Delayed Menstruation: Pregnancy Concerns and Testing

Delayed menstruation and pregnancy issues?

Hello Doctor, in February, my period started on the 20th with a small amount and stopped that night (I had taken medication due to viral gastroenteritis; could this have affected my period?).
Then it returned on the 22nd and lasted until the 27th or 28th.
I took emergency contraception, but I forgot when exactly I took it; I know I took it before my period started.
In March, I had unprotected intercourse on the 8th, 14th, and 20th, but there was no ejaculation inside.
I was originally expecting my period on March 20th, but it did not come.
I used a pregnancy test on March 29th, which showed one line.
As of now, my period has not arrived by April 5th.
I have experienced slight nausea but no vomiting, a slight change in taste, and increased drowsiness.
My body temperature has been normal, peaking at 36.9°C for just one day, but it has mostly been in the mid-35s to low 36s.

Doctor, I have a few questions:
1.
Could the irregularity of my February period cause me to skip this month?
2.
What is the likelihood of pregnancy? Is it possible that I am already pregnant?
3.
Since the pregnancy test on March 29th showed one line and my period still hasn’t arrived, when can I test again to confirm whether I am pregnant? Thank you, Doctor.

Zhang Minjie, 20~29 year old female. Ask Date: 2020/04/05

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if the pregnancy test shows negative, it is likely that the chances of being pregnant are low.
Wishing you good health.

Reply Date: 2020/04/05

More Info

Delayed menstruation can be a source of anxiety for many individuals, particularly when there are concerns about potential pregnancy. In your case, there are several factors at play that could contribute to the delay in your menstrual cycle, including recent health issues, medication use, and sexual activity.

1. Impact of Illness and Medication: You mentioned experiencing viral gastroenteritis in February, which can indeed affect your menstrual cycle. Stress on the body, whether from illness or other factors, can lead to hormonal fluctuations that may delay menstruation. Additionally, if you took any medications during your illness, it's important to consider that some medications can also impact your menstrual cycle. However, without knowing the specific medications you took, it's difficult to assess their potential effects.

2. Pregnancy Probability: Regarding your sexual activity in March, you indicated that you had unprotected intercourse but did not experience ejaculation. While the withdrawal method (pulling out) can reduce the likelihood of pregnancy, it is not foolproof. Pre-ejaculate fluid can contain sperm, and if there was any leakage, there is still a possibility of pregnancy. Given that you took emergency contraception (the "morning-after pill") before your expected period in February, it is designed to prevent ovulation and reduce the chance of pregnancy. However, its effectiveness can vary based on when it is taken in relation to your menstrual cycle.

3. Testing for Pregnancy: You used a home pregnancy test on March 29, which returned a negative result. Home pregnancy tests are generally reliable, especially when taken after a missed period. However, if your period has not arrived by now (April 5), it may be advisable to retest. The best time to take a pregnancy test is typically one week after a missed period for the most accurate results. If you continue to experience symptoms such as nausea, changes in appetite, or fatigue, it would be prudent to consult with a healthcare provider for further evaluation.

4. Next Steps: If your period does not arrive soon and you continue to have concerns about pregnancy, consider scheduling an appointment with a healthcare provider. They can perform a blood test, which is more sensitive than a home pregnancy test, and can also provide guidance on your menstrual health. Additionally, they can help assess whether any underlying issues may be contributing to your delayed menstruation.

In summary, while there are several factors that could explain your delayed menstruation, including illness and the use of emergency contraception, the possibility of pregnancy cannot be completely ruled out. Retesting for pregnancy after a missed period and consulting with a healthcare provider for further evaluation would be the best course of action to address your concerns. Remember, maintaining open communication with your healthcare provider about your symptoms and any medications you are taking is crucial for your overall health.

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