Post-Menstrual Symptoms: Nausea and Abdominal Discomfort

Post-menstrual nausea and lower abdominal discomfort?

Hello, doctor.
My girlfriend had her period from April 15 to 21, and according to her mobile app, the fertile window was predicted to be around April 26.
On April 26, we engaged in foreplay, but we used the withdrawal method, and there was no direct contact between our genitals or bodily fluids.
My girlfriend had her next period from May 15 to 21, which was normal in flow and lasted for 7 days.
However, on the afternoon of May 23, she experienced severe nausea and some abdominal discomfort (a feeling of bloating, but not quite gas), along with some mild cramping in her uterus.
After using the restroom, she noticed brown discharge (which only appeared that once).

I would like to ask the doctor: 1.
Both my girlfriend and I are a bit worried that she might be experiencing early pregnancy symptoms.
However, if she were pregnant, she shouldn't have had her period on May 15, right? Additionally, her last period was from May 15 to 21, and according to the app, her ovulation period is from May 25 to 31.
2.
Regarding the brown discharge, nausea, headache, and uterine cramping that my girlfriend mentioned, along with her experiencing mild headache and uterine discomfort again on May 24 around 5 PM, is it possible that these symptoms are related to ovulation pain or its effects, given that it is near her ovulation period?
P.S.
My girlfriend's menstrual cycle is consistently 7 days, with a total cycle length of 28 to 30 days.
Thank you for your assistance, doctor.

Cheng, 20~29 year old female. Ask Date: 2019/05/26

Dr. Huang Jianzhong reply Obstetrics and Gynecology

My girlfriend had her period from April 15 to 21, and according to her mobile app, the fertile window was predicted to be around April 26.
On April 26, we engaged in foreplay, but we used the withdrawal method, and there was no direct contact between our genitals or bodily fluids.
My girlfriend had her next period from May 15 to 21, which was normal in flow and lasted for 7 days.
However, on the afternoon of May 23, she experienced severe nausea and some abdominal discomfort (a feeling of bloating, but not quite like gas), along with mild uterine cramping.
After using the restroom, she noticed a small amount of brown discharge (which only appeared that once).

I would like to ask the doctor: 1.
We are both a bit worried about the possibility of pregnancy.
Is it possible that this is morning sickness? Answer: It is unlikely to be morning sickness, but if she were pregnant, she should not have had her period on May 15.
Additionally, I would like to clarify that her last menstrual period was from May 15 to May 21, and according to the app, her ovulation period is predicted to be from May 25 to May 31.

2.
Yesterday, my girlfriend mentioned the brown discharge, nausea, headache, and uterine cramping, and on May 24 around 5 PM, she again experienced mild headache and uterine cramping.
Is it possible that these symptoms are related to ovulation pain or its effects, given that it is around the ovulation period? Answer: It is possible.
P.S.
My girlfriend's menstrual cycle is consistently 7 days, with a total cycle length of 28 to 30 days.

Reply Date: 2019/05/26

More Info

Understanding post-menstrual symptoms, especially in the context of potential pregnancy or ovulation-related discomfort, can be quite complex. Based on the details you've provided, let's break down the situation and address your concerns.

1. Menstrual Cycle and Pregnancy Concerns: Your girlfriend's menstrual cycle appears to be regular, with her last period occurring from May 15 to May 21. Given that she had a normal menstrual period, it is unlikely that she is pregnant from the encounter on April 26, especially since you mentioned that there was no direct contact with bodily fluids, and the act was concluded with external ejaculation. Typically, if a woman has a normal menstrual period, it indicates that she is not pregnant. However, it is important to note that menstrual cycles can sometimes be affected by various factors, including stress, hormonal changes, and health conditions.

2. Symptoms of Nausea and Abdominal Discomfort: The symptoms your girlfriend is experiencing, such as nausea, abdominal discomfort, and the presence of brown discharge, could be attributed to several factors. The brown discharge you mentioned is often old blood, which can occur at the end of a menstrual cycle or during ovulation. It is not uncommon for women to experience some spotting or discharge around the time of ovulation, which can be mistaken for other issues.
3. Ovulation Pain (Mittelschmerz): The symptoms of abdominal discomfort and "pressure" in the uterus could indeed be related to ovulation, which typically occurs about 14 days before the next expected period. If her cycle is regular, ovulation would likely occur around May 25 to May 31, as you noted. Some women experience mittelschmerz, or ovulation pain, which can manifest as a dull ache or sharp pain on one side of the abdomen, along with other symptoms like nausea or changes in discharge.

4. Headaches and Other Symptoms: The headaches and feelings of nausea can also be linked to hormonal fluctuations that occur during the menstrual cycle. Hormonal changes can lead to various symptoms, including headaches, mood swings, and gastrointestinal discomfort.
5. When to Seek Medical Attention: While many of these symptoms can be normal and related to the menstrual cycle or ovulation, if your girlfriend's symptoms persist, worsen, or are accompanied by severe pain, heavy bleeding, or other concerning signs, it would be wise to consult a healthcare professional. They can perform a thorough evaluation, including a physical examination and possibly imaging or blood tests, to rule out any underlying conditions.

In summary, while the symptoms your girlfriend is experiencing could be related to her menstrual cycle or ovulation, it is essential to monitor her condition. If there are any significant changes or concerns, seeking medical advice is always the best course of action. Regular communication and support during this time can also help alleviate anxiety and ensure that both of you feel more at ease.

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