Delayed Menstruation: Possible Causes and Concerns - Obstetrics and Gynecology

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Understanding delayed menstruation can be complex, as it can arise from a variety of causes, both physiological and pathological. In your case, considering the timeline you've provided, let's break down the potential reasons for your delayed menstruation and the associated concerns.

1. Menstrual Cycle Basics: A typical menstrual cycle lasts about 28 days, but it can vary from 21 to 35 days in adults. Your last menstrual period (LMP) was from August 13 to August 18, making your expected next period around September 9. If your cycle is regular, a delay could indicate several possibilities.

2. Ovulation and Conception: You mentioned that your estimated ovulation date was August 26, and you had sexual intercourse on September 1, using protection. The timing of your intercourse relative to ovulation is crucial. While condoms are effective, no contraceptive method is 100% foolproof. If sperm was present, there is a possibility of conception, especially if the condom failed or was used improperly.

3. Pregnancy Symptoms: The absence of menstruation is one of the earliest signs of pregnancy. Other early signs can include breast tenderness, nausea, fatigue, and changes in basal body temperature. Your reported temperature of 37.7°C could be a sign of ovulation or early pregnancy, but it could also indicate an impending illness, such as a cold or flu, especially if you are experiencing other symptoms like fatigue or malaise.

4. Other Causes of Delayed Menstruation: Aside from pregnancy, several other factors can lead to a delayed period:
- Stress: Emotional or physical stress can disrupt hormonal balance, leading to delayed ovulation and menstruation.

- Weight Changes: Significant weight loss or gain can affect your menstrual cycle.

- Hormonal Imbalances: Conditions like polycystic ovary syndrome (PCOS) or thyroid disorders can lead to irregular cycles.

- Illness: Acute illnesses can temporarily affect your menstrual cycle.

- Medications: Certain medications, including hormonal contraceptives, can alter your cycle.

5. Consultation with Healthcare Providers: Given that you have seen a traditional Chinese medicine practitioner who noted a "slippery pulse," which may suggest a hormonal imbalance or other issues, it might be beneficial to follow up with a healthcare provider who can conduct a more comprehensive evaluation. This could include a pregnancy test, blood tests to check hormone levels, and possibly an ultrasound if there are concerns about other underlying conditions.

6. Next Steps: If your period does not arrive in the next few days, consider taking a home pregnancy test for confirmation. If the test is positive, schedule an appointment with your healthcare provider to discuss your options and next steps. If the test is negative and your period still does not come, further evaluation may be necessary to determine the underlying cause.

In summary, while there is a possibility of pregnancy given the timing of your intercourse and your missed period, other factors could also be at play. Monitoring your symptoms and consulting with a healthcare provider will provide clarity and help address any concerns you may have.