Irregular Periods: Pregnancy Concerns and PCOS Insights

Pregnancy status

Hello Dr.
Chang, I am asking on behalf of my girlfriend.
Her menstrual cycle is approximately 31 days, but she has previously experienced irregularities with her periods (the longest being 59 days).
She was supposed to start her period on December 4th, but it has not arrived yet.
We have had sexual intercourse (the last time was two weeks ago), but it was limited to genital rubbing over underwear.
We have done several pregnancy tests in between, all of which were negative (the last one was at the clinic on December 19th).
The doctor did not provide a clear reason, only mentioning that the eggs appear to be irregularly arranged and prescribed a medication to induce menstruation, stating that her period might come as soon as Thursday.
I would like to ask: 1.
Is it possible that she is pregnant? 2.
Is it normal for her to experience intermittent lower abdominal pain before seeing the doctor? 3.
Could it be polycystic ovary syndrome (PCOS), considering she is prone to acne and is overweight?

Niming, 20~29 year old female. Ask Date: 2020/12/24

Dr. Zhang Kunmin reply Obstetrics and Gynecology

Hello, based on your description, the chances of pregnancy are low, and there have been no confirmed reports in the past.
However, as long as there are active sperm in the vagina during the ovulation period, there is still a possibility of pregnancy regardless of the method of exposure.
It is advisable to take appropriate contraceptive measures.

There are many factors that can affect the menstrual cycle or cause intermenstrual bleeding, such as age, environment, lifestyle, stress, emotional instability, weight changes, medications, emergency contraception, diet, polycystic ovary syndrome, uterine or cervical lesions, infections, and ovulation, among others.
If you are experiencing abdominal pain or have concerns about polycystic ovaries, it is recommended to consult a physician for ultrasound, urine, and blood tests for confirmation.
Thank you! Wishing you peace and health.

Dr.
Zhang

Reply Date: 2020/12/24

More Info

Understanding irregular periods and the implications for pregnancy, especially in the context of Polycystic Ovary Syndrome (PCOS), can be quite complex. Your girlfriend's situation, characterized by a history of irregular menstrual cycles and recent missed periods, raises several important questions.

1. Is Pregnancy Possible?
Given that your girlfriend has had irregular periods, determining the likelihood of pregnancy can be challenging. While she has engaged in sexual activity, the nature of that activity (friction through clothing) typically presents a lower risk for pregnancy compared to unprotected intercourse. The negative pregnancy tests she has taken further suggest that pregnancy is unlikely. However, it is important to note that false negatives can occur, especially if the tests are taken too early or if the hormone levels are not yet detectable. If her period does not arrive after the administration of the medication prescribed by her doctor, a follow-up pregnancy test or consultation may be warranted.

2. Is Abdominal Pain Normal?
Experiencing intermittent abdominal pain can be common in women with irregular cycles, particularly if they have conditions like PCOS. This pain could be related to hormonal fluctuations, ovulation, or even the effects of the medication prescribed to induce menstruation. However, if the pain is severe, persistent, or accompanied by other concerning symptoms (such as heavy bleeding, fever, or unusual discharge), it is crucial to seek medical attention. It is also worth noting that stress and anxiety about the situation can exacerbate physical symptoms, including abdominal discomfort.

3. Could It Be PCOS?
The symptoms you describe, such as irregular periods, difficulty with weight management, and acne, are indeed consistent with PCOS. This condition is characterized by hormonal imbalances that can lead to irregular ovulation and menstrual cycles. Women with PCOS may also experience symptoms such as excessive hair growth, thinning hair, and skin issues. The mention of "eggs arranged abnormally" could suggest that her ovaries are exhibiting the classic "string of pearls" appearance often seen in ultrasound images of women with PCOS.
In summary, while pregnancy is a possibility, the combination of negative pregnancy tests and the nature of the sexual activity suggests it is less likely. The abdominal pain may be related to her hormonal fluctuations or the effects of medication. Lastly, given her symptoms, it would be prudent for her to discuss the possibility of PCOS with her healthcare provider, as this condition can have implications for her reproductive health and overall well-being.

If your girlfriend continues to experience irregular cycles or other symptoms, it may be beneficial for her to seek a comprehensive evaluation from a healthcare provider who specializes in reproductive health. This could include blood tests to assess hormone levels, an ultrasound to evaluate ovarian structure, and a discussion about lifestyle modifications that can help manage PCOS symptoms. Understanding her condition can empower her to make informed decisions about her health and reproductive plans.

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