Irregular Menstrual Cycles: Possible Causes and Concerns

Is it a gynecological disease or pregnancy?

I have been experiencing irregular menstrual cycles, and recently I often feel alternating sharp pains in both sides of my abdomen (about 2 cm below the rib cage).
Sometimes, I also feel alternating sharp pains in the positions of my left and right ovaries.
My period has not yet arrived, and I previously did not pay attention to whether ovulation could cause these alternating sharp pains.
At times, my abdomen feels distended as if liquid is moving inside (I can see it expanding and contracting, with the abdominal bulge being slightly higher than the uterus).

I have washed my hands after coming into contact with semen and wiped them with tissue.
Is it possible for any residue to remain? Could I have become pregnant from touching my genital area while bathing? Is it possible for sperm to remain on the male partner's hands and enter the body during genital contact? I have used a pregnancy test stick, test strips, and a pregnancy test kit, testing five times at different intervals, and each time there was only one line.
Could it be an ectopic pregnancy that is not detectable? Or could it be that the urine sample was not midstream, leading to a negative result?
I do not typically have a tendency to have a distended lower abdomen, but I am concerned that the recent abdominal swelling could indicate ovarian cancer or pregnancy.
If I were to seek medical evaluation, could I have only an abdominal ultrasound without a transvaginal ultrasound?

Niming, 20~29 year old female. Ask Date: 2016/06/27

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, the chances of pregnancy are low.
However, it is not possible to determine pregnancy solely based on subjective symptoms.
I recommend that if your period is more than a week late, you should take a urine test to check for pregnancy.
Thank you! Wishing you peace and health.
Dr.
Zhang

Reply Date: 2016/06/27

More Info

Irregular menstrual cycles can be a source of concern for many individuals, and understanding the possible causes and implications is crucial for managing one's reproductive health. Based on your description, it seems you are experiencing not only irregular cycles but also abdominal pain and bloating, which can be indicative of various underlying conditions.

Possible Causes of Irregular Menstrual Cycles
1. Hormonal Imbalances: The menstrual cycle is regulated by a complex interplay of hormones. Conditions such as polycystic ovary syndrome (PCOS), thyroid disorders, or adrenal gland issues can lead to irregular cycles.

2. Stress and Lifestyle Factors: High levels of stress, significant weight changes, excessive exercise, or changes in diet can disrupt hormonal balance and lead to irregular periods.

3. Ovarian Issues: Conditions affecting the ovaries, such as ovarian cysts or endometriosis, can cause pain and irregularities in the menstrual cycle. The pain you describe in the area of the ovaries could be related to such conditions.

4. Pregnancy and Related Complications: If there is a possibility of pregnancy, even with negative home pregnancy tests, it is essential to consider the risk of ectopic pregnancy, especially if you are experiencing abdominal pain. Ectopic pregnancies can sometimes yield negative urine tests, particularly if the pregnancy hormone (hCG) levels are low.

5. Other Medical Conditions: Conditions such as fibroids, pelvic inflammatory disease (PID), or even gastrointestinal issues can cause abdominal pain and bloating, which might be mistaken for gynecological problems.

Concerns Regarding Your Symptoms
- Abdominal Pain and Bloating: The alternating pain in your lower abdomen and the sensation of fluid movement could indicate ovarian cysts or other pelvic issues. It is important to monitor these symptoms closely.

- Pregnancy Concerns: Regarding your concerns about potential pregnancy from contact with semen, while the risk is generally low, it is not impossible. If there is any uncertainty, it is advisable to consult a healthcare provider for a more definitive evaluation.

- Ectopic Pregnancy: If you suspect pregnancy and are experiencing significant abdominal pain, it is crucial to seek medical attention immediately, as ectopic pregnancies can be life-threatening.

Diagnostic Approaches
- Ultrasound: An abdominal ultrasound can provide valuable information about the reproductive organs and help identify any cysts, fibroids, or other abnormalities. While a transvaginal ultrasound offers more detailed images of the ovaries and uterus, an abdominal ultrasound can still be informative.

- Blood Tests: A blood test measuring hCG levels can help confirm or rule out pregnancy, including ectopic pregnancy. Additionally, hormone levels can be assessed to identify any imbalances.

Recommendations
1. Consult a Healthcare Provider: Given your symptoms, it is advisable to see a gynecologist or a healthcare provider specializing in reproductive health. They can perform the necessary examinations and tests to determine the cause of your irregular cycles and abdominal pain.

2. Monitor Symptoms: Keep a detailed record of your menstrual cycle, any pain experienced, and other symptoms. This information can be helpful for your healthcare provider.

3. Avoid Self-Diagnosis: While it is natural to worry about conditions like ovarian cancer, many symptoms can overlap with less serious issues. A healthcare provider can help clarify your concerns through appropriate testing.

4. Consider Lifestyle Factors: If stress or lifestyle changes are contributing to your symptoms, consider strategies for stress management, such as exercise, meditation, or counseling.

In summary, while irregular menstrual cycles and abdominal pain can be concerning, many potential causes exist, ranging from hormonal imbalances to benign conditions. Seeking medical advice is essential for proper diagnosis and treatment.

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