Premenstrual Symptoms: Pain, Pregnancy Tests, and More

Is it premenstrual syndrome?

Hello Doctor, my menstrual cycle is about 30-32 days.
My last period was from February 2 to February 6, and the app predicts my next period on March 4.
I would like to ask you: 1.
I have been experiencing sharp pain, dull pain, and diarrhea in my lower left abdomen for the past four days.
Are these symptoms common before menstruation? 2.
It has been 14 days since my last sexual intercourse, and the pregnancy test result is negative.
Is this reliable? 3.
If I take a pregnancy test 18 days after sexual intercourse and it is negative, does that mean there is no possibility of pregnancy? Thank you, Doctor.

Ting, 20~29 year old female. Ask Date: 2022/02/25

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, it is likely premenstrual syndrome (PMS).
Since it has been over 12 days and the pregnancy test is negative, it is unlikely that you are pregnant.
Wishing you good health.

Reply Date: 2022/02/25

More Info

Understanding premenstrual symptoms and their implications can be quite complex, especially when considering the possibility of pregnancy. Let's address your questions one by one, while also providing some additional context regarding menstrual cycles, pregnancy tests, and related symptoms.

1. Left Lower Abdominal Pain Before Menstruation: Experiencing left lower abdominal pain, especially if it is sharp or cramping, can indeed be a symptom associated with the premenstrual phase. This discomfort is often linked to the hormonal changes that occur in the body as it prepares for menstruation. The pain can be due to increased prostaglandin levels, which cause the uterus to contract. However, if the pain is severe or accompanied by other concerning symptoms (like heavy bleeding or fever), it is advisable to consult a healthcare provider to rule out conditions such as ovarian cysts or endometriosis.

2. Pregnancy Test After 14 Days: If you have taken a pregnancy test 14 days after your last sexual intercourse and it returned a negative result, it is generally considered reliable, especially if you are testing after a missed period. Most home pregnancy tests are designed to detect the hormone hCG (human chorionic gonadotropin), which is produced shortly after a fertilized egg attaches to the uterine lining. Testing too early can lead to false negatives, so waiting until at least the expected date of your period is recommended for the most accurate result.

3. Testing 18 Days Post-Sexual Intercourse: If you test negative 18 days after sexual intercourse, it is highly likely that you are not pregnant. At this point, hCG levels would be sufficiently elevated if conception had occurred, making it detectable by standard home pregnancy tests. However, if you continue to experience symptoms of pregnancy or if your period does not arrive, it would be wise to consult a healthcare professional for further evaluation.

Additional Considerations
- Menstrual Cycle Variability: It’s important to note that menstrual cycles can vary from month to month due to various factors such as stress, diet, exercise, and hormonal fluctuations. A cycle length of 30-32 days is within the normal range, but any significant changes in your cycle pattern should be discussed with a healthcare provider.

- Premenstrual Syndrome (PMS): Symptoms of PMS can include mood swings, fatigue, bloating, breast tenderness, and abdominal pain. These symptoms can sometimes mimic early pregnancy signs, which can lead to confusion. Keeping a symptom diary can help you track patterns and discuss them with your doctor.

- When to Seek Medical Advice: If you experience persistent pain, significant changes in your menstrual cycle, or other unusual symptoms, it is essential to seek medical advice. Conditions like pelvic inflammatory disease (PID), ectopic pregnancy, or other gynecological issues can present with similar symptoms and require prompt attention.

In conclusion, while your symptoms may be consistent with premenstrual syndrome, the negative pregnancy test after 14 days is a strong indicator that you are not pregnant. However, if you have ongoing concerns or if your symptoms worsen, it is always best to consult a healthcare professional for personalized advice and care.

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