Missed Period: Could It Be Pregnancy or Just Irregular Cycles?

Is a late period a sign of pregnancy?

Hello! My girlfriend's menstrual cycle for the last two times was 34-35 days.
Her last period started on January 30 and ended on February 4.
The app predicts her next period should be on March 5.
We had intercourse from February 27 to March 1, using condoms throughout and without ejaculation.
We also used a pH 5.5 lubricant.
However, as of today (March 17), her period still hasn't arrived.
She tested negative for pregnancy on the morning of March 12 and the afternoon of March 13.
However, during an ultrasound at the clinic, the doctor mentioned that the endometrium looks intact and that it could be an early sign of pregnancy! Although she was prescribed medication to induce menstruation, the instructions were to wait a week and test for pregnancy again if the urine test is negative before taking the medication.
What is the likelihood of pregnancy in this situation? Is it normal for her period to be delayed for this long? Thank you!

Jo, 30~39 year old female. Ask Date: 2021/03/17

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
You can take menstrual induction medication, and your period should come within a week after taking it.
If it doesn't come, you should consult a gynecologist.
Wishing you good health.

Reply Date: 2021/03/17

More Info

When it comes to missed periods and the possibility of pregnancy, several factors need to be considered. Your girlfriend's menstrual cycle has been relatively regular, with a typical length of 34-35 days. The last menstrual period (LMP) started on January 30 and ended on February 4. Based on this cycle, the next expected period would be around March 5. However, since you mentioned that you had unprotected intercourse from February 27 to March 1, this timing falls within her fertile window, which typically occurs around ovulation—approximately 14 days before the next expected period.

Given that her period has not arrived by March 17, this delay could be concerning. The fact that she has taken two urine pregnancy tests on March 12 and 13, both of which returned negative results, is also noteworthy. Urine tests are generally reliable, but they can sometimes yield false negatives, especially if taken too early. The hormone human chorionic gonadotropin (hCG), which is produced during pregnancy, may not be at detectable levels in the urine if the test is taken before a missed period or if the pregnancy is very early.

The ultrasound examination revealing a "very intact endometrium" could indicate that her body is preparing for a potential pregnancy, but it does not confirm pregnancy on its own. An intact endometrium is a sign that the uterine lining is thickened, which can occur in both pregnant and non-pregnant states, particularly if a period is delayed.

In terms of the likelihood of pregnancy, while the use of condoms significantly reduces the risk of pregnancy, no contraceptive method is 100% effective. Factors such as condom breakage or slippage, as well as the presence of pre-ejaculatory fluid, can contribute to the risk of pregnancy. The use of pH-balanced lubricants is generally safe, but it is important to ensure that they are compatible with condoms to avoid any potential breakage.

Given the circumstances, it is advisable for your girlfriend to wait a few more days and then retest for pregnancy. If her period does not arrive and the subsequent test is still negative, it may be worth consulting with a healthcare provider for further evaluation. They might suggest a blood test for hCG, which is more sensitive than urine tests and can detect pregnancy earlier.

Additionally, irregular cycles can be influenced by various factors, including stress, hormonal imbalances, changes in weight, or underlying medical conditions. If her cycles have been irregular in the past, this could also contribute to the missed period. It is essential to monitor her symptoms and any changes in her body, as these can provide further clues about her reproductive health.

In conclusion, while there is a possibility of pregnancy given the timing of intercourse and the missed period, the negative urine tests and the ultrasound findings suggest that it may be too early to confirm pregnancy definitively. It is crucial to follow up with a healthcare provider for further testing and to discuss any concerns regarding menstrual irregularities.

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