Pregnancy Concerns: Symptoms and Ultrasound Insights

Hello, doctor. Thank you for your help?

Hello Doctor, I engaged in some touching behavior at the end of May (unsure if there was any vaginal contact with pre-ejaculate).
In early June, I experienced some bleeding (uncertain if it was my menstrual period) — the first three days had a normal flow and typical menstrual cramps, but after that, I was unsure.
At the end of June, I took two pregnancy tests, and in mid-July, I took another one, all of which were negative.
At the end of July, the doctor mentioned that my endometrial thickness was insufficient (less than 1 cm) and prescribed medication to induce menstruation.
A few days later, menstruation was successfully induced, but the flow was lighter and even stopped for a day before resuming.
Afterward, I consulted the doctor again, who noted that the thickness had decreased, but I continued to experience symptoms like nausea and breast tenderness.

1.
Is it possible that I could be pregnant under these circumstances?
2.
Given that it has been at least 9 weeks since the touching incident and the ultrasound showed thickness of less than 1 cm, would a pregnancy be detectable at 9 weeks?
Thank you, and I apologize for the lengthy message.

Niming, 20~29 year old female. Ask Date: 2019/08/09

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, the early stages of pregnancy may not present specific symptoms, and subjective symptoms alone cannot be used for diagnosis.
If you are uncertain whether the bleeding is menstrual or are concerned about being pregnant, it is advisable to discuss this with your examining physician or consult an obstetrician-gynecologist for appropriate tests.
Thank you! Wishing you safety and health.
Dr.
Zhang

Reply Date: 2019/08/09

More Info

Understanding pregnancy concerns can be quite complex, especially when symptoms and medical evaluations are involved. Based on your description, it seems you have experienced a series of events that have raised questions about the possibility of pregnancy and the associated symptoms. Let’s break down your concerns and provide some insights.

1. Possibility of Pregnancy: Given your timeline, it appears that you engaged in intimate behavior in late May, followed by some bleeding in early June. The fact that you had negative pregnancy tests throughout July suggests that pregnancy is unlikely. However, it is important to note that pregnancy tests can sometimes yield false negatives, especially if taken too early or if the hormone levels are not yet high enough to be detected. The symptoms you mentioned, such as nausea and breast tenderness, can also be attributed to hormonal fluctuations rather than pregnancy.
2. Ultrasound Findings: You mentioned that during an ultrasound, your doctor noted that the endometrial thickness was less than 1 cm. In early pregnancy, a thicker endometrial lining is typically expected, as it supports the implantation of a fertilized egg. If the lining is thin, it may indicate that pregnancy is unlikely. Generally, by 9 weeks of pregnancy, an ultrasound should be able to detect a gestational sac if pregnancy has occurred. If your endometrial lining is still thin, it further supports the notion that pregnancy may not be present.

3. Symptoms of Nausea and Breast Tenderness: These symptoms can be caused by a variety of factors, including hormonal changes related to your menstrual cycle, stress, or other underlying health issues. It’s not uncommon for women to experience premenstrual symptoms that mimic early pregnancy signs. If your symptoms persist and are concerning, it would be wise to consult with your healthcare provider for further evaluation.

4. Follow-Up and Further Testing: If you continue to experience symptoms that are unusual for you, or if you have any other concerns, it would be beneficial to have a follow-up appointment with your healthcare provider. They may recommend additional blood tests to check hormone levels or further imaging studies to assess your reproductive health.

5. Emotional and Physical Well-being: It’s important to take care of your emotional and physical health during this time. Stress and anxiety can exacerbate physical symptoms, so consider engaging in relaxation techniques, maintaining a balanced diet, and ensuring you get adequate rest.

In summary, while the symptoms you are experiencing can be concerning, the combination of negative pregnancy tests and ultrasound findings suggests that pregnancy is unlikely. However, if you have ongoing symptoms or concerns, it is crucial to continue communicating with your healthcare provider for personalized advice and care. They can provide the most accurate information based on your specific medical history and current health status.

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