Delayed Periods: Pregnancy Concerns and Urinary Infections

Are you pregnant?

Help my girlfriend with a question: Her last menstrual period started on October 30 and ended on November 3, with an average cycle of about 31 days.
She had sexual intercourse between November 17 and 20 (using condoms throughout, but she is concerned about possible semen leakage).
Afterward, she experienced pain when urinating, and a few days later, she had itching in the genital area, especially at night and in the morning.
On November 29, after urinating, she noticed light pink blood-tinged discharge, which seemed normal.
On that day, she felt some discomfort in her lower abdomen (her period was expected on November 30), but as of today (December 12), her period is 12 days late (she has never been this late before, usually only 2-4 days).
On the night of November 30, she used a pregnancy test, which showed one line.
On the evening of December 1, she visited a gynecologist, and after a urine test, she was diagnosed with a urinary tract infection and confirmed she was not pregnant.
The doctor prescribed medication (Ural urinary alkalinizer, Uphalexin cephalexin monohydrate, Antamin chlorpheniramine).
On the morning of December 5, she took another pregnancy test, which showed no pregnancy, and on the morning of December 10, she tested again, which also showed no pregnancy (this was the last test).
Up until today, she has been experiencing some bloating, fluctuating body temperature, but has had a slightly elevated temperature in the past two days.
Her abdomen is no longer uncomfortable, but her lips are dry.
She has been under a lot of stress lately, and I am worried that this might be causing the delay.
Could the medications prescribed by the doctor affect the pregnancy test results? What could be the reason for her delayed period, especially with four negative pregnancy tests? I am quite concerned.

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

Dr. Lü Lizheng reply Obstetrics and Gynecology

The pregnancy test results can be trusted 18 days after sexual intercourse.
If the sexual activity occurred on November 17, then 18 days later would be December 5.
Since you tested negative for pregnancy on both December 5 and December 10, it is likely that you are not pregnant.
There are many possible reasons for a missed period, such as hormonal imbalances, so it is advisable to seek medical evaluation.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/12/12

More Info

It sounds like your girlfriend is experiencing a complex situation with her menstrual cycle, potential urinary tract infection (UTI), and concerns about pregnancy. Let's break down the key points and provide some clarity.

Delayed Periods and Pregnancy Concerns
Given that your girlfriend's last menstrual period (LMP) was on October 30 and she has a regular cycle of about 31 days, her period was expected around November 30. The fact that it is now December 12 and she is 12 days late is indeed concerning, especially since she has never experienced such a significant delay before.
The first thing to consider is the possibility of pregnancy. Although she used condoms during intercourse, there is always a small risk of pregnancy due to potential condom failure or leakage. However, the multiple home pregnancy tests (HPTs) showing negative results are reassuring. Home pregnancy tests are generally reliable, especially when taken after a missed period. If the tests are consistently negative, it is unlikely that she is pregnant.

Urinary Tract Infection (UTI)
Your girlfriend was diagnosed with a UTI on December 1, which can sometimes cause symptoms that may be mistaken for menstrual symptoms, such as abdominal discomfort or changes in discharge. The medications prescribed (Ural, Cephalexin, and Chlorpheniramine) are typically safe and should not affect the results of a pregnancy test. Cephalexin is an antibiotic that treats bacterial infections, and Ural is used to relieve UTI symptoms by alkalinizing the urine.

Factors Affecting Menstrual Cycle
There are several reasons why her period might be delayed aside from pregnancy:
1. Stress: High levels of stress can significantly impact the menstrual cycle. Stress can disrupt hormonal balance, leading to delayed ovulation and, consequently, a delayed period.

2. Illness: The UTI and any associated discomfort can also affect the menstrual cycle. The body sometimes reacts to infections by altering hormone levels.

3. Weight Changes: Significant weight loss or gain can also impact menstrual regularity.

4. Hormonal Imbalance: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular cycles.

5. Medications: While the medications prescribed for the UTI should not affect her menstrual cycle directly, any other medications or supplements she may be taking could potentially have an impact.

Recommendations
1. Follow-Up with a Healthcare Provider: Since her period is significantly delayed, it would be wise for her to follow up with her healthcare provider. They may want to conduct further tests to rule out any underlying conditions that could be causing the delay.

2. Monitor Symptoms: Keep track of any additional symptoms she may experience, such as severe abdominal pain, fever, or unusual discharge, which could indicate a more serious issue.

3. Manage Stress: Encourage her to engage in stress-reducing activities, such as exercise, meditation, or hobbies she enjoys.
4. Hydration and Nutrition: Ensure she is staying hydrated and eating a balanced diet, which can help regulate her menstrual cycle.

5. Consider a Pregnancy Test Again: If her period does not arrive soon, it may be worth taking another pregnancy test or consulting with a healthcare provider for a blood test, which can detect pregnancy earlier than home tests.

In summary, while the negative pregnancy tests are reassuring, the delay in her period could be attributed to stress, the UTI, or other factors. It is essential to monitor her symptoms and consult with a healthcare provider for further evaluation and peace of mind.

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