Delayed Menstruation: Possible Causes and Concerns

My period hasn't arrived yet?

Hello doctor, my girlfriend's menstrual periods from January to March were normal, occurring from December 31 to January 6, February 1 to February 7, and March 5 to March 11.
During this time, there was no sexual intercourse until March 6, when I engaged in genital rubbing against her inner thigh, resulting in the release of pre-ejaculatory fluid.
At that time, my girlfriend was wearing underwear and a sanitary pad, and I wiped off the pre-ejaculatory fluid afterward.
On March 23 (the ovulation day marked on the calendar), my girlfriend noticed some brownish blood while showering in the evening.
This continued on March 24 and 25, but it was only a small amount, and she did not experience any abdominal discomfort.
In April, her menstrual period was expected to start on April 6, but it is now two days late.
I would like to ask the doctor: 1.
Could this be a sign of pregnancy? 2.
Or could the stress and late nights over the past few days be causing the delay?

Xiao Feng, 20~29 year old female. Ask Date: 2023/04/08

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the likelihood of pregnancy should be low.
Please observe for another 1 to 2 weeks, and if your period still does not arrive, it is recommended to see a gynecologist.
Wishing you good health.

Reply Date: 2023/04/08

More Info

Understanding delayed menstruation can be a source of concern for many women, and it is essential to consider various factors that could contribute to this phenomenon. Based on the information provided, your girlfriend has had regular menstrual cycles from December to March, with the last period occurring from March 5 to March 11. The subsequent events, including the occurrence of brownish discharge and the delay of her expected period in April, raise several questions.

1. Could this be a sign of pregnancy?
While it is possible for any unprotected sexual activity to lead to pregnancy, the specific scenario you described—where there was no direct penetration and the contact was limited to grinding against her thigh while she was wearing underwear and a sanitary pad—significantly reduces the likelihood of pregnancy. Sperm must typically enter the vagina to fertilize an egg, and the presence of a sanitary pad would act as a barrier. However, if there was any direct contact with the vaginal area or if sperm was transferred in any way, there is a slight chance of pregnancy.
To confirm or rule out pregnancy, it would be advisable for your girlfriend to take a home pregnancy test, especially if her period does not arrive soon. These tests are most accurate when taken after a missed period.

2. Could stress or other external factors be causing the delay?
Yes, stress is a well-known factor that can affect the menstrual cycle. Emotional stress, changes in routine, sleep disturbances, or significant lifestyle changes can all lead to hormonal fluctuations that may delay menstruation. Additionally, factors such as changes in diet, exercise, and overall health can also impact menstrual regularity.

In your girlfriend's case, if she has experienced increased stress or changes in her daily routine, it could explain the delay in her period. The brownish discharge she noticed could be related to hormonal changes or the onset of her period, which may be delayed but not absent.

3. Other potential causes of delayed menstruation:
Besides pregnancy and stress, there are other medical conditions that can lead to delayed menstruation. These include:
- Polycystic Ovary Syndrome (PCOS): A hormonal disorder that can cause irregular periods.

- Thyroid Disorders: Both hypothyroidism and hyperthyroidism can affect menstrual cycles.

- Weight Changes: Significant weight loss or gain can disrupt hormonal balance.

- Medications: Certain medications, including hormonal contraceptives, can affect menstrual regularity.

- Underlying Health Conditions: Conditions such as diabetes or other endocrine disorders can also play a role.

In conclusion, while the likelihood of pregnancy seems low given the circumstances, it is essential for your girlfriend to monitor her symptoms and consider taking a pregnancy test for peace of mind. If her period does not arrive soon or if she experiences any unusual symptoms, it would be prudent for her to consult a healthcare provider for further evaluation. They can provide a comprehensive assessment and determine if any underlying issues need to be addressed.

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