Pregnancy Testing: What to Do When Your Period is Late

Pregnancy test questions?

Hello doctor, my menstrual cycle is about 30 to 35 days (mostly 35 days).
Over the past two years, my periods have become shorter and the flow has decreased (to less than half of what it used to be).
My last period started around October 1st, and I had sexual intercourse during the fertile window from October 19th to 21st (I have not had sexual intercourse since then).
It was unprotected and there was no ejaculation inside.
I was expecting my period to come around November 5th to 7th, but it hasn't arrived yet.
On November 11th, I went to a clinic for a urine pregnancy test, which came back negative (no ultrasound was performed).
I took the medication prescribed by the doctor to induce my period, but I have been feeling nauseous.
For the past two days, I have had a sensation in my abdomen as if my period is about to start (a traditional Chinese medicine practitioner also indicated that it feels like my period is coming), but today it still hasn't arrived (it is the first day after taking the medication).
I would like to know if it is still possible for the pregnancy test to be inaccurate after almost 21 days since the sexual intercourse? I have been pregnant before but had a medical abortion.
This time, the symptoms do not seem like pregnancy, but my body temperature has been slightly elevated, and I feel nauseous, without the excessive sleepiness I experienced during my previous pregnancy.

ruru, 20~29 year old female. Ask Date: 2016/11/15

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is generally recommended to wait at least 12 days after conception to take a pregnancy test for accurate results.
The chances of pregnancy are low.
Typically, menstruation should occur within one week after finishing menstrual induction medication.
If your period has not started more than one week after completing the medication, it is advisable to consult a gynecologist.
Wishing you good health.

Reply Date: 2016/11/15

More Info

When it comes to pregnancy testing, timing is crucial, especially if your menstrual cycle is regular and you experience a delay. Based on your situation, it seems you have a cycle that typically ranges from 30 to 35 days, with the last period starting on October 1. You had unprotected intercourse during your fertile window around October 19-21, and your period was expected between November 5-7. Given that you have not yet menstruated and have already taken a urine pregnancy test on November 11, which returned a negative result, there are several factors to consider.

Firstly, it is important to understand that home pregnancy tests are generally reliable when taken after a missed period. Most tests can detect the hormone hCG (human chorionic gonadotropin) in urine about 14 days after conception. Since your last sexual encounter was around 21 days ago, it is reasonable to expect that a pregnancy test should provide an accurate result at this point. However, if you tested too early or if the test was not performed correctly, it could yield a false negative.

In your case, since you have taken a pregnancy test and received a negative result, but your period has still not arrived, it may be beneficial to wait a few more days and test again. Hormonal fluctuations, stress, changes in weight, and other factors can affect your menstrual cycle, leading to delays even if you are not pregnant. Additionally, the use of medication, such as the menstrual induction drugs you mentioned, can also influence your body’s hormonal balance and may cause symptoms like nausea or abdominal discomfort.

If your period does not arrive within a week or two after your initial test, or if you continue to experience symptoms such as elevated body temperature and nausea, it would be advisable to consult with a healthcare provider. They may recommend a blood test for pregnancy, which is more sensitive than urine tests and can detect lower levels of hCG. Furthermore, a healthcare professional can evaluate your symptoms and provide guidance on whether further investigation is needed, especially considering your history of a previous pregnancy and medical management.

In summary, if your period is delayed and you have had a negative pregnancy test, it is reasonable to wait a few more days and test again. If the test remains negative and your period does not start, or if you have concerning symptoms, seek medical advice. Understanding your body’s signals and maintaining open communication with your healthcare provider is key to managing your reproductive health effectively.

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