Delayed Menstruation: Possible Causes and Concerns - Obstetrics and Gynecology

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Delayed menstruation?


Hello Doctor, my period was supposed to start on July 29, but it hasn't arrived yet.
Let me explain my situation.
My last menstrual period started on June 29 and lasted for five days.
Starting on July 13, I experienced breast tenderness, lower abdominal discomfort, and irritability, which are typical premenstrual symptoms.
On July 19, the lower abdominal discomfort suddenly intensified, and I felt some cramping, but it gradually improved by the evening.
From July 20 to July 22, I went to Hong Kong with my boyfriend for a three-day, two-night trip, during which I had almost no premenstrual symptoms.
In the early morning of July 22, while we were showering together, my boyfriend penetrated me slightly from behind, about the length of the glans, but it was painful, so he withdrew after one or two minutes, and I helped him finish manually.
After returning home, I started experiencing headaches on July 23 for three consecutive days.
On July 25, I began to have breast tenderness and lower abdominal discomfort again, and I often felt moist down below, but the discharge was clear, white, or yellow-green.
On July 29, my period still did not come, and the aforementioned symptoms continued.
I kept feeling like something was flowing out, but it was just discharge, the color remained the same, until today.
My menstrual cycle is not very regular, but the average cycle is 30-32 days.
This year, my period started on January 31, February 28, March 30, April 27, May 26, and June 29.
After helping my boyfriend finish in the bathroom, I rinsed off the semen on my hands before washing my genital area.
Yesterday, I asked my boyfriend if he ejaculated or if anything came out when he penetrated me, and he confirmed that he did not.
Additionally, I have had slight headaches over the past two days.
I would like to ask the doctor if there is a possibility of pregnancy.
The feeling of my period being overdue is really causing me anxiety.
Thank you.

Zhuzi, 20~29 year old female. Ask Date: 2018/08/02

Dr. Huang Jianzhong reply Obstetrics and Gynecology


My period was supposed to start on July 29, but it hasn't arrived yet.
I would like to explain my situation to the doctor.
My last menstrual period started on June 29 and lasted for five days.
Starting on July 13, I experienced breast tenderness, lower abdominal discomfort, and irritability, which are typical premenstrual symptoms.
On July 19, the lower abdominal discomfort suddenly intensified, and I felt some cramping, but it gradually improved by the evening.
From July 20 to July 22, I went to Hong Kong with my boyfriend for three days and had almost no premenstrual symptoms.
On July 22, while showering together, my boyfriend inserted his penis slightly, about the length of the glans, but I felt pain and he withdrew after about one to two minutes.
He then finished manually.
After returning home, I started experiencing headaches on July 23 for three consecutive days.
On July 25, I had breast tenderness and lower abdominal discomfort again, and I often felt dampness down below, with discharge that was clear, white, or yellow-green in color.
On July 29, my period still did not come, and the aforementioned symptoms persisted.
I kept feeling like something was flowing out, but it was just discharge, with the same colors as before, up until today.
My menstrual cycle is not very regular, but the average cycle is 30-32 days.
This year, my period started on January 31, February 28, March 30, April 27, May 26, and June 29.
After helping my boyfriend finish in the bathroom, I rinsed my hands to remove any semen before washing my genital area.
Yesterday, I asked my boyfriend if he had ejaculated or if anything had leaked out when he inserted himself, and he confirmed that he did not.
Additionally, I have had slight headaches over the past two days.
I would like to ask the doctor if there is a possibility of pregnancy in this situation.

Answer: Since your boyfriend only inserted his glans for one to two minutes without ejaculation or any leakage, and you rinsed your hands after contact with semen before washing your genital area, it is unlikely that you could be pregnant.

Reply Date: 2018/08/02

More Info


Understanding delayed menstruation can be a source of anxiety for many individuals, particularly when accompanied by various physical symptoms. In your case, there are several factors to consider regarding your delayed period and the symptoms you are experiencing.

Firstly, it is important to note that menstrual cycles can vary significantly from person to person and even from month to month for the same individual. A typical menstrual cycle ranges from 21 to 35 days, with an average of about 28 days. You mentioned that your average cycle is around 30-32 days, and your last period started on June 29. Given that today is past July 29, you are indeed experiencing a delay.

Several potential causes for delayed menstruation include:
1. Pregnancy: Given the sexual encounter you described, there is a possibility of pregnancy, even if penetration was brief and there was no ejaculation. Pre-ejaculate fluid can contain sperm, and if it came into contact with the vaginal area, it could lead to conception. If you suspect pregnancy, taking a home pregnancy test (HPT) can provide clarity. These tests are most accurate when taken after a missed period.

2. Hormonal Imbalances: Hormonal fluctuations can lead to changes in your menstrual cycle. Stress, significant weight changes, excessive exercise, or underlying health conditions such as polycystic ovary syndrome (PCOS) can disrupt your hormonal balance and affect your cycle.

3. Stress and Emotional Factors: You mentioned feeling emotionally unsettled, which can also impact your menstrual cycle. Stress can lead to the release of cortisol, which may interfere with the hormones that regulate your menstrual cycle.

4. Physical Health Issues: Conditions such as thyroid disorders, uterine fibroids, or other gynecological issues can also cause changes in your menstrual cycle. If you have a history of such conditions, it may be worth discussing with your healthcare provider.

5. Lifestyle Factors: Changes in your lifestyle, such as travel, changes in diet, or sleep patterns, can also affect your menstrual cycle. The trip you took to Hong Kong may have contributed to some of these changes.

Regarding the symptoms you described—breast tenderness, abdominal discomfort, and changes in vaginal discharge—these can be associated with premenstrual syndrome (PMS) or early pregnancy symptoms. The presence of clear, white, or yellow-green discharge can be normal, but if it has an unusual odor or is accompanied by itching or irritation, it may indicate an infection that should be evaluated by a healthcare provider.

Given your situation, here are some recommendations:
- Take a Pregnancy Test: If you have not done so already, consider taking a home pregnancy test. If it is positive, schedule an appointment with your healthcare provider for further evaluation and guidance.

- Monitor Symptoms: Keep track of any additional symptoms you may experience, such as changes in discharge, pain, or any other unusual signs.

- Consult a Healthcare Provider: If your period does not start soon or if you have concerns about your symptoms, it is advisable to consult with a healthcare provider. They can perform a thorough evaluation, including a physical examination and possibly blood tests, to determine the underlying cause of your delayed menstruation.

In summary, while pregnancy is a possibility given your recent sexual activity, other factors could also be at play. It is essential to address your concerns with a healthcare professional who can provide personalized advice and support. Remember that menstrual irregularities are common and can often be resolved with appropriate care.

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