Delayed Period: Pregnancy Chances and Next Steps

Menstruation is delayed by 10 days and has not arrived?

Hello, doctor.
This is a follow-up to my previous question: I had my period from March 11 to March 18.
I had unprotected intercourse with ejaculation outside on March 23, and again from April 3 to April 6, also unprotected with external ejaculation.
From April 4 to April 8, I experienced nipple pain, which later subsided.
On April 12, I felt a pulling pain in my lower abdomen and had some bowel movement sensations, thinking my period was about to start, but the pain disappeared, and I had no other premenstrual symptoms.
However, this month I have been very anxious, often staying up late with insufficient sleep, and I have been socializing, drinking, and smoking.
What is the likelihood of pregnancy, doctor?
Response from Dr.
Tsao Kuo-Tao, Obstetrician and Gynecologist: Hello, the chances of pregnancy should be low.
I suggest waiting another week, and if your period still hasn't arrived, please see a gynecologist.
Wishing you good health.

Later, on April 15, I visited a gynecologist for a pregnancy test, which showed one line.
During the ultrasound, she mentioned that my endometrial lining was thinner, possibly indicating a lighter flow, which is why my period hasn't come.
She prescribed Norina for three days, two pills twice a day.

On April 19, after finishing the medication, I took another pregnancy test the next day, which still showed one line, but my period still hasn't arrived.
That evening, I went to another gynecologist who performed a transvaginal ultrasound, but she said there were no signs of my period coming.
The endometrial thickness was normal, and the discharge was also normal.
She prescribed another medication, Medrone, for three days, three times a day, one pill each time, but I haven't started taking it yet because I'm afraid it might delay my period further.

Doctor, how many days after taking the medication should I expect my period to come? Since she said there are no signs of my period approaching, could it still be a pregnancy? However, I tested for pregnancy on the ninth day of my missed period, and it was still negative.
When can I be certain that I am not pregnant?

CC, 30~39 year old female. Ask Date: 2024/04/20

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, you should not be pregnant.
Normally, after taking menstrual induction medication, you should expect your period within a week.
It's best to refrain from taking any more menstrual induction medication and wait to see what happens.
Wishing you good health.

Reply Date: 2024/04/20

More Info

It sounds like you're going through a challenging time with your menstrual cycle and potential pregnancy concerns. Let's break down your situation and provide some clarity on the various aspects involved.

Understanding Your Menstrual Cycle and Pregnancy Chances
From your description, your last menstrual period (LMP) started on March 11 and ended on March 18. You had unprotected intercourse on March 23 and again from April 3 to April 6. You mentioned experiencing symptoms such as breast tenderness and abdominal pain, which can sometimes be associated with early pregnancy or premenstrual syndrome (PMS). However, the absence of your period and the negative pregnancy tests can be concerning.

Pregnancy Testing and Timing
You took a pregnancy test on April 15, which showed a negative result (one line). This is significant because it suggests that, at that time, you were not pregnant. The fact that you have had two negative tests (one on April 15 and another after taking Norina) indicates that the likelihood of pregnancy is low, especially since you mentioned that your menstrual cycle is irregular.

Hormonal Medications and Menstrual Regulation
You were prescribed Norina and Medrone. Norina is often used to help regulate menstrual cycles, while Medrone is a corticosteroid that can influence various bodily functions, including hormonal balance. After taking these medications, it can take a few days to a couple of weeks for your period to return, depending on your body's response to the hormones. It's essential to follow your doctor's instructions regarding these medications, as they can help in managing your cycle.

When to Seek Further Medical Advice
If your period does not arrive within a week after completing the medications, or if you continue to experience symptoms that concern you, it would be wise to follow up with your healthcare provider. They may recommend further testing, such as blood tests to check for pregnancy or hormonal levels, or an ultrasound to assess your reproductive health.

Lifestyle Factors and Their Impact
You mentioned feeling anxious, having irregular sleep patterns, and engaging in social drinking and smoking. These lifestyle factors can significantly impact your menstrual cycle and overall reproductive health. Stress, in particular, can lead to hormonal imbalances that may delay your period. It might be beneficial to focus on stress management techniques, such as mindfulness, yoga, or other relaxation methods, to help regulate your cycle.

Conclusion
In summary, while the chances of pregnancy seem low given your negative tests and the timing of your menstrual cycle, it's crucial to monitor your symptoms and follow up with your healthcare provider if your period does not arrive soon. They can provide personalized advice based on your health history and current situation. Remember to take care of your overall well-being, as physical and mental health are interconnected, especially during this time.

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