Pregnancy Tests: Positive Results Despite Menstrual Bleeding

Menstruation has occurred, but the pregnancy test shows a positive result?

Hello Dr.
Peng, my girlfriend recently took a pregnancy test, and the result was positive.
However, she still had her period at the time of the test.
Her menstrual cycle is very irregular, with periods lasting about two to three weeks and occurring approximately every two weeks or longer.
She has had her period almost every month in October and November, and it has been quite irregular.
We have always used condoms during intercourse, and the most recent times were from October 14 to 25 (no intercourse), October 26 (intercourse but no ejaculation), and November 2 (intercourse but no ejaculation).
She tested positive on November 9.
She also has lupus erythematosus; could this affect the accuracy of the pregnancy test? I want to take her to the hospital for an examination, but we live in a remote area with very few clinics, and she is afraid of being seen by her parents or acquaintances, which is why she hasn't gone.
I am very anxious about this, as I have not been eating or sleeping well lately.
Please respond, thank you very much!

Hao ji tian shui bu hao de ren, 20~29 year old female. Ask Date: 2002/11/11

Dr. Peng Yiguo reply Obstetrics and Gynecology

Patients with lupus erythematosus who are taking corticosteroids may indeed experience changes in their menstrual cycle, including the amount and duration of menstruation.
Regarding the menstrual period from October 14 to 25, it is questionable whether it was a true menstrual flow; otherwise, it would be unlikely to test positive for pregnancy on November 9.
The disease itself does not affect the accuracy of pregnancy tests.
The contraceptive effectiveness of condoms is approximately 75-80%, which is related to the timing and quality of use.
I recommend repeating the pregnancy test, and if it remains positive, consult a gynecologist for an ultrasound scan.
If there is ongoing bleeding, progesterone supplementation should be considered until the presence and health of the embryo are confirmed.

Reply Date: 2002/11/11

More Info

Understanding pregnancy tests and the implications of positive results despite menstrual bleeding can be quite complex, especially in cases where menstrual cycles are irregular and there are underlying health conditions such as lupus.
Firstly, it's important to understand how pregnancy tests work. Most home pregnancy tests detect the presence of human chorionic gonadotropin (hCG) in urine, a hormone produced shortly after a fertilized egg attaches to the uterine lining. Typically, hCG levels rise rapidly in early pregnancy, doubling approximately every 48 to 72 hours. However, if a woman is experiencing irregular menstrual cycles, it can complicate the interpretation of test results.

In your girlfriend's case, she has a history of irregular menstrual cycles, which can make it difficult to determine when she might have conceived. If she had a positive pregnancy test on November 9, it indicates that hCG is present in her system, suggesting that she is likely pregnant. However, the presence of menstrual bleeding can lead to confusion.
Menstrual bleeding during early pregnancy can occur for several reasons. One common reason is implantation bleeding, which can happen when the fertilized egg attaches to the uterine lining. This type of bleeding is usually light and short-lived. However, if the bleeding is heavier or accompanied by pain, it could indicate a potential issue, such as a threatened miscarriage or other complications.
Regarding the lupus diagnosis, systemic lupus erythematosus (SLE) can affect pregnancy in various ways. While lupus itself does not directly interfere with the accuracy of pregnancy tests, it can lead to complications during pregnancy, including an increased risk of miscarriage or preterm birth. Additionally, certain medications used to manage lupus may also have implications for pregnancy. It is crucial for your girlfriend to consult with a healthcare provider to discuss her lupus management and its potential impact on her pregnancy.

Given the circumstances, it is understandable that both you and your girlfriend are feeling anxious about the situation. If she is hesitant to visit a healthcare facility due to privacy concerns, consider exploring telemedicine options. Many healthcare providers offer virtual consultations, which can provide her with the necessary guidance without the need for an in-person visit.

In summary, a positive pregnancy test amidst irregular menstrual bleeding can indicate pregnancy, but it is essential to monitor the situation closely. If the bleeding continues or worsens, or if she experiences significant pain, it is crucial to seek medical attention promptly. Additionally, managing her lupus during this time is vital for both her health and the health of the pregnancy. Encourage her to prioritize her well-being and seek the necessary medical advice, even if it means exploring alternative options for consultation.

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