Do You Need a Pregnancy Test or Gynecological Check-Up After Your Period?

If menstruation has started, is it still necessary to take a pregnancy test or consult a gynecologist?

Hello, my last menstrual period was on December 7 (with a cycle of about 33-35 days).
During this time, I had unprotected sexual intercourse and I have polycystic ovary syndrome.
However, I had taken birth control pills for three years to regulate my cycle, and my periods were normal for two years after stopping the medication! My period was due but did not arrive, so I took a pregnancy test twice over the course of two weeks, but only one line appeared (I later discovered that the pregnancy test was expired).
After two months without a period, I thought I might be pregnant and stopped taking Chinese medicine.
Then, on February 3, my period surprisingly arrived, with the first day having blood clots and the flow being similar to my usual menstruation.
By the third day, February 6, the flow decreased significantly and felt like it was almost gone.
Should I still take a pregnancy test or see a gynecologist? Is there a possibility of an ectopic pregnancy? I'm unclear whether this is a menstrual period, a natural miscarriage, or something else.
Could you please help clarify this for me?

Ma, 20~29 year old female. Ask Date: 2017/02/06

Dr. Huang Jianzhong reply Obstetrics and Gynecology

The last menstrual period was on December 7 (with a cycle of about 33-35 days).
There was unprotected sexual intercourse during this time, and there is a history of polycystic ovary syndrome.
The menstrual period was expected but did not arrive for two weeks, and a pregnancy test was taken, which showed only one line.
After two months without menstruation, it was thought that pregnancy might have occurred, but on February 3, menstruation surprisingly started.
On the first day, there were blood clots, and the flow was similar to a normal period.
By the third day, February 6, the flow decreased significantly.
Should a pregnancy test or a visit to a gynecologist be done? Is there a possibility of an ectopic pregnancy? It is unclear whether this is menstruation, a natural miscarriage, or something else.
Answer: It is advisable to take a pregnancy test or visit a gynecologist for safety.

Reply Date: 2017/02/06

More Info

When it comes to determining whether you need a pregnancy test or a gynecological check-up after your period, there are several factors to consider, especially given your history of polycystic ovary syndrome (PCOS) and the irregularities you've experienced.

Firstly, it’s important to understand that a missed period can be caused by various factors, including hormonal imbalances, stress, weight changes, and conditions like PCOS. Since you mentioned that your menstrual cycle is typically around 33 to 35 days and that you have a history of regular cycles after stopping birth control, the absence of your period for two months is certainly noteworthy.

You indicated that you had unprotected intercourse during this time, which raises the question of whether you could be pregnant. The fact that you took a pregnancy test and received a negative result (especially with an expired test) means that it may not be reliable. Pregnancy tests are most accurate when taken after a missed period, typically about one week after the expected date of menstruation. Given that your last menstrual period was on December 7 and you had a negative test shortly after, it would be advisable to retest, ideally with a new test, around two weeks after your missed period for a more accurate result.

Regarding your recent bleeding on February 3, it’s crucial to differentiate between a normal menstrual period and potential complications such as a miscarriage or ectopic pregnancy. The presence of blood clots and the volume of bleeding you described could suggest a normal period, especially if it resembles your typical menstrual flow. However, if the bleeding was significantly different from your usual menstrual pattern or if you experience severe pain, it would be prudent to seek medical attention.

As for the possibility of an ectopic pregnancy, this condition occurs when a fertilized egg implants outside the uterus, most commonly in a fallopian tube. Symptoms can include sharp abdominal pain, vaginal bleeding, and dizziness. If you are not experiencing these symptoms, the likelihood of an ectopic pregnancy is lower, but it is still a concern that should be evaluated by a healthcare professional if you have any doubts.

In summary, given your situation, here are the steps I would recommend:
1. Retest for Pregnancy: Use a new, reliable pregnancy test about a week after your expected period. This will give you a clearer indication of whether you are pregnant.

2. Monitor Symptoms: Keep track of any additional symptoms you may experience, such as unusual pain, heavy bleeding, or other changes in your body.

3. Consult a Gynecologist: If your period does not return, or if you have any concerns about the nature of your bleeding, it is advisable to schedule an appointment with a gynecologist. They can perform a thorough evaluation, including a blood test for pregnancy and possibly an ultrasound, to determine the cause of your symptoms.

4. Consider Hormonal Factors: Given your history of PCOS, it might also be beneficial to discuss with your doctor the potential for hormonal treatments or lifestyle changes that could help regulate your menstrual cycle.

In conclusion, while it may not be immediately necessary to undergo a gynecological check-up if your symptoms are mild and you have a negative pregnancy test, it is essential to remain vigilant and proactive about your reproductive health, especially with your history of irregular cycles and PCOS. Always prioritize your health and seek medical advice when in doubt.

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