Delayed Menstruation: Pregnancy Tests and Possible Causes

Menstrual delay or missed period?

On May 16, I had intimate contact with my boyfriend and later asked a doctor about the probability of pregnancy.
The doctor said the chances were low.
I had my menstrual periods on June 5 and July 14.
Since that encounter in May, we have not been intimate again.
I took pregnancy tests 15 and 37 days after the encounter, and both were negative; however, I used urine that had been stored for four hours and tested after my period was overdue.

Q1: Does using urine that has been stored for four hours and testing after my period is overdue affect the accuracy of the pregnancy test results?
Q2: Since we have not been intimate since May, but my period has not arrived in August, could this indicate pregnancy or something else? Thank you.

Rourou, 10~19 year old female. Ask Date: 2017/08/25

Dr. Huang Jianzhong reply Obstetrics and Gynecology

On May 16, I had intimate contact with my boyfriend and later asked a doctor about the chances of pregnancy.
The doctor said the chances were low.
I had my menstrual periods on June 5 and July 14.
Since that encounter in May, we have not been intimate again.
I took pregnancy tests 15 and 37 days later, and both were negative, but I used urine that had been stored for four hours and tested after my period was overdue.

Q1: Will using urine stored for four hours and testing after my period is overdue affect the accuracy of the pregnancy test results?
A: It should not affect the accuracy of the results.
Q2: Since we have not been intimate since May, but my period has not come in August, could this indicate pregnancy or something else?
A: It is likely due to hormonal imbalance.

Reply Date: 2017/08/25

More Info

Understanding delayed menstruation and the implications of pregnancy tests can be quite complex, especially when various factors come into play. Based on the information provided, let's address your questions systematically.

Q1: Does using urine stored for 4 hours and testing after the expected period affect the accuracy of the pregnancy test results?
The accuracy of home pregnancy tests (HPTs) can be influenced by several factors, including the concentration of the hormone human chorionic gonadotropin (hCG) in the urine. Generally, it is recommended to use first-morning urine for testing because it is typically more concentrated, which increases the likelihood of detecting hCG if pregnancy has occurred.
If you stored your urine for four hours, it may have diluted the hCG concentration, especially if you consumed fluids during that time. However, most modern pregnancy tests are designed to be sensitive enough to detect hCG levels even in less concentrated urine. Testing after your expected period is generally a good practice, as it allows more time for hCG to build up in your system if you are pregnant. Therefore, while the storage of urine could potentially affect the result, it is unlikely to be the sole reason for a negative result if you tested after your period was due.

Q2: If there has been no sexual activity since May and the August period has not arrived, could this indicate pregnancy or another issue?
Given that you have not engaged in sexual activity since May and have had negative pregnancy tests, the likelihood of being pregnant is very low. The tests you conducted after the expected period, especially if they were done correctly, would typically provide reliable results.
However, there are several reasons why menstruation might be delayed aside from pregnancy. Stress is a significant factor that can affect the menstrual cycle. The body’s response to stress can lead to hormonal imbalances, which may delay or even skip periods. Other factors include changes in weight, exercise habits, and underlying medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders.

If your period is significantly delayed (more than a week or two), it is advisable to consult a healthcare provider. They may recommend further testing or evaluations to determine the underlying cause of the delay. This could include blood tests to check hormone levels or an ultrasound to assess the reproductive organs.

In summary, while the chances of pregnancy seem low given the circumstances, it is essential to monitor your body and seek medical advice if your period does not arrive soon. It’s always better to err on the side of caution when it comes to reproductive health.

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