Pregnancy Testing and Hormonal Influence on Results

Pregnancy test questions?

Doctor, I would like to ask a question.
I started taking the contraceptive pill in October last year and stopped in May this year (my cycle has been consistently 28 to 30 days).
In June, my period was 10 days late (I got my period on the 38th day).
In July, my period came on time (28th day, July 16).
On July 22, I had intercourse with my boyfriend; we used a condom, and he did not ejaculate inside, but afterward, he touched my genital area with his hand.
On July 31, I noticed brown discharge with a little bit of blood, which stopped after wiping.
On the morning of August 1, I started bleeding (similar to my menstrual period) and went to see a gynecologist.
The doctor said it was ovulatory bleeding and prescribed progesterone for three days (later, I read that some people said it was fine to let it pass naturally, so I only took the medication for two days).
On August 6, I started bleeding again in the afternoon, and on the morning of August 7, I experienced heavy bleeding (similar to the second day of my period), but it stopped by the evening.
On the morning of August 8, I went to a different gynecologist, who said the bleeding was due to stopping the medication and performed a pregnancy test, which came back negative.
Additionally, there was a cyst on my right ovary.
The doctor then prescribed progesterone for another seven days and said that if I bled again after finishing the medication, it would be my period.
From August 9 to August 15, I continued taking the prescribed progesterone.
On the evening of August 16, I experienced cramping in my lower right abdomen.
On the morning of August 17, I took a home pregnancy test and saw a very faint second line within five minutes (it was hard to see unless looked at closely).
So, I would like to ask the doctor, does this count as pregnancy? Also, does taking progesterone affect the pregnancy test results?

Lin, 10~19 year old female. Ask Date: 2017/08/17

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I started taking preconception medication in October last year and stopped in May this year (my menstrual cycle has been consistently between 28 to 30 days).
In June, my period was 10 days late (it arrived on the 38th day).
My period came on time in July (28th day, July 16).
On July 22, I had intercourse with my boyfriend; we used a condom, and he did not ejaculate inside, but afterward, he touched my genital area with his hand.
On the evening of July 31, I noticed brown discharge with a little bit of blood, which disappeared after wiping.
On the morning of August 1, I started bleeding (similar to my menstrual period).
I went to the gynecologist, who said it was ovulatory bleeding and prescribed progesterone for three days (later, I read that some people said it was fine to let it resolve naturally, so I only took the medication for two days).
On the afternoon of August 6, I started bleeding again, and on the morning of August 7, I experienced heavy bleeding (similar to the second day of my period), but it stopped by the evening.
On the morning of August 8, I switched to another gynecologist, who said the subsequent bleeding was due to stopping the medication and performed a pregnancy test, which came back negative.
Additionally, there was a cyst on my right ovary.
The doctor prescribed progesterone for another seven days and said that if I bled again a few days after finishing the medication, it would be my period.
I continued taking the prescribed progesterone from August 9 to August 15.
On the evening of August 16, I experienced sharp pain in my lower right abdomen.
On the morning of August 17, I took a home pregnancy test and saw a very faint second line within five minutes (it was hard to see unless looked at closely).

1.
Does this count as pregnancy? Answer: I will take another home pregnancy test on August 24.
2.
Does taking progesterone affect the pregnancy test results? Answer: No, it will not affect the pregnancy test results.

Reply Date: 2017/08/17

More Info

Understanding pregnancy testing and the influence of hormonal medications on test results is crucial for anyone trying to conceive or navigating early pregnancy. Based on your detailed account, let's break down the situation and address your concerns.

Pregnancy Testing and Timing
From your description, it appears that you have been monitoring your menstrual cycle closely. You mentioned that your cycle typically ranges from 28 to 30 days. After stopping your contraceptive pill in May, you experienced a delayed period in June, which is not uncommon as your body adjusts to the hormonal changes. The subsequent cycles seem to have returned to a more regular pattern, but you experienced some unusual bleeding and spotting.

The timing of your pregnancy test is critical. You indicated that you had a faint positive line on the pregnancy test on August 17, which suggests that you may indeed be pregnant. Pregnancy tests work by detecting the hormone human chorionic gonadotropin (hCG), which is produced shortly after a fertilized egg attaches to the uterine lining. Typically, hCG levels can be detected in urine about 14 days after conception, but this can vary based on individual circumstances.

Influence of Hormonal Medications
You also inquired about the impact of taking progesterone (yellow body hormone) on the results of your pregnancy test. Generally, progesterone supplements do not affect the accuracy of urine pregnancy tests. They are often prescribed to support the uterine lining and help maintain a pregnancy, especially in cases of luteal phase defects or after ovulation induction. However, it’s important to note that while progesterone can help sustain an early pregnancy, it does not cause a positive pregnancy test.

Bleeding and Spotting
The bleeding you experienced could be attributed to several factors. The initial spotting you described on July 31, followed by heavier bleeding, could be related to ovulation or a potential early miscarriage, especially given the timing of your cycles and the hormonal treatments you received. The fact that your doctor identified the bleeding as "ovulatory bleeding" suggests that it might not be related to pregnancy but rather a normal physiological response.

However, the subsequent heavy bleeding and the presence of a cyst on your right ovary warrant careful monitoring. If you are indeed pregnant, any significant bleeding should be evaluated by a healthcare provider to rule out complications such as an ectopic pregnancy or miscarriage.

Recommendations
1. Follow-Up Testing: Since you have a faint positive pregnancy test, it would be advisable to repeat the test in a few days. If you are pregnant, the hCG levels should rise, resulting in a darker line on the test. Alternatively, a blood test for hCG at your doctor’s office can provide a more definitive answer.

2. Monitor Symptoms: Keep track of any additional symptoms, such as cramping, heavy bleeding, or unusual pain. If you experience severe pain or heavy bleeding, seek medical attention promptly.

3. Consult Your Doctor: Given the complexities of your situation, including the use of hormonal medications and the irregular bleeding, it’s essential to maintain open communication with your healthcare provider. They can provide personalized advice and may recommend further testing or monitoring based on your specific circumstances.

4. Emotional Support: Navigating early pregnancy and potential complications can be emotionally taxing. Consider seeking support from friends, family, or a counselor to help manage any anxiety or stress you may be experiencing.

In summary, while the faint line on your pregnancy test is a positive sign, it’s essential to follow up with your healthcare provider for further evaluation and to ensure your health and the health of your potential pregnancy.

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