Abdominal Discomfort Despite Regular Menstrual Cycles

I have been getting my period, but I feel something unusual in my lower abdomen?

Hello Doctor: I had my last sexual intercourse on August 13th, and I got my period at the end of August, which was somewhat heavy on the first day.
I had another period at the end of September, which was light.
In November, my period started heavy on the first day, then became light on the second day and ended on the third day.
I also had my period at the beginning of December, which was heavy on the first day, then light on the second day, and ended on the third day.
On September 14th, I used a pregnancy test, and after five minutes, I only saw one line, so I discarded it.
In mid-November, I felt unwell and went to see a gynecologist.
He did not perform a pregnancy test but conducted a pelvic exam and said everything looked healthy.
When I asked the doctor about the possibility of pregnancy, he said that the endometrium was not thickened, so there was no pregnancy.
However, I still feel something unusual in my lower abdomen and would like to ask the doctor if this could be a sign of pregnancy.
If I were pregnant, I would be 16 weeks along now; is there a way to terminate it? Can a simple pelvic exam determine if there is a pregnancy? I am really worried.
Thank you, Doctor.

Niming, 20~29 year old female. Ask Date: 2016/12/08

Dr. Lü Lizheng reply Obstetrics and Gynecology

The pregnancy test conducted on September 14, which is 18 days after your sexual intercourse on August 13, can be considered reliable, indicating that you are not pregnant.
During a pelvic examination, the firmness and size of the uterus can provide clues about pregnancy status; an ultrasound can also be used to check for pregnancy.
However, the most accurate method remains a pregnancy test.
If you are still concerned, you can purchase a home pregnancy test and check again.
There are many potential reasons for discomfort in the lower abdomen; to determine the cause, a medical evaluation is necessary.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/12/08

More Info

Understanding abdominal discomfort despite having regular menstrual cycles can be quite perplexing, especially when pregnancy is a concern. Based on the information you've provided, it seems that you have had regular menstrual cycles since your last sexual encounter in August, with varying flow patterns. You also mentioned that you took a pregnancy test in September, which returned negative, and a subsequent visit to a gynecologist confirmed that your uterus did not show signs of pregnancy.

Firstly, it's important to note that a negative pregnancy test, especially when taken after a missed period, is generally reliable. Home pregnancy tests detect the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy. If you tested negative and your menstrual cycles have continued, the likelihood of being pregnant is low. Additionally, the gynecologist's assessment that your endometrial lining was not thickened further supports this conclusion.

However, the abdominal discomfort you are experiencing could be attributed to several factors unrelated to pregnancy. Common causes of abdominal discomfort in women include:
1. Menstrual Cycle Variations: Hormonal fluctuations during your menstrual cycle can lead to discomfort, bloating, or cramping, even if your periods are regular.

2. Ovulation Pain: Some women experience pain during ovulation, known as mittelschmerz, which can occur around the middle of the menstrual cycle.

3. Gastrointestinal Issues: Conditions such as irritable bowel syndrome (IBS), constipation, or even dietary intolerances can cause abdominal discomfort.

4. Pelvic Inflammatory Disease (PID): This is an infection of the reproductive organs that can cause pain and discomfort in the lower abdomen.

5. Ovarian Cysts: These fluid-filled sacs on the ovaries can sometimes cause discomfort, especially if they rupture.

6. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside of it, leading to pain and discomfort.

7. Urinary Tract Infections (UTIs): These can also cause lower abdominal pain and discomfort.

Given that your gynecologist performed an internal examination and found no immediate issues, it may be beneficial to consider these other potential causes. If the discomfort persists or worsens, further evaluation may be warranted. This could include imaging studies like an ultrasound or additional laboratory tests to rule out any underlying conditions.

Regarding your concern about the possibility of being pregnant at this stage (16 weeks), if you were indeed pregnant, it would typically be detectable through a blood test or ultrasound, even if the home test was negative. If you are still worried about the possibility of pregnancy, you can consult your healthcare provider for a blood test, which is more sensitive than home tests.

In summary, while your symptoms may be concerning, the likelihood of pregnancy seems low based on your menstrual history and medical evaluations. However, if discomfort continues, seeking further medical advice is advisable to explore other potential causes and ensure your overall health. Regular check-ups and open communication with your healthcare provider are key to addressing any ongoing concerns.

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