Could It Be Pregnancy? Irregular Cycles and Symptoms

Could it be pregnancy?

Between early April and the end of May, I took emergency contraceptive pills three times, and I tested for pregnancy in between, all of which were negative.
My menstrual periods occurred on the following dates: (April 14 to April 18), (April 30 to May 4), and (May 28 to June 1).
I had sexual intercourse on April 3, April 23, April 29, May 20, and May 27, without using condoms and with external ejaculation.
I was still very anxious when my period did not come in June.
On July 12, I visited a doctor, and an ultrasound showed no pregnancy.
The doctor prescribed medication to induce menstruation, which I took for a few days, and my period came (July 15 to July 19) with heavy flow and significant pain in my abdomen and lower body.
Afterward, I checked an app that indicated a low probability of pregnancy, and I had intercourse on August 7, August 10, and August 11, using condoms and not taking emergency contraception.
The app recorded my period as coming on (August 15 to August 19), but it did not arrive.
On the morning of September 2, I took a pregnancy test with the first morning urine, which was negative.
Later, on September 14, I consulted a traditional Chinese medicine practitioner to regulate my menstrual cycle, and the herbal ingredients included (Xiaoyao San, Bawei Dihuang Wan, Wengqing Yin, Huanglian, and Ganwei Wang).
Today, I tested again with the first morning urine, and the result was also negative.

Could my menstrual irregularities be due to taking too many emergency contraceptive pills, or is there something wrong with my uterus? This month, on certain days, I felt a slight but strong stabbing pain in my lower abdomen, which extended to my vaginal area.
What could be the reason for this?

Gua, 10~19 year old female. Ask Date: 2017/09/17

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Between early April and the end of May, I took emergency contraception three times, and I tested for pregnancy in between, all of which were negative.
My menstrual periods occurred on the following dates: (April 14-18), (April 30-May 4), and (May 28-June 1).
I had sexual intercourse on April 3, April 23, April 29, May 20, and May 27, without using condoms and with external ejaculation.
I was still worried when my period did not come in June, so on July 12, I went to the hospital for an ultrasound, which showed no pregnancy.
The doctor prescribed medication to induce menstruation, and after taking it for a few days, my period came (July 15-19) with heavy flow and significant pain in my abdomen and lower body.
Afterward, I checked the pregnancy probability on an app, which indicated low risk, and I had sexual intercourse on August 7, August 10, and August 11, all while using condoms and without taking emergency contraception.
However, my period did not arrive, and on the morning of September 2, I took a pregnancy test which was negative.
On September 14, I visited a traditional Chinese medicine doctor to regulate my menstrual cycle, and the herbal ingredients included Xiao Yao San, Ba Wei Di Huang Wan, Wen Qing Yin, Huang Lian, and Gan Wei Wang.
Today, I took another pregnancy test with the first morning urine, and it was also negative.

1.
Is my irregular menstruation due to taking too much emergency contraception, or is there an issue with my uterus? Answer: After taking medication to induce menstruation, I had a heavy flow (July 15-19).
I had sexual intercourse on August 7, August 10, and August 11, all while using condoms and without taking emergency contraception.
My period did not come, and the pregnancy test on the morning of September 2 was negative.
I saw a traditional Chinese medicine doctor on September 14 to regulate my menstrual cycle, indicating a possible hormonal imbalance.

2.
This month, I experienced a slight but strong stabbing pain in my lower abdomen, which seemed to extend to my vagina.
Why is this happening? Answer: A pelvic examination and ultrasound are needed.

Reply Date: 2017/09/17

More Info

It sounds like you have been through a lot of uncertainty regarding your menstrual cycle and potential pregnancy. Let's break down your concerns and provide some clarity based on medical knowledge.

Understanding Your Menstrual Cycle and Pregnancy Testing
1. Irregular Cycles and Hormonal Influence: Irregular menstrual cycles can be influenced by various factors, including stress, hormonal imbalances, and the use of emergency contraception (the "morning-after pill"). These pills can disrupt your normal hormonal patterns, leading to changes in your cycle. It is not uncommon for women who have taken emergency contraception to experience changes in their menstrual cycle, such as delayed periods or heavier bleeding.

2. Pregnancy Testing: Home pregnancy tests are generally reliable, especially when taken after a missed period. However, if you are testing too early or if your hormone levels are not high enough, you may receive a false negative. Given that you have tested negative multiple times and had an ultrasound that confirmed you are not pregnant, it is likely that you are not pregnant at this time.

3. Symptoms and Concerns: The sharp pain you are experiencing in your lower abdomen could be due to several reasons. It may be related to ovulation, menstrual cramps, or even a condition such as ovarian cysts. If the pain is severe or persistent, it is essential to consult with a healthcare provider for further evaluation.

Potential Causes of Your Symptoms
- Hormonal Fluctuations: After taking emergency contraception, your body may take some time to readjust, which can lead to symptoms such as abdominal pain, mood swings, and changes in your menstrual cycle.

- Ovarian Cysts: Sometimes, women can develop cysts on their ovaries, which can cause pain and discomfort. These are usually benign and resolve on their own, but they should be monitored by a healthcare professional.

- Pelvic Inflammatory Disease (PID): If you have had multiple sexual partners or unprotected sex, there is a risk of sexually transmitted infections (STIs) that could lead to PID, which can cause abdominal pain and irregular bleeding.

Recommendations
1. Consult a Healthcare Provider: Given your ongoing symptoms and concerns about your menstrual cycle, it would be wise to see a healthcare provider. They can perform a thorough examination, possibly including blood tests and imaging studies, to rule out any underlying conditions.

2. Monitor Your Cycle: Keep track of your menstrual cycle, noting any changes in flow, duration, and associated symptoms. This information can be helpful for your healthcare provider.

3. Consider Lifestyle Factors: Stress, diet, and exercise can all impact your menstrual cycle. Ensuring you maintain a balanced diet, regular exercise, and effective stress management techniques can help regulate your cycle.

4. Avoid Overuse of Emergency Contraception: While emergency contraception is a valuable option, it should not be used as a regular form of birth control. If you find yourself needing it frequently, consider discussing long-term contraceptive options with your healthcare provider.

Conclusion
In summary, while your symptoms and irregular cycles can be concerning, they are often manageable with the right medical guidance. It is essential to communicate openly with your healthcare provider about your symptoms and any concerns you may have regarding your reproductive health. They can provide you with the most accurate information and support tailored to your specific situation.

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