose malabsorption, lactase deficiency, lactose intolerance;
• Children and adolescents up to 16 years of age;
• Pregnancy;
• Hypersensitivity to the components of the drug.

Relative (required to be used with extreme caution, since the likelihood of complications is high):

• Jaundice (including history);
• Diseases of the biliary tract or liver;
• Crohn's disease;
• breastfeeding period.

Method of application and dosage

In cases where vomiting occurs within 3 hours after taking the drug, another tablet should be taken.

The drug can be taken at any time of the menstrual cycle. With an irregular menstrual cycle, it is recommended to first exclude pregnancy.

After taking Postinor, local barrier contraceptive methods (cervical cap, condoms) should be used until the next menstruation.

Side effects

When taking Postinor, allergic reactions may occur (swelling of the face, itching, rash, urticaria); often - delayed menstruation (no more than 5-7 days), soreness of the mammary glands, headache, dizziness, diarrhea, vomiting; very often - acyclic spotting (bleeding), pain in the lower abdomen, fatigue, nausea.

special instructions

The drug should be used exclusively for emergency contraception. Its effectiveness after unprotected intercourse, during which contraceptives were not used, decreases over time: if 24 hours or less have passed after intercourse, the effectiveness of the drug is 95%, 25-48 hours - 85%, 49-72 hours - 58% .

Postinor is not a substitute for the use of permanent methods of contraception. The drug, in most cases, does not affect the nature of the menstrual cycle, however, it is possible to delay menstruation for several days and the appearance of acyclic spotting. If there is a delay in menstruation for more than 5-7 days and a change in its nature (abundant or scanty discharge), pregnancy should be excluded. With the appearance of pain in the lower abdomen and fainting, an ectopic (ectopic) pregnancy should be excluded.

Adolescents under 16 years of age in exceptional cases (including rape) are allowed to use the drug after consulting a gynecologist and confirming pregnancy.

After using emergency contraception, a gynecologist should be consulted to determine the most appropriate method for permanent contraception.

Postinor does not protect against sexually transmitted diseases.

The effectiveness of the drug may decrease with violations of the function of the gastrointestinal tract (for example, Crohn's disease).

drug interaction

The metabolism of levonorgestrel can be accelerated when it is used simultaneously with liver enzyme inducers; its effectiveness may be reduced by griseofulvin, rifabutin, tetracycline, ampicillin, ritonavir, rifampicin. preparations containing St. John's wort, carbamazepine, phenytoin, barbiturates, including primidone, tretinoin, topiramate, tacrolimus, oxcarbazepine, nevirapine, lansoprazole, amprenavir.

Levonorgestrel reduces the effectiveness of anticoagulant and hypoglycemic drugs, increases plasma concentrations of glucocorticosteroids, and may increase the risk of cyclosporine toxicity by suppressing its metabolism.

Terms and conditions of storage

Store in a dry place, out of the reach of children and protected from light, at temperatures up to 25 °C.

Shelf life - 5 years.

In no case!
The sooner, the better. The sooner you take the pill, the more likely you are to prevent pregnancy.
Postinor is a solution to the problem with the help of a pill: just 2 pills and you will not need any abortion.
Some people refer to emergency contraceptive pills as “next day pills.” But this does not oblige you to wait until the next day. You can drink the Postinor tablet immediately or use it up to three days after unprotected intercourse (sex), or if you are afraid that the method of contraception you are using has not justified itself.

How to take POSTINOR?

The package contains 2 tablets.
The first pill should be taken no later than 72 hours after unprotected sex, the second - 12 hours after the first.

Take Postinor as soon as possible! The sooner, the better!

The sooner you take Postinor, the more likely it will be effective. Ideally, you should try to take your first pill within 24 hours of unprotected intercourse, as this is when emergency contraception is most effective.

The effectiveness of emergency contraception depends on the number of hours that have passed since unprotected sex.

When can I take POSTINOR?

POSTINOR is a safe way to prevent pregnancy up to 72 hours after contraceptive failure or unprotected intercourse (sex), with a low incidence of side effects.
It is highly unlikely that you will experience any serious or long-term side effects after taking Postinor. As a rule, you can continue your day in the usual way.

Do not take POSTINOR:

If you are already pregnant, because it will not work, although it will not harm you or your fetus.
If you are allergic to levonorgestrel or any of the other ingredients of Postinor.

Postinor will not protect you from HIV infection and other sexually transmitted diseases (STDs).

How often can I take POSTINOR?

It is not a regular method of contraception. Try to use it as little as possible, only in emergency cases. But never forget: this method has far fewer side effects and health risks than abortion pills or medical abortion.

Strictly speaking, Postinor should not be taken more than once during one menstrual cycle. If Postinor is used more than once during the menstrual cycle, then this will most likely disrupt your menstrual cycle.
Emergency contraception does not work as well as regular methods of contraception. Your doctor, nurse, or family planning clinic can tell you about long-term contraceptive methods that are more effective in preventing you from getting pregnant.

