Missed Period for Two Months: Am I Pregnant or Experiencing Miscarriage?

If your menstrual period has been absent for nearly two months, could you be pregnant?

Hello Doctor, my last menstrual cycle started on November 15.
Normally, based on my cycle, my next period should have arrived by December 20 at the latest, but as of yesterday (January 7), it still hasn't come.
During this time, I had several instances of unprotected intercourse with withdrawal.
At the beginning of January, I took a home pregnancy test that showed negative, but my period still hasn't arrived, and my routine and stress levels have been normal.
I initially thought I might be pregnant, but this morning I experienced significant abdominal pain and noticed a small amount of blood.
Could you please advise whether this is the onset of my period or a miscarriage? Thank you.

Miss Wei, 10~19 year old female. Ask Date: 2018/01/08

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My last menstrual cycle started on November 15.
Normally, based on my cycle, my next period should arrive by December 20 at the latest, but as of yesterday (January 7), it still hasn't come.
During this period, I had several instances of sexual intercourse, all of which were unprotected with external ejaculation.
At the beginning of January, I took a home pregnancy test that showed negative results, but my period still hasn't arrived, and my routine and stress levels have been normal.
I initially thought I might be pregnant, but this morning I experienced abdominal pain and noticed a small amount of blood.
Could you please tell me if this is my period or a miscarriage? Answer: It should be your period.

Reply Date: 2018/01/08

More Info

When experiencing a missed period for two months, it is understandable to be concerned about the possibility of pregnancy or other underlying health issues. Based on the information provided, your last menstrual cycle began on November 15, and you expected your next period by December 20. However, as of January 7, you have not had your period, and you have engaged in unprotected sexual intercourse with withdrawal as the method of contraception. You also mentioned that a home pregnancy test taken in early January showed a negative result.

Given these circumstances, there are several factors to consider regarding your missed period and the abdominal pain you are experiencing.
1. Pregnancy Possibility: While you have had unprotected intercourse, the withdrawal method is not a reliable form of contraception. Pre-ejaculate fluid can contain sperm, which means there is still a possibility of pregnancy even if ejaculation occurs outside the vagina. However, since your home pregnancy test was negative, it is less likely that you are pregnant, especially if the test was taken correctly and at the appropriate time.

2. Menstrual Cycle Irregularities: It is not uncommon for menstrual cycles to become irregular due to various factors, including stress, changes in weight, hormonal imbalances, or underlying health conditions. If your lifestyle and stress levels have remained stable, it may be worth considering other potential causes for your missed periods.

3. Abdominal Pain and Bleeding: The abdominal pain and the presence of a small amount of blood could indicate several things. It could be the onset of your menstrual period, especially if the bleeding is light and accompanied by cramping. Alternatively, it could be a sign of a miscarriage if you were indeed pregnant, but given the negative pregnancy test, this seems less likely. Other possibilities include ovulation pain, a cyst, or other gynecological issues.

4. When to Seek Medical Attention: If your symptoms persist, worsen, or if you experience heavy bleeding, it is essential to seek medical attention. A healthcare provider can perform a more sensitive pregnancy test, such as a blood test, and conduct an ultrasound if necessary to determine the cause of your symptoms.
5. Next Steps: If your period does not arrive within the next week, or if you continue to experience pain or unusual symptoms, it would be advisable to consult a healthcare professional. They can provide a thorough evaluation and determine if further testing or treatment is needed.

In summary, while the likelihood of pregnancy seems low given the negative test result, it is crucial to monitor your symptoms closely. Irregular periods can occur for various reasons, and abdominal pain should not be ignored. Seeking medical advice will help clarify your situation and ensure that any potential health issues are addressed promptly.

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