Delayed Period and Abdominal Discomfort: Am I Pregnant?

Delayed menstruation and abdominal discomfort—could this indicate pregnancy?

Hello Doctor, I would like to explain my situation.
My last menstrual period was from May 22 to May 28, and I had sexual intercourse on May 29 with a condom.
Since my average menstrual cycle is 31 days, I expected my next period to arrive around June 22, but it did not come.
I have been feeling bloated in my abdomen, experiencing a general feeling of heat, slight lower back pain, and tenderness in my breasts.
On June 23, I visited a traditional Chinese medicine practitioner who prescribed me medication to induce menstruation.
The doctor checked my pulse and indicated that my period was likely coming soon.

On June 24, still feeling uneasy, I went to a gynecologist for an examination.
A urine test came back negative, and an ultrasound showed that my uterus appeared somewhat enlarged, with no abnormalities in the fallopian tubes.
The doctor suggested that my period might be approaching or that I could be pregnant, and prescribed me three days' worth of medication to induce menstruation.
The doctor advised that if my period did not arrive within ten days after finishing the medication, I should return for further testing to check for pregnancy.

That evening, June 24, I experienced some bleeding, which I thought was my period, but until June 25, it was just very light brown spotting, almost negligible.
My abdomen continued to feel bloated and painful.
On June 26, I purchased a Clearblue pregnancy test and the result was negative.

1.
Given that it has been about 27-29 days since my last sexual intercourse and the subsequent urine tests have also been negative, what is the likelihood of pregnancy? I am worried that both the hospital and pharmacy pregnancy tests may have given false negatives.

2.
Since it has been nearly a month with two negative tests, what could the brown spotting indicate? If my period still does not arrive in ten days, I will return to the gynecologist for further examination.
Thank you, Doctor, for taking the time to help me with my questions.
I appreciate it!

Peng, 20~29 year old female. Ask Date: 2023/06/27

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the chances of pregnancy should be low.
Normally, you should expect your period to arrive within a week after taking the menstrual induction medication.
Just wait a little longer and take care of your health.

Reply Date: 2023/06/27

More Info

Based on the information you've provided, it seems you are experiencing a delay in your menstrual cycle, abdominal discomfort, and some unusual spotting. Let's break down your situation and address your concerns regarding the possibility of pregnancy.

1. Delayed Period and Timing of Intercourse: You mentioned that your last menstrual period (LMP) was from May 22 to May 28, and you had sexual intercourse on May 29 while using a condom. Given that your menstrual cycle averages 31 days, your next expected period would have been around June 22. Since you did not get your period, it is understandable that you are concerned about the possibility of being pregnant. However, the use of a condom significantly reduces the risk of pregnancy, provided it was used correctly and did not break.

2. Pregnancy Testing: You reported that you took a urine pregnancy test on June 24, which came back negative. It's important to note that home pregnancy tests are generally reliable, especially when taken after a missed period. However, testing too early can sometimes yield false negatives. Since you are now about 27-29 days post-intercourse and have had two negative tests, the likelihood of pregnancy decreases, but it is not impossible.

3. Spotting and Abdominal Discomfort: The coffee-colored spotting you experienced could be due to several factors. It might be a sign of your period approaching, known as premenstrual spotting. Alternatively, it could be related to hormonal fluctuations or other benign causes. The abdominal discomfort you are feeling could also be related to premenstrual symptoms or other non-pregnancy-related issues, such as gastrointestinal discomfort or stress.

4. Next Steps: Since you have experienced a delay in your period and have had two negative pregnancy tests, it is advisable to wait for about 10 days after your last test (as suggested by your doctor) to see if your period arrives. If it does not, returning to your gynecologist for further evaluation is a good idea. They may perform a blood test, which is more sensitive than a urine test, and can provide a more definitive answer regarding pregnancy.

5. Other Considerations: If you continue to experience discomfort or if the spotting changes in color or amount, it is essential to seek medical advice sooner. Additionally, if you have any other symptoms such as severe pain, fever, or unusual discharge, these could indicate a need for immediate medical attention.

In summary, while the chances of pregnancy seem low given the circumstances and negative tests, it is essential to monitor your symptoms and follow up with your healthcare provider if your period does not arrive in the next week or so. They can provide you with the best guidance based on a thorough evaluation of your health and any underlying conditions that may be contributing to your symptoms. Remember, your health and peace of mind are paramount, so do not hesitate to seek medical advice when in doubt.

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