If you are pregnant

If you are already pregnant, then the Postinor tablet simply will not work, and besides, it will not harm either the existing pregnancy or the fetus.
If you think you are pregnant, contact your doctor or family planning clinic as soon as possible.

If you have already taken Postinor once since your last period and now find that you are pregnant, do not take Postinor again.

What should I do if I vomit after taking Postinor?

After taking Postinor, some women (about 1 in 100) may experience nausea or vomiting.

If you vomit within 3 hours after taking the Postinor tablet, you need to take another Postinor tablet.

If vomiting occurs more than 3 hours after taking the Postinor tablet, you do not need to take the Postinor tablet again.

How do I know if the POSTINOR tablet has worked?

You will know that the Postinor tablet has worked when your next menstrual cycle begins and the cycle is normal.

When should you see a doctor?

• If your period is more than 5 days late, or if it is unusually heavy or light.
• If you are still concerned that you are pregnant.
• If you have sudden or unusual pain in your lower abdomen and your period is late.
• If you have any doubts about your health or the method of contraception that is best for you.

The site provides reference information for informational purposes only. Diagnosis and treatment of diseases should be carried out under the supervision of a specialist. All drugs have contraindications. Expert advice is required!

Elena asks:

Hello! My name is Lena, I'm 22 years old. Sexual intercourse was on July 25, the condom broke. About an hour later I took a postinor tablet, followed by 17 hours later. Monthly constants, cycle of 28 days. My period is due on July 27th. Please tell me how much this drug will help me, because I was late with the second pill for a couple of hours. And is pregnancy possible during these periods, like these are safe days. Thanks for the help!!!

If semen enters the female genital tract, pregnancy is possible. Prem drug postinor significantly reduces the likelihood of pregnancy. Important in the case of emergency contraception is the earliest taking the first pill.

Katya asks:

Hello! I took Postinor 25 hours after the unprotected PA, the next pill - 12 hours later, according to the instructions. For the third day I have not observed any consequences, only yellowish discharge, similar to thrush. Can you tell me, please, is it possible that these are signs of pregnancy ??
Thank you!

If intermenstrual bleeding does not begin on the 5-7th day of taking the drug, it is necessary to consult a gynecologist and donate blood for hCG, to exclude pregnancy.

Karina asks:

Hello! I took Postinor after 36 hours, and after 5 days the action will begin? If there is no pregnancy, will there still be bleeding?

Postinor begins to act immediately after taking the tablet (after it is dissolved and absorbed in the intestine). Bleeding, which should appear 5-6 days after the use of this drug, indicates the highest contraceptive effect and the exact absence of pregnancy. If there is no bleeding at all or it occurs later, you will need to undergo an examination by a gynecologist to exclude pregnancy. You can read more about Postinor and its effects on the body in our section: Postinor.

Karina asks:

thanks for the answer! I have another problem ((in general, I drank as expected, after 5 hours menstruation began, my stomach hurt for 3 days, yesterday I started tingling in the lower abdomen, intensified in the evening, it hurts to press on the lower abdomen, today is the same, only it hurts less .can it be from postinor?

The listed symptoms may be associated with taking the hormonal contraceptive Postinor, so you should not worry. As a rule, these symptoms disappear on their own, specific measures are not required. You can get more information about this in the section: Hormonal contraceptives

Anya asks:

Hello! immediately after unprotected intercourse, I drank a glass of milk with iodine, after which, within 24 hours, I drank the first postinor tablet (the second one, as per the instructions), but after 5 days there were no changes, is there a chance that there is a pregnancy?

As a rule, bleeding after Postinor begins 6 days after taking the last pill. If it is absent, then it is necessary to exclude the possibility of pregnancy. To do this, I recommend that you do a blood test for hCG 7-10 days after intercourse. You can get more information on this issue in the section: Analysis for hCG

Maria asks:

I had intercourse for two days in a row, and both times they didn’t use protection, everything about me, 48 hours after the first time, I drank Postinor, but it turned out that I got pregnant anyway, could it be?

Unfortunately, this situation is possible, since Postinor is not a 100% effective remedy. In addition, the time of taking Postinor is also important - the longer the interval from sexual intercourse to taking Postinor, the less its effectiveness. You can get more information on this issue in the thematic section of our website: Postinor

rita asks:

torn condom torn drank after 8 hours postinor further according to the instructions I have a question, menstruation should go in 1-2 days how to understand if menstruation goes, did postinor work

In the event that you begin menstrual flow, then pregnancy can be completely excluded and this will mean that the drug has worked. Read more about the effect of the drug Postinor, read in a series of articles by clicking on the link: Postinor.

Victoria asks:

Tell me, within 12 hours after intercourse I drank postinor, then the second pill, all on time. Menstruation began (as it should be according to the cycle, it coincided) 6 days after the act and taking the postinor. after 2 weeks, menstruation began again, more precisely spotting, often black. 4 days later, heavy periods began. Can you tell me if this may be a consequence of taking Postinor and will it return to normal in the next month or is it necessary to urgently consult a doctor?

