Lower Abdominal Pain and Pregnancy Concerns in Women

Lower abdominal pain?

Hello, Doctor.
My period started around mid-November and then again on December 17.
I had sexual activity on January 5, but I am still a virgin and did not have actual intercourse; I only engaged in manual stimulation with fingers that had semen on them near the vaginal opening.
As of now, my period has not arrived.
On January 27, I had a urine and blood test for hCG, which showed 0.500, and the ultrasound indicated no pregnancy.
Is this pregnancy test result accurate and does it confirm that I am not pregnant? However, I have been experiencing some abdominal pain recently, and for the past couple of days, I noticed a few drops of reddish-brown or coffee-colored spots on my underwear, but there was nothing on the tissue after wiping.
Since I am planning to travel abroad for six months in early February and have been stressed about the possibility of being pregnant, I would like to know if the chances of pregnancy are high or if there could be other reasons for these symptoms.
Thank you.

Xiao Jie, 20~29 year old female. Ask Date: 2018/01/28

Dr. Huang Jianzhong reply Obstetrics and Gynecology

Around mid-November, menstruation occurred, followed by another on December 17.
On January 5, there was sexual activity, but it was not penetrative intercourse; rather, it involved manual stimulation of the vaginal opening with fingers that had come into contact with semen.
As of now, menstruation has not yet arrived.
On January 27, a urine and blood test for hCG showed a level of 0.500, and an ultrasound indicated no signs of pregnancy.
Is this pregnancy test result accurate and does it confirm that there is no pregnancy?
Answer: The blood test showing hCG at 0.500 is accurate and confirms that there is no pregnancy.
However, there has been a sensation of cramping in the lower abdomen, and over the past two days, there have been small amounts (about 1-2 drops) of reddish-brown or coffee-colored stains on underwear, but no blood was observed on toilet paper after wiping.
Since there are plans to travel abroad for six months in early February, and due to anxiety about potential pregnancy, there has been significant mental stress lately.
Is there a significant possibility of pregnancy, or could it be due to other reasons?
Answer: The cramping sensation in the lower abdomen is likely due to other reasons and not related to pregnancy.

Reply Date: 2018/01/28

More Info

Understanding lower abdominal pain and pregnancy concerns in women is a multifaceted issue that requires careful consideration of various factors, including menstrual cycles, sexual activity, and potential pregnancy. Based on the information provided, it seems that you are experiencing some anxiety regarding the possibility of being pregnant, especially given the recent sexual activity and the symptoms you are experiencing.

Firstly, let's address the pregnancy testing results. You mentioned that on January 27, you had a urine and blood test for HCG (human chorionic gonadotropin) which returned a value of 0.500, indicating that you are not pregnant. Typically, an HCG level below 5 mIU/mL is considered negative for pregnancy, while levels above 25 mIU/mL are considered positive. Therefore, your result suggests that you are not pregnant. Additionally, an ultrasound that shows no signs of pregnancy further supports this conclusion.

However, the symptoms you are experiencing, such as lower abdominal pain and the presence of light red-brown or coffee-colored spotting, could be attributed to several factors. It's important to note that lower abdominal pain can arise from various causes, not all of which are related to pregnancy. Common causes include:
1. Menstrual Cycle Irregularities: If your menstrual cycle is irregular, it could lead to unexpected symptoms, including abdominal pain and spotting. Stress can also affect your menstrual cycle, potentially causing delays or changes in flow.

2. Ovulation Pain: Some women experience pain during ovulation, known as mittelschmerz, which can occur around the middle of the menstrual cycle. This pain is usually mild and temporary.

3. Hormonal Fluctuations: Changes in hormone levels can lead to various symptoms, including abdominal discomfort and spotting. This can happen due to stress, changes in diet, or other lifestyle factors.

4. Pelvic Inflammatory Disease (PID): If the pain is severe or accompanied by other symptoms such as fever or unusual discharge, it could indicate an infection that requires medical attention.

5. Early Pregnancy Symptoms: Although your tests indicate you are not pregnant, some women may experience symptoms similar to pregnancy due to hormonal changes or other factors.

Given your concerns about potential pregnancy and the symptoms you are experiencing, it is advisable to consult with a healthcare provider. They can perform a thorough examination, possibly including additional blood tests or imaging studies, to determine the cause of your symptoms and provide appropriate treatment if necessary.

In conclusion, while your test results suggest that you are not pregnant, the symptoms you are experiencing warrant further investigation. Stress and anxiety can also contribute to physical symptoms, so addressing your mental well-being is equally important. If you continue to experience pain or if your symptoms worsen, seeking medical advice is crucial to ensure your health and peace of mind.

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