Delayed Menstruation: Pregnancy Risks and Other Causes

Menstrual delay?

You had protected sexual intercourse with your girlfriend at the beginning of October without ejaculation, and the other three to four times involved only manual stimulation without direct genital contact.
Her usual menstrual cycle starts around the 22nd of each month, with her last period beginning on September 17th.
However, as of now (November 3rd), she has not yet had her period.
What is the likelihood of pregnancy in this situation, or could there be other reasons for her delayed menstruation (such as staying up late)? Thank you.

Cheng, 10~19 year old female. Ask Date: 2018/11/03

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the factors that can affect the menstrual cycle are numerous, including age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraception, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, ovulation, pregnancy, and breastfeeding, among others.
Additionally, the failure rate of correctly using condoms throughout intercourse is still about 5%.
As long as active sperm are present in the vagina during the ovulation period, there remains a possibility of pregnancy regardless of the method of intercourse.
It is advisable to consult a gynecologist if your menstrual period does not arrive as expected, to check for hormonal imbalances or other underlying causes.
Thank you! Wishing you peace and health, Dr.
Zhang.

Reply Date: 2018/11/03

More Info

Delayed menstruation can be a source of concern for many individuals, especially when there is a possibility of pregnancy. In your case, given that you engaged in protected sexual intercourse in early October and have not experienced menstruation since September 17, it is understandable to seek clarity on the likelihood of pregnancy and other potential causes for the delay.

First and foremost, the likelihood of pregnancy from the sexual encounters you described appears to be low. You mentioned using a condom during intercourse and that there was no ejaculation. Condoms are generally effective at preventing pregnancy when used correctly. However, it is important to note that no contraceptive method is 100% effective. Additionally, the risk of pregnancy from manual stimulation (using hands) is negligible, especially if there was no direct contact with semen or vaginal fluids.

That said, the absence of menstruation can be attributed to various factors beyond pregnancy. Stress, changes in routine, significant weight fluctuations, and hormonal imbalances can all contribute to delayed menstruation. For instance, you mentioned that you have been staying up late, which can disrupt your body's natural circadian rhythms and potentially affect your menstrual cycle. Other lifestyle factors, such as diet, exercise, and emotional stress, can also play a significant role in menstrual irregularities.

If pregnancy is a concern, the most straightforward way to confirm or rule it out is through a home pregnancy test. These tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced during pregnancy. It is advisable to take the test after a missed period for the most accurate result. If the test is negative and menstruation does not occur within a week or two, it may be prudent to consult a healthcare provider for further evaluation.

In summary, while the chances of pregnancy in your situation seem low, it is essential to consider other factors that could be causing the delay in menstruation. If the absence of your girlfriend's period continues or if she experiences any unusual symptoms (such as severe pain or heavy bleeding), seeking medical advice is recommended. A healthcare professional can provide a thorough evaluation, including potential hormonal assessments or other diagnostic tests, to determine the underlying cause of the delayed menstruation.

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