Pregnancy or Illness? Changes in Menstrual and Digestive Health

Is it an illness or a change in the body due to pregnancy? Menstruation?

Hello Dr.
Lu: My bowel movements have been normal these past few days, as I was previously having a bowel movement only every three to five days (with diarrhea), which I had gotten used to.
However, I've heard that if a habit suddenly changes, it could indicate either illness or pregnancy.
As for pregnancy symptoms, I am on my third pregnancy and have only experienced breast and nipple tenderness, loss of appetite, frequent urination, occasional abdominal pain, leg cramps, and itchy skin (especially around the incision from my cesarean section).
Ten days ago, I noticed a light pink discharge after urination, and about five days later, I had two drops of brown discharge.
How can I determine if I have irregular menstruation? If irregular menstruation leads to a missed period, why would I still experience symptoms of pregnancy or premenstrual symptoms? However, my usual premenstrual symptoms include increased hunger, excessive sleepiness, and chest and abdominal discomfort.
If my period is about to start, why am I not experiencing these symptoms? I have heard that in the case of an ectopic pregnancy, the HCG levels in urine may be lower, which could result in a home pregnancy test not detecting it.
I had unprotected intercourse on July 7.
If I have irregular menstruation, when would be the best time to take a pregnancy test for accurate results? Thank you.

Niming, 30~39 year old female. Ask Date: 2015/08/05

Dr. Lü Lizheng reply Obstetrics and Gynecology

1.
You have listed some symptoms, but these symptoms can only serve as a reference and cannot be used to confirm pregnancy.

2.
Even in the case of an ectopic pregnancy, pregnancy tests can still detect it, even if the hormone levels are slightly lower than in a normal pregnancy.
This means that as long as there is a pregnancy, whether it is normal or ectopic, a pregnancy test can detect it.

3.
Generally, if conception has occurred for more than two weeks, a pregnancy test should be able to confirm pregnancy.
Therefore, if sexual intercourse occurred at the end of July, a test can be taken by mid-August.

Respectfully, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/08/05

More Info

Understanding the complexities of pregnancy and its associated symptoms can be challenging, especially when there are overlapping signs of illness or hormonal changes. Based on your description, it seems you are experiencing a variety of symptoms that could indicate either pregnancy or other health issues. Let's break down your concerns and provide clarity.

Changes in Bowel Habits
You mentioned a recent change in your bowel habits, transitioning from having bowel movements every three to five days to a more regular pattern. This change can indeed be a sign of pregnancy, as hormonal fluctuations can affect gastrointestinal motility. However, it can also indicate other health issues, such as dietary changes, stress, or gastrointestinal disorders. If your bowel movements have normalized, it may not be a cause for concern, but if you experience any discomfort or significant changes, it would be wise to consult a healthcare provider.

Pregnancy Symptoms
You noted several symptoms that are commonly associated with early pregnancy, including breast tenderness, decreased appetite, frequent urination, occasional abdominal pain, leg cramps, and skin itching. The presence of light spotting (the pink and brown discharge you mentioned) can also be a common occurrence in early pregnancy, often referred to as implantation bleeding. However, it can also be a sign of other conditions, such as hormonal imbalances or even early miscarriage.

Menstrual Irregularities
Your question about menstrual irregularities is pertinent. It is not uncommon for women to experience changes in their menstrual cycle due to various factors, including stress, hormonal changes, or pregnancy. The symptoms you typically experience before your period, such as increased hunger, fatigue, and breast tenderness, may not manifest in the same way if you are pregnant. This is because pregnancy hormones can alter the typical premenstrual symptoms.

Ectopic Pregnancy and HCG Levels
You raised a valid concern regarding ectopic pregnancy and HCG levels. In cases of ectopic pregnancy, HCG levels can indeed be lower than expected, which may lead to negative results on home pregnancy tests. It is essential to follow up with a healthcare provider if you suspect an ectopic pregnancy, especially if you experience severe abdominal pain or other concerning symptoms.

Timing for Pregnancy Testing
Regarding when to take a pregnancy test, it is generally recommended to wait until after your missed period for the most accurate results. If you have irregular cycles, testing about two weeks after potential conception (or ovulation) may provide a more reliable result. Home pregnancy tests are designed to detect HCG in urine, which typically rises significantly after implantation.

Conclusion
In summary, the symptoms you are experiencing could indicate pregnancy, but they could also be attributed to other health issues or hormonal changes. It is crucial to monitor your symptoms closely and consider taking a home pregnancy test if you suspect you might be pregnant. If you continue to experience irregularities in your menstrual cycle or have any concerning symptoms, I strongly recommend consulting with a healthcare provider for further evaluation and guidance. They can perform blood tests to measure HCG levels and provide a more definitive answer regarding your pregnancy status and overall health.

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