Concerns About Early Pregnancy Symptoms and Medication Effects

Early pregnancy: Lendormin 0.25mg and Divaprodium?

The patient had her last menstrual cycle on November 7 and has not menstruated since December 21, which is now 45 days late.
On the evening of December 21 at 8 PM, she visited the clinic for an ultrasound and pregnancy test, both of which indicated she was not pregnant, although the endometrial lining was thick.
She was administered a menstrual induction injection (Progesterone 50 mg), and the physician indicated that menstruation should occur within 3-7 days.
If menstruation does not occur within a week, she should return for a follow-up.
Today is the third day, December 24, and there are still no signs of menstruation, and she continues to experience nausea and vomiting.
From October 26 to November 29, she was prescribed two medications: Venlafaxine and Sulpiride.
From November 30 to December 21, she was on three medications: Venlafaxine, Diphenhydramine, and Lendormin 0.25 mg.
She has experienced nausea and vomiting from December 10 to December 24, which she suspects may be related to the medications.
However, she questions why the symptoms would only appear halfway through the course of treatment if they were indeed caused by the medications.
She stopped taking the medications on December 21, but as of December 24, she still has nausea and vomiting (possibly related to the progesterone injection?).
The patient notes that she did not experience such intense symptoms during her previous pregnancies.
Due to mild depression, she was taking Lendormin 0.25 mg and Diphenhydramine from November 30 to December 21.
Upon review, both medications are classified as Category X and D, which raises concerns.
If she does not menstruate by December 28 and a follow-up indicates pregnancy, there is a worry that the medications taken during that period may have caused harm (such as teratogenic effects).
She is seeking the physician's advice on what to do, as she is feeling anxious throughout the day.
She previously thought that the medications might have caused hormonal imbalances leading to the missed period, but she has been experiencing breast tenderness, nausea, and lower abdominal discomfort.
She has seen online accounts of individuals experiencing nausea before confirming pregnancy, and she is concerned about the lack of menstruation despite receiving the injection.
She apologizes for the disturbance.

Hen danxin de baba, 30~39 year old female. Ask Date: 2020/12/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, if the pregnancy test on December 21st was negative, it is likely that you are not pregnant.
You should wait another week, and if your period still hasn't arrived, you can return to your original obstetrician.
Don't overthink it.
Wishing you good health.

Reply Date: 2020/12/24

More Info

When it comes to early pregnancy symptoms and the effects of medications taken prior to or during pregnancy, there are several important factors to consider. First, let's address the concerns regarding the medications taken before realizing pregnancy and their potential impact on the fetus.

1. Medication Safety During Early Pregnancy: Many medications can have varying effects on a developing fetus, and their safety is often categorized into different classes based on their risk levels. For instance, medications classified as Category A are considered safe, while those in Category X are contraindicated in pregnancy due to evidence of fetal harm. The medications you mentioned, such as Lendormin (which is classified as Category X) and Divaprodium (which is classified as Category D), raise valid concerns. Category D indicates that there is positive evidence of human fetal risk, but the potential benefits may warrant use in pregnant women despite the risks.
If you have taken these medications during the early stages of pregnancy, it is crucial to consult with a healthcare provider. They can assess the specific circumstances, including the timing of medication exposure relative to conception and the potential risks involved.
2. Symptoms of Early Pregnancy: The symptoms you are experiencing, such as nausea and breast tenderness, are common early signs of pregnancy, often referred to as "morning sickness." These symptoms can occur regardless of the medications taken and are influenced by hormonal changes in the body. It is also important to note that every pregnancy can be different; some women may experience significant nausea in one pregnancy and none in another.
3. Menstrual Irregularities: The absence of menstruation can be attributed to various factors, including hormonal imbalances, stress, or the effects of medications. The use of hormonal treatments, such as the progesterone injection you received, can also affect your menstrual cycle. If your period does not arrive within a week of the expected date, it is advisable to take a pregnancy test or consult your healthcare provider for further evaluation.

4. Next Steps: Given your concerns about potential medication effects and the ongoing symptoms, it is essential to follow up with your healthcare provider. They may recommend a blood test to confirm pregnancy and assess hormone levels, which can provide more clarity on your situation. If pregnancy is confirmed, your provider can discuss the implications of the medications taken and any necessary monitoring or interventions.

5. Emotional Well-being: It is understandable to feel anxious about the potential effects of medications on a developing fetus. Consider discussing your concerns with a mental health professional or a support group for expectant mothers. They can provide emotional support and help you navigate the uncertainties of early pregnancy.

In summary, while some medications can pose risks during pregnancy, the specific impact depends on various factors, including the timing and dosage of the medication, as well as individual health circumstances. It is crucial to maintain open communication with your healthcare provider to ensure the best possible outcomes for both you and your baby.

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