Can I Rule Out Pregnancy? Menstrual Irregularities and Ovarian Cysts

Can I get pregnant?

Hello Doctor, I had my menstrual period on September 17 and had sexual intercourse on October 13.
Initially, there was unprotected penetration for a couple of thrusts, but then I used a condom for the rest of the intercourse.
I ejaculated after pulling out.
I took a pregnancy test on the evening of October 26, which was negative, and another test on the morning of October 27, which was also negative.
My period started on the afternoon of October 27 and lasted for about 7 days, which was normal for me.
After October 13, I did not have any sexual intercourse.
However, my period did not come in November.
I took a pregnancy test on November 4, which was negative, and another test on November 25, which was also negative.
On December 1, I visited a doctor.
The doctor did not ask about sexual activity or perform a urine test; I only mentioned that my period did not come in November and that I had abdominal pain for over two weeks.
The doctor performed an ultrasound and noted a cyst on my right ovary, prescribed me medication to induce menstruation, and told me that the cyst would gradually disappear once my period started.
On the morning of December 4, I took the last pill to induce menstruation, but my period still has not come.
I took a pregnancy test on the afternoon of December 5, which was negative, and another test on the morning of December 6, which was also negative.
However, I occasionally experience sharp pain in my lower abdomen, and I have dull pain as well.
On the afternoon of December 5, I suddenly had lower back pain.
Over the past few days, my discharge has changed from clear to milky white, and this morning it turned yellow.
I would like to ask the doctor: Q1: Can I completely rule out the possibility of pregnancy? Q2: Is the absence of my period due to stress and the cyst? Q3: What causes a cyst to form? Q4: Is the lower back pain and changes in discharge an indication that my period is about to come? Thank you for your answers.

Xiao Lin, 10~19 year old female. Ask Date: 2018/12/06

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
It is always best to take preventive measures beforehand and not to rely on the safe period.
Generally, you should expect your period to come within a week after finishing the emergency contraceptive pill; just wait for your menstruation.
The development of cysts is mostly due to individual physiological factors.
Wishing you good health.

Reply Date: 2018/12/06

More Info

When it comes to understanding the complexities of menstrual irregularities and ovarian cysts, especially in the context of potential pregnancy, there are several factors to consider. Based on your detailed history, let’s address your questions one by one.

Q1: Can I completely rule out the possibility of pregnancy?
Given your timeline, it appears that you have taken multiple pregnancy tests, all of which returned negative results. The fact that you had a normal menstrual period following your sexual encounter on October 13, along with subsequent negative tests, strongly suggests that you are not pregnant. However, it is important to note that while home pregnancy tests are generally reliable, they can sometimes yield false negatives, especially if taken too early. If you continue to experience symptoms that concern you, it may be worthwhile to consult your healthcare provider for a blood test, which can detect pregnancy earlier than urine tests.

Q2: Is the absence of my period due to stress and the cyst?
Yes, both stress and the presence of an ovarian cyst can contribute to menstrual irregularities. Stress can significantly impact hormonal balance, leading to delayed or missed periods. Ovarian cysts, particularly functional cysts, can also disrupt the normal menstrual cycle. They are common and often resolve on their own, but they can sometimes cause symptoms such as pain or changes in your menstrual cycle.

Q3: What causes the formation of a cyst?
Ovarian cysts are fluid-filled sacs that can form on the ovaries. They are often a normal part of the menstrual cycle. Functional cysts, which are the most common type, develop during the menstrual cycle and usually resolve without treatment. They can form when the follicle (which contains the egg) does not release the egg or when the follicle collapses after releasing the egg but fills with fluid instead. Other types of cysts can be caused by conditions like endometriosis or polycystic ovary syndrome (PCOS).

Q4: Is the lower back pain and changes in discharge indicative of an impending period?
Lower back pain and changes in vaginal discharge can be associated with the menstrual cycle. As your body prepares for menstruation, you may experience various symptoms, including cramping, back pain, and changes in discharge. The shift from clear to white and then yellow discharge can indicate hormonal changes or the onset of your period. However, if the pain is severe or accompanied by other concerning symptoms, it is advisable to seek medical attention.

In summary, while your symptoms and the timeline suggest that pregnancy is unlikely, the absence of your period could be attributed to stress and the presence of a cyst. It’s essential to monitor your symptoms and maintain open communication with your healthcare provider. If your menstrual irregularities persist or worsen, further evaluation may be necessary to rule out other underlying conditions. Regular check-ups and a healthy lifestyle can also help manage stress and support reproductive health.

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