Delayed Periods: When to Test for Pregnancy and Seek Help

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Dear Doctor,
Last time you advised me to take a pregnancy test again on August 5 if my period still hasn't arrived.
If the test on August 5 still shows negative, does that mean there is no possibility of pregnancy and I should go to the hospital to induce menstruation? Since July 27 (the day my period was due) until now (August 3), I have been experiencing a persistent feeling of heaviness and bloating in my lower abdomen, with occasional sharp and cramping pains, similar to premenstrual symptoms.
A few days ago, I noticed watery discharge.
What could be the cause of this? Thank you, Doctor!

Xiao Mi, 20~29 year old female. Ask Date: 2019/08/03

Dr. Huang Jianzhong reply Obstetrics and Gynecology

If the menstrual period has not arrived and a pregnancy test is taken again on August 5th, if the result still shows negative, does that mean there is no possibility of pregnancy and it is necessary to go to the hospital for menstrual induction? Answer: Since July 27th (the day the period was missed) until now (August 3rd), there has been a continuous feeling of heaviness and occasional sharp or cramping pain in the lower abdomen, similar to the sensation before menstruation.
A few days ago, there was also a watery discharge.
What could be the reason for this? Answer: It is likely that menstruation is about to occur.

Reply Date: 2019/08/03

More Info

When it comes to understanding delayed periods, it’s essential to consider various factors that could contribute to this situation. Based on your timeline, you last had your period on July 18, and you engaged in sexual activity on the same day. Given that ovulation typically occurs about 14 days before the next expected period, it seems unlikely that conception occurred from that encounter. You mentioned using an ovulation test that indicated an LH surge on July 31, which aligns with typical ovulation timing. However, since you have tested for pregnancy on August 4 and August 14 with negative results, it raises questions about the reasons for your delayed period.

The absence of menstruation can be attributed to several factors, including hormonal imbalances, stress, changes in weight, and underlying medical conditions. Stress, in particular, can significantly impact the menstrual cycle. The body’s response to stress can lead to the disruption of the hypothalamic-pituitary-ovarian axis, which regulates the menstrual cycle. This disruption can result in delayed periods or even missed cycles altogether.

In your case, since you are experiencing persistent symptoms such as lower abdominal discomfort and unusual discharge, it is crucial to monitor your condition closely. The sensation of heaviness or pain in the lower abdomen can sometimes be associated with premenstrual syndrome (PMS) or other conditions like ovarian cysts or endometriosis. The presence of watery discharge could indicate hormonal fluctuations, which are common in cases of delayed menstruation.

If you take a pregnancy test on August 5 and it still shows a negative result, it does not definitively rule out pregnancy, especially if the test is taken too early. However, if you continue to experience symptoms without the onset of menstruation, it may be wise to consult a healthcare provider. They can perform a more sensitive blood test for pregnancy or conduct an ultrasound to evaluate your reproductive organs for any abnormalities.

Regarding your question about whether you should seek medical assistance if your period does not arrive, it is generally advisable to consult with a healthcare professional if your period is more than a week late, especially if you have negative pregnancy tests and are experiencing discomfort. They can help determine the underlying cause of your symptoms and suggest appropriate treatment options.

In summary, while a delayed period can sometimes be a sign of pregnancy, it can also result from various other factors. If your pregnancy test remains negative and your symptoms persist, seeking medical advice is the best course of action. Your healthcare provider can help you navigate this situation, ensuring that you receive the appropriate care and support. Remember, it’s essential to prioritize your health and well-being during this time.

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