Can Pregnancy Be Ruled Out? Delayed Periods and Symptoms

Is it possible to rule out pregnancy?

From July to October, my menstrual cycle has been approximately 28 days, with menstruation typically starting at the end of the month.
The first day of my last menstrual period was on October 27.
I had sexual intercourse on November 14, initially without a condom, but then used one until the end, and I confirmed that the condom did not break.
I took a home pregnancy test on November 21, which showed negative results.
However, my period, which was expected on November 28, did not arrive.
On December 3, I visited a gynecology clinic, where another pregnancy test also showed negative results, and I received an injection to induce menstruation.
After six days, my period still had not come, so I returned to the gynecology clinic on December 9, where I was tested for pregnancy again, which also showed negative, and I received another injection to induce menstruation.

Between December 7 and 10, I experienced occasional abdominal cramping and some breast fullness, but there was no pain and no symptoms typically associated with pregnancy.
Can I rule out the possibility of being pregnant? Is it possible that the abdominal cramping and breast fullness could indicate that my period is approaching?

Sunny, 10~19 year old female. Ask Date: 2021/12/11

Dr. Wu Xianghui reply Obstetrics and Gynecology

1.
For pregnancy concerns, please perform a home pregnancy test or visit a gynecologist for evaluation four weeks after your most recent sexual intercourse.
2.
The menstrual cycle can be influenced by various psychological and physiological factors; if your period is more than two months late, it is advisable to consult a gynecologist for evaluation.
3.
Repeated use of hormonal medications can lead to menstrual irregularities.

Reply Date: 2021/12/11

More Info

When it comes to understanding delayed periods and the possibility of pregnancy, it is essential to consider various factors that can influence menstrual cycles and the symptoms experienced. Based on your description, it appears that you have been tracking your menstrual cycle closely, and you have experienced a delay in your period despite having had sexual intercourse. You have also taken multiple pregnancy tests, all of which have returned negative results.
Firstly, it is important to note that a missed or delayed period can be caused by a variety of factors beyond pregnancy. Stress, hormonal imbalances, changes in weight, illness, and lifestyle changes can all contribute to irregularities in the menstrual cycle. In your case, you mentioned that your last menstrual period started on October 27, and you had unprotected intercourse on November 14. Although you initially did not use protection, you confirmed that the condom was intact during subsequent intercourse. This significantly reduces the likelihood of pregnancy, especially since you have taken multiple pregnancy tests that have all returned negative results.

The fact that you received a negative pregnancy test on November 21 and again during your visits to the gynecologist on December 3 and December 9 further supports the idea that pregnancy is unlikely. Additionally, the administration of medication to induce menstruation, such as the injection you received, is typically effective in prompting a period, especially if there is no underlying pregnancy.

Regarding your symptoms of abdominal cramping and breast tenderness, these can indeed be indicative of an approaching menstrual period. Many women experience premenstrual symptoms (PMS) that can include bloating, breast tenderness, and cramping as the body prepares for menstruation. However, if your period does not arrive after receiving hormonal treatment, it may be worth investigating further.

Given that you have experienced a significant delay in your menstrual cycle and have had multiple negative pregnancy tests, it is reasonable to consider that pregnancy can be ruled out as a cause of your symptoms. However, if your period does not start soon, or if you continue to experience discomfort, it would be advisable to follow up with your healthcare provider. They may recommend additional tests, such as blood tests to check hormone levels, or an ultrasound to assess your reproductive organs for any abnormalities.

In conclusion, while the symptoms you are experiencing could suggest that your period is on its way, the negative pregnancy tests and the hormonal treatment you have received make it unlikely that you are pregnant. It is essential to monitor your symptoms and maintain open communication with your healthcare provider to ensure that any underlying issues are addressed. If your period does not arrive soon, or if your symptoms worsen, seeking further medical advice would be prudent.

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