Delayed Period and Thickened Endometrium: Am I Pregnant?

Menstruation is delayed by 14 days, pregnancy test shows one line, and there is thickening of the endometrium?

The last menstrual period started on November 24.
Sexual intercourse occurred on December 3 and December 10, both with condom use.
Pregnancy tests taken on January 9 in the afternoon and January 10 in the morning both showed one line.
An ultrasound performed on January 10 in the afternoon indicated that the endometrium is thickening, suggesting that menstruation is imminent.
I would like to ask if there is still a possibility of pregnancy, or if I should just wait for my period to arrive.
Thank you!

Miss Yang, 20~29 year old female. Ask Date: 2023/01/10

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, a negative pregnancy test indicates that you are likely not pregnant.
Since it has been over 14 days, you may consider taking medication to induce menstruation.
Wishing you good health.

Reply Date: 2023/01/10

More Info

When it comes to the question of whether you might be pregnant given your delayed period and the observation of a thickened endometrium, there are several factors to consider. Based on your timeline, your last menstrual period was on November 24, and you had sexual intercourse on December 3 and December 10, both times using condoms. You took a pregnancy test on January 9 and January 10, which both showed a negative result (one line). However, during your visit to the gynecologist on January 10, an ultrasound indicated that your endometrium was thickened, which is often a sign that your body is preparing for menstruation.

Firstly, it’s important to understand that a thickened endometrium can occur for various reasons. In a typical menstrual cycle, the endometrium thickens in response to hormonal changes, particularly estrogen, in preparation for a potential pregnancy. If fertilization does not occur, the endometrium will eventually shed, leading to menstruation. Therefore, a thickened endometrium can indicate that your body is in the luteal phase of your cycle, which is the phase after ovulation and before your period starts.

The fact that you had two negative pregnancy tests suggests that you are likely not pregnant. Home pregnancy tests are generally quite accurate, especially when taken after a missed period. However, it’s worth noting that false negatives can occur, particularly if the test is taken too early or if the urine is diluted. If you suspect that you might be pregnant despite the negative tests, you could consider waiting a few days and testing again, or consulting your healthcare provider for a blood test, which can detect pregnancy earlier and more accurately than home tests.

Regarding the possibility of pregnancy, the use of condoms significantly reduces the likelihood of conception, but no contraceptive method is 100% effective. If there was any breakage or slippage of the condom, there could be a risk of pregnancy. However, given that you have had two negative tests and your doctor’s assessment of your endometrium, it seems more likely that your period is simply delayed.

In terms of what to do next, if your period does not arrive within a week or so, you should follow up with your healthcare provider. They may recommend further evaluation, such as a repeat ultrasound or additional hormone testing, to determine the cause of your delayed period and thickened endometrium. Conditions such as hormonal imbalances, stress, significant weight changes, or underlying health issues can also lead to delayed menstruation and changes in the endometrium.

In summary, while there is a possibility of pregnancy, the negative tests and the medical evaluation suggest that it is more likely that your period is simply delayed. Monitoring your symptoms and following up with your healthcare provider will be the best course of action to ensure your reproductive health is managed appropriately.

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