Abdominal Bloating and Breast Sensitivity in Women

Abdominal bloating and chest sensitivity?

Long-term irregular menstruation has been experienced, with approximately four months of amenorrhea.
Sexual intercourse occurred on 8/15, and pregnancy tests conducted on 9/8, 10/15, and 11/10 all showed a single line (negative).
On 9/9, a visit to the obstetrics and gynecology department was made for menstrual regulation, and oral contraceptives were started.
Menstruation occurred from 10/12 to 10/19 (this was the only time medication was taken, and it was not continued afterward).
Around 10/5, noticeable abdominal distension was observed (especially in the lower abdomen), and there was a significant sound of bloating upon percussion.
Lying flat while sleeping provided more comfort, and upon waking, the abdomen felt less distended and uncomfortable; however, throughout the day, it gradually became more distended with a feeling of heaviness.
Additionally, there have been occasional breast tenderness and sensitivity, with these symptoms persisting for over a month (no menstruation in November).
Due to the abdominal bloating and breast tenderness experienced while taking oral contraceptives, I would like to ask the physician whether the three negative pregnancy tests can rule out pregnancy.
Is the occasional breast tenderness and pain possibly due to hormonal changes from the medication? In this situation, should I consult an obstetrician-gynecologist or a gastroenterologist?

Ding, 20~29 year old female. Ask Date: 2020/11/25

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is likely that you are not pregnant.
If you are experiencing abdominal bloating, it is recommended to see a gastroenterologist.
Wishing you good health.

Reply Date: 2020/11/25

More Info

Understanding abdominal bloating and breast sensitivity in women can be complex, especially when considering the interplay of hormonal changes, menstrual irregularities, and potential underlying health conditions. Based on your description, it seems you are experiencing a combination of symptoms that may be related to hormonal fluctuations, particularly given your recent use of birth control pills and the irregularity of your menstrual cycle.

Firstly, the fact that you have had a prolonged period without menstruation (approximately four months) followed by a return of your menstrual cycle after starting birth control pills suggests that your body is adjusting to hormonal changes. Birth control pills work by altering hormone levels to prevent ovulation and regulate menstrual cycles. However, these hormonal changes can also lead to side effects such as breast tenderness and abdominal bloating.

The abdominal bloating you are experiencing, particularly noticeable in the lower abdomen, could be attributed to several factors. One possibility is that the hormonal changes from the birth control pills are affecting your gastrointestinal system, leading to increased gas production or changes in gut motility. Additionally, if you have been experiencing stress or dietary changes, these could also contribute to bloating. The fact that you feel more comfortable lying flat and that the bloating seems to decrease upon waking may indicate that your symptoms are related to fluid retention or gas accumulation, which can fluctuate throughout the day.

Regarding the breast sensitivity and occasional pain, this is also a common side effect of hormonal changes. Many women experience breast tenderness, especially in the days leading up to their menstrual period, due to fluctuations in estrogen and progesterone levels. Since you have recently started taking birth control pills, your body may still be adjusting to these new hormone levels, which could explain the ongoing breast sensitivity.

As for your concerns about pregnancy, the fact that you have taken multiple pregnancy tests and received negative results (one line) is a strong indication that you are not pregnant. Home pregnancy tests are generally quite accurate when used correctly, especially if taken after a missed period. However, if you continue to have symptoms that concern you, it may be worth consulting with a healthcare provider for further evaluation.

Given your symptoms, it would be advisable to see a gynecologist (婦產科) for a thorough examination. They can assess your menstrual irregularities, evaluate your breast symptoms, and possibly perform an ultrasound or other tests to rule out any underlying conditions. If gastrointestinal issues persist, a referral to a gastroenterologist (肝膽腸胃科) may also be warranted to explore any potential digestive concerns.

In summary, your symptoms of abdominal bloating and breast sensitivity are likely related to hormonal changes from your recent use of birth control pills and the irregularities in your menstrual cycle. It is essential to seek professional medical advice to address these concerns comprehensively and ensure that there are no other underlying health issues. Regular follow-ups with your healthcare provider will help monitor your symptoms and adjust your treatment plan as necessary.

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