Delayed Menstruation: Pregnancy Concerns and Medication Effects

Menstruation is delayed by eight days?

Last month, I had sexual intercourse on the third day of my menstrual period, using the withdrawal method.
My normal cycle is 28 days.
In July, my period was delayed by four days, so I went to the hospital for a urine test and ultrasound to rule out pregnancy.
After that, the doctor prescribed three days' worth of medication to induce menstruation.
Today, my period is delayed by eight days, and the pregnancy test is negative.
Does this mean that the possibility of pregnancy is essentially ruled out after 37 days without a positive test?
I had sexual intercourse again while taking the medication, still using the withdrawal method.
Could this lead to pregnancy? How many days after finishing the medication should I return for a follow-up if my period does not come? If I want to confirm that there is no pregnancy from the last sexual encounter, when is the best time to test again? Should I wait for my period to arrive to rule out the possibility of pregnancy?
After taking the medication, I feel a dull sensation in my lower abdomen but still have no bleeding.
Does this mean that my period is about to come? Given the above, is there still a chance of pregnancy? I would appreciate your help in answering these questions.
Thank you.

Lala, 20~29 year old female. Ask Date: 2021/07/24

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, generally when taking menstrual induction medication, menstruation should occur within a week after finishing the medication, which indicates that pregnancy is unlikely.
You can continue to monitor your condition.
Wishing you good health.

Reply Date: 2021/07/24

More Info

Understanding delayed menstruation and the implications of sexual activity and medication can be quite complex, especially when considering the possibility of pregnancy. Based on the information provided, let's break down your concerns regarding delayed menstruation, the effects of medication, and the likelihood of pregnancy.

Firstly, you mentioned that your menstrual cycle is typically 28 days and that you had sexual intercourse on the third day of your last period, using the withdrawal method (coitus interruptus). This method, while it can reduce the likelihood of pregnancy, is not foolproof. However, since you have had a negative pregnancy test 37 days after the sexual encounter, it is reasonable to conclude that the likelihood of pregnancy is low, especially if you have also undergone an ultrasound that ruled out pregnancy.

Regarding the use of medication to induce menstruation, it is important to understand that these medications can sometimes cause side effects, including cramping or discomfort in the lower abdomen, which you have experienced. This discomfort can be a sign that your body is responding to the medication, but it does not guarantee that menstruation will occur immediately. The timing of your period can vary, especially after taking hormonal medications, and it may take some time for your body to adjust.

If you had sexual intercourse while taking the medication to induce menstruation, and if the withdrawal method was used, the risk of pregnancy remains low but is not entirely eliminated. The effectiveness of the withdrawal method can be compromised, particularly if pre-ejaculate fluid contains sperm. However, given your negative pregnancy test results, it seems unlikely that you are pregnant.

As for when to return to the doctor, if your period does not arrive within a few days after completing the medication, it would be advisable to follow up with your healthcare provider. They may want to conduct further tests or evaluations to determine the cause of your delayed menstruation.
To ensure the most accurate results when testing for pregnancy, it is generally recommended to wait at least one week after a missed period to take a home pregnancy test. Since you have already tested negative, you may want to wait until your next expected period or consult your doctor for further guidance if your menstruation does not resume.

In summary, while the likelihood of pregnancy seems low based on your negative tests and the timing of your menstrual cycle, it is essential to monitor your body’s responses and maintain open communication with your healthcare provider. If you continue to experience discomfort or if your period does not arrive, seeking medical advice is the best course of action. Remember, every individual’s body reacts differently, and your healthcare provider can offer personalized guidance based on your specific situation.

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