These bleedings are associated with taking the hormonal contraceptive Postinor. In such cases, nothing needs to be done, the menstrual cycle will recover on its own. I recommend that you use barrier methods of contraception. You can get more detailed information on the question you are interested in in the relevant section of our website by clicking on the following link: Postinor

Damira asks:

Hello. On February 1, I had sexual intercourse and the condom broke within an hour, I took 1 tablet of Postinor, then after 12 hours the second one. should arrive around February 15. What should I do?

As a rule, after taking Postinor, bleeding begins on the 6th day, but in some cases it may be later. Given that you took the drug correctly, you should not worry, nothing needs to be done now. You can get more detailed information on the issue that interests you in the relevant section of our website by clicking on the following link: Postinor. You can also get additional information in the following sections of our website: Probability of getting pregnant, Menstrual cycle and menstruation

Marina asks:

Hello! I am 40 years old. Yesterday at 19.00 there was unprotected intercourse, the very middle of the cycle, a dangerous week. This morning at 10.00 I took the first Postinor tablet, 15 hours passed after PA. The lower abdomen ached, the heartbeat became more frequent, in general, all the signs, the effects of the drug. Waiting for the bleeding to start. My question is: Can I start taking Tri-regol on the first day of bleeding after taking Postinor?

In this situation, you should take the second Postinor tablet 12 hours later, after which, after 6 days, as a rule, menstrual bleeding begins. It is not the beginning of menstruation, so you do not need to take Tri-regol - wait for the next menstruation and from the first day of the cycle you can use cyclic hormonal contraceptives if they are prescribed to you by your gynecologist.

You can get additional information on the question you are interested in in the relevant section of our website by clicking on the following link: Postinor, as well as in the section: Emergency contraception Hormonal contraceptive Tri-regol: instructions for use and in a series of articles: Hormonal contraceptives

Valentina asks:

Menstruation was on June 18, June 2 was an unprotected PA, but the partner did not finish me, I believe him.
After about 10 hours I drank Postinor, after 12 hours another one, just in case.
Is it possible to rule out pregnancy?
Or what should I expect?

In this situation, there was no need to use emergency contraception if there was no ejaculation in the vagina. Taking Postinor excludes pregnancy, so there is no reason to worry. Further I recommend you to apply barrier methods of contraception. You can get more detailed information on the question you are interested in in the relevant section of our website by clicking on the following link: Postinor and in a series of articles: Emergency contraception. You can also get additional information in the following section of our website: Probability of getting pregnant

Marina asks:

Hello, I took postinor after 40 hours, 4 days have already passed and visions of a dark color appeared and my stomach hurts all the time, I had sex 2 days before my period, tell me if the drug will help and what is the probability of pregnancy ?!

The probability of pregnancy is excluded if you have taken the hormonal contraceptive Postinor in a timely manner. The presence of spotting confirms that pregnancy has not occurred, so there is no reason to worry. You can get more detailed information on the question you are interested in in the relevant section of our website by clicking on the following link: Postinor and in a series of articles: Emergency contraception. You can also get additional information in the following section of our website: Probability of getting pregnant

Elena asks:

Unprotected intercourse, after 3 hours I immediately drank 2 Postinor tablets (I didn’t read the instructions, unfortunately), then I had sexual intercourse during the day. It's been 5 days with slight bleeding. Q: Is it a long acting drug?

The emergency contraceptive Postinor, according to the instructions, must be used according to the scheme - 2 tablets with an interval of 12 hours, and the contraceptive effect extends to sexual intercourse that took place before Postinor was taken. The presence of spotting indicates the absence of pregnancy, so you should not worry. We recommend that you do not panic and continue to use barrier methods of contraception, and if you have regular sex life, personally consult with your gynecologist to select a reliable contraceptive.

You can get more detailed information on the question you are interested in in the relevant section of our website by clicking on the following link: Postinor and in a series of articles: Emergency contraception. You can also get additional information in the following section of our website: Probability of getting pregnant

Elena asks:

The condom broke in the middle of the menstrual cycle. After 4 hours I drank the first tablet of Postinor, after 12 hours the second. There are no sensations, today is the 4th day after unprotected intercourse, there is no discharge. Did Postinor work?

As a rule, after taking the hormonal contraceptive Postinor, spotting is observed after 6 days, but in some cases it may be absent, which, nevertheless, does not give grounds to judge the absence of the effect of the use of this emergency contraceptive. Given that the drug was taken in a timely manner, there is no reason to panic.

Elena asks:

On the 8th, my partner and I had an unprotected PA. He did not cum inside me, after about 25 hours I took the first pill and after 12 hours I took the second. Can you please tell me how to help? How soon should menstruation start?

If during intercourse there was no ejaculation in the vagina, then there is no chance of pregnancy. In this situation, there was no need to use Postinor emergency contraception. After taking this medicine, spotting usually starts after 6 days, and the next menstruation may come late.