Delayed Menstruation: When to Seek Medical Advice

Regarding the issue of delayed menstruation?

Hello, doctor.
I am the author of this article https://adoctor.tw/article/122172 &SortBy=q_no&PageNo=1.
I have followed your advice and taken a pregnancy test, which came back negative; however, I am still experiencing light bleeding that has persisted.
From April 22 (Saturday) to April 24 (Monday), I noticed bleeding that appeared to be about the size of a 5 to 10 NT dollar coin (the amount for the entire day) on the sanitary pad.
I also recall that in mid-April, I had 1 to 2 instances of finger insertion (my hands were not particularly clean, but they were dry).
I am a bit concerned that this might be implantation bleeding.
My girlfriend is currently feeling a dull ache in her lower abdomen, the ovarian pain has subsided, and she seems to be in low spirits.
What is the accuracy of the pregnancy test at this point, and is there a need to seek medical attention?

Niming, 20~29 year old female. Ask Date: 2017/04/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

There is a need for medical attention.

Reply Date: 2017/04/25

More Info

Understanding delayed menstruation and the associated symptoms can be a complex issue, especially when considering the various factors that can influence menstrual cycles. In your case, you have already taken a significant step by conducting a pregnancy test, which returned a negative result. However, you are still experiencing some unusual symptoms, including light bleeding and discomfort in the lower abdomen.
First, it’s essential to understand that a negative pregnancy test is generally reliable, especially if taken after a missed period. Most home pregnancy tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy. If the test is negative and you are still experiencing bleeding, it is less likely that you are pregnant. However, there are exceptions, such as very early pregnancy or certain medical conditions that can lead to false negatives.

The light bleeding you described, which occurred from April 22 to April 24, could be attributed to several factors. One possibility is that it could be implantation bleeding, which can occur when a fertilized egg attaches to the lining of the uterus. However, this typically happens around the time of a missed period, and given that your test was negative, this is less likely. Other potential causes for light bleeding include hormonal fluctuations, stress, changes in weight, or even the onset of a menstrual period that is lighter than usual.

Given that your girlfriend is experiencing persistent discomfort in her lower abdomen and has noted changes in her emotional state, it is advisable to seek medical attention. While some mild discomfort can be normal, especially if it is related to hormonal changes, any ongoing or severe pain should be evaluated by a healthcare professional. This is particularly important if the discomfort is accompanied by other symptoms such as fever, heavy bleeding, or unusual discharge.

In terms of the timing of the pregnancy test, it is generally recommended to wait at least one week after a missed period for the most accurate results. If your girlfriend's menstrual cycle is irregular, it may be beneficial to track her cycles over a few months to identify any patterns or irregularities.
When visiting a healthcare provider, it would be helpful to discuss the following:
1. Menstrual History: Provide details about her menstrual cycle, including any changes in frequency, duration, and flow.

2. Symptoms: Discuss the nature of the abdominal discomfort, any other symptoms she may be experiencing, and the timeline of these symptoms.

3. Pregnancy Test Results: Share the results of the pregnancy test and any concerns regarding potential pregnancy.

4. Lifestyle Factors: Mention any recent stressors, changes in weight, or other lifestyle factors that could be influencing her menstrual cycle.

In conclusion, while a negative pregnancy test is reassuring, the presence of light bleeding and abdominal discomfort warrants further evaluation. It is always better to err on the side of caution when it comes to health concerns, especially those related to reproductive health. Seeking medical advice will provide clarity and ensure that any underlying issues are addressed appropriately.

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