Why Is My Period Late After Multiple Negative Pregnancy Tests?

Multiple pregnancy tests have been taken, but menstruation has not yet occurred?

Hello, doctor.
I would like to ask about my situation.
I got my period on April 24, and on April 29, I had sexual intercourse with my boyfriend.
We used a condom and practiced withdrawal, and later on May 11 and May 30, I took pregnancy tests, both showing a single line, indicating no pregnancy.
On May 22, I had sexual relations with my boyfriend again, using a condom, but he ejaculated inside.
Afterward, he checked the condom with water to ensure it didn't break, and he confirmed that there was no possibility of semen leakage after he pulled out immediately.

According to my regular cycle, I should have gotten my period by May 24 (my cycles are quite regular, usually not more than three days late).
However, today is June 1, and my period is eight days late.
I took another pregnancy test this morning, which also showed a single line, indicating no pregnancy.
On May 28, which was the fourth day of my missed period, I went to a gynecologist for an examination.
The results showed no pregnancy, but they found that my ovaries were enlarged, with a cyst about five centimeters in size.

I would like to ask if an ovarian cyst can affect my delayed period.
Is my delayed period related to the internal ejaculation on the 22nd while using a condom? Is the result of a pregnancy test taken ten days after intercourse using morning urine reliable?

Niming, 10~19 year old female. Ask Date: 2016/06/01

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle or cause intermenstrual bleeding are numerous, including environment, lifestyle, stress, emotional instability, diet, age, lesions in the uterus or cervix, and pregnancy, among others.
It is advisable to consult a gynecologist if your period does not arrive as expected, to check for hormonal imbalances or early pregnancy.
Thank you! Wishing you peace and health, Dr.
Chang.

Reply Date: 2016/06/01

More Info

When experiencing a late period accompanied by multiple negative pregnancy tests, it can be concerning and confusing. In your case, you mentioned that your last menstrual period started on April 24, and after having sexual intercourse on April 29 and May 22, you have not seen your period by June 1, which is eight days late. You have also conducted several pregnancy tests, all returning negative results. Additionally, you visited a gynecologist who noted enlarged ovaries and a 5 cm cyst.

There are several factors to consider regarding your late period:
1. Pregnancy Testing Accuracy: Home pregnancy tests are generally reliable when used correctly, especially when taken after a missed period. However, testing too early can lead to false negatives. Since you mentioned that you tested on May 30 and June 1, these tests should be accurate if taken with morning urine, which is typically more concentrated. If you had intercourse on May 22 and tested ten days later, it is likely that if you were pregnant, the test would have detected it by then.

2. Ovarian Cysts: The presence of a 5 cm ovarian cyst can indeed affect your menstrual cycle. Ovarian cysts can disrupt normal hormonal balance, potentially leading to delayed or missed periods. Functional cysts, which are common, can form during the menstrual cycle and may cause symptoms such as delayed menstruation, pelvic pain, or changes in menstrual flow. In some cases, they can resolve on their own, but they may also require monitoring or treatment if they cause significant symptoms.

3. Stress and Lifestyle Factors: Stress is a well-known factor that can impact menstrual cycles. You mentioned that you have been under stress, which could contribute to hormonal fluctuations that delay your period. Other lifestyle factors, such as changes in weight, exercise habits, or sleep patterns, can also affect your menstrual cycle.

4. Hormonal Imbalances: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular menstrual cycles. If you have a history of irregular periods or other symptoms, it may be worth discussing further testing with your healthcare provider.

5. Timing of Intercourse and Contraceptive Use: You indicated that you used condoms during intercourse, which is a reliable method of contraception when used correctly. The fact that your boyfriend checked the condom for integrity and that there was no ejaculation outside the condom further reduces the likelihood of pregnancy. However, no contraceptive method is 100% effective, so it's always good to be cautious.

Given these factors, it is advisable to follow up with your healthcare provider. They may recommend further evaluation of the ovarian cyst, including monitoring its size and symptoms, and possibly conducting blood tests to check hormone levels. If your period does not return or if you experience additional symptoms, further investigation may be warranted to rule out other underlying conditions.

In summary, while the presence of an ovarian cyst can contribute to a delayed period, stress and lifestyle factors may also play a significant role. Continue to monitor your symptoms, and if your period does not resume soon or if you have concerns, seek further medical advice.

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