Delayed Menstruation and Lower Abdominal Pain: Possible Causes Explained

Menstruation has been absent for a long time, and there is lower abdominal pain?

Hello Doctor, I have had irregular menstrual cycles since I started menstruating in fifth grade.
The shortest interval has been about a month and a half, and the longest was six months.
I received treatment two years ago, and my cycles normalized for a while, occurring approximately every 35-40 days.
However, earlier this year, due to work-related stress, my schedule was disrupted for a week, and my menstrual cycle became irregular again.
The last period I had was in mid-June, and it has been four months since then.
During this time, I have had sexual intercourse, but I took a home pregnancy test in mid-August, which showed no signs of pregnancy, and I have not experienced any physiological symptoms of pregnancy either.

About two weeks ago, I thought I had a cold and endured sneezing for a long time, which led to pain in my lower abdomen.
Now that the cold has resolved, the lower abdominal pain persists, and sometimes it even hurts when I lie down.
Additionally, my lower abdomen feels bloated.
Doctor, could this be a sign of pregnancy, or could it be another condition? I would appreciate your clarification on my concerns.
Thank you.

Xiao Ling, 20~29 year old female. Ask Date: 2001/10/17

Dr. Wei Fumao reply Obstetrics and Gynecology

If your period is late, you should take a pregnancy test.
Please address any abdominal pain promptly, as it may indicate inflammation.

Reply Date: 2001/10/17

More Info

Delayed menstruation and lower abdominal pain can be concerning symptoms, especially when they occur together. Given your history of irregular menstrual cycles since the onset of menstruation, it is important to consider various factors that could contribute to your current symptoms.

Firstly, the irregularity of your menstrual cycle can be attributed to several factors, including hormonal imbalances, stress, changes in lifestyle, and underlying medical conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders. Stress, particularly from work or personal life, can significantly impact your hormonal balance, leading to delayed menstruation. The disruption of your routine, as you mentioned, could have exacerbated this issue.

Regarding the possibility of pregnancy, it is reassuring that you have taken a home pregnancy test in August, which returned negative. However, it is important to note that home pregnancy tests are most accurate when taken after a missed period. If you are still experiencing symptoms and your period has not returned, it may be worth repeating the test or consulting with a healthcare provider for a blood test, which can detect pregnancy earlier and more accurately.

The lower abdominal pain you are experiencing could have several potential causes. Since you mentioned that the pain has persisted for two weeks, it is essential to consider both gynecological and gastrointestinal issues. Possible gynecological causes include:
1. Ovarian Cysts: These fluid-filled sacs can develop on the ovaries and may cause pain, especially if they rupture or become large.

2. Pelvic Inflammatory Disease (PID): This infection of the reproductive organs can lead to significant abdominal pain and is often associated with irregular periods.

3. Ectopic Pregnancy: Although your pregnancy test was negative, if there is any chance of pregnancy, an ectopic pregnancy (where the fertilized egg implants outside the uterus) should be ruled out, as it can cause severe pain and is a medical emergency.

4. Endometriosis: This condition occurs when tissue similar to the lining of the uterus grows outside of it, leading to chronic pain and irregular periods.

On the gastrointestinal side, the pain could be related to:
1. Gastrointestinal Issues: Conditions such as irritable bowel syndrome (IBS), constipation, or even a urinary tract infection (UTI) can cause lower abdominal pain and discomfort.

2. Muscle Strain: If you have been coughing or sneezing frequently due to a cold, it is possible to strain abdominal muscles, leading to localized pain.

Given the complexity of your symptoms and the duration of your abdominal pain, it is advisable to seek medical attention. A healthcare provider can perform a thorough evaluation, including a physical examination, and may recommend imaging studies such as an ultrasound to assess for any gynecological issues or other underlying conditions.

In summary, while pregnancy is a possibility that should be ruled out, there are numerous other potential causes for your symptoms. It is crucial to address these concerns with a healthcare professional who can provide a comprehensive assessment and appropriate management. Your health and well-being are paramount, and timely intervention can help alleviate your symptoms and address any underlying issues.

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