Can I Rule Out Pregnancy? Irregular Menstrual Cycles

Is it possible to rule out pregnancy? (Continued 2)

Hello, doctor.
My last menstrual period started on August 14, with an average cycle of about 35 to 37 days.
I expected my period to arrive on September 18, but it did not.
I took a home pregnancy test on September 26, which was negative.
This morning, October 5, I experienced bleeding and discomfort in my lower abdomen similar to menstrual cramps.
I had sexual intercourse on August 14, 22, 24, September 6, 13, 20-22, and October 1.
Based on the above situation, can we conclude that this is a normal menstrual period, or could it be a miscarriage due to inadequate embryo development? Thank you.

Wu, 30~39 year old female. Ask Date: 2015/10/06

Dr. Lü Lizheng reply Obstetrics and Gynecology

Diagnosing whether there is a pregnancy (or miscarriage) or irregular menstruation is not straightforward.
Generally, a urine pregnancy test is used to determine pregnancy (or miscarriage).
However, since you tested negative for pregnancy on September 26, it is possible that you are not pregnant, or you may be pregnant but tested too early to detect it.
It is advisable to wait a few days and test again for more accurate results.
Some individuals opt for a blood test, which can provide results a few days earlier than a urine test.
If there is not only vaginal bleeding but also the passage of tissue, that tissue can be sent for pathological examination to determine if a miscarriage has occurred.
However, if there is no tissue passed other than bleeding, this method would not be applicable.
Sincerely, Dr.
Li-Cheng Lu, Taoyuan Hospital.

Reply Date: 2015/10/06

More Info

Based on the information provided, it appears that you are experiencing irregular menstrual cycles, which can complicate the assessment of whether you are pregnant or if the bleeding you are experiencing is related to your menstrual cycle. Given your average cycle length of 35 to 37 days, your expected period would have been around September 18. Since you did not get your period on time and had a negative pregnancy test on September 26, it raises some questions about your menstrual health and potential pregnancy.

Irregular menstrual cycles can be caused by a variety of factors, including hormonal imbalances, stress, changes in weight, and underlying health conditions. In your case, the bleeding you experienced on October 5, along with the cramping, could indicate the onset of your menstrual period. However, it is also possible that this bleeding could be related to other factors, such as an early miscarriage or implantation bleeding if you were indeed pregnant.

Implantation bleeding typically occurs around the time your period is due and is usually lighter than a normal menstrual flow. It can be accompanied by mild cramping. However, since you had a negative pregnancy test on September 26, it is less likely that this bleeding is due to implantation if you were not pregnant at that time.

The fact that you have had multiple instances of unprotected sexual intercourse during your cycle also increases the possibility of pregnancy. However, the negative test result and the timing of your bleeding suggest that it may be more likely that your body is simply experiencing a delayed menstrual cycle.

If you are concerned about the possibility of pregnancy or if you continue to experience irregular bleeding, it is advisable to consult with a healthcare provider. They may recommend further testing, such as a blood test for hCG (the hormone produced during pregnancy), or an ultrasound to assess your reproductive health. Additionally, they can help determine if there are any underlying issues contributing to your irregular cycles, such as polycystic ovary syndrome (PCOS) or thyroid dysfunction.

In summary, while the bleeding you are experiencing could be a normal menstrual period, it is essential to monitor your symptoms and consult with a healthcare professional for a definitive diagnosis. They can provide guidance on managing your menstrual health and any potential pregnancy concerns. Remember that maintaining a healthy lifestyle, managing stress, and tracking your menstrual cycle can also help in understanding your reproductive health better.

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