Delayed Menstruation: When to Seek Medical Advice

Delayed menstruation?

My period is 14 days late...
I took two home pregnancy tests in between, both of which were negative! So I decided to see a doctor.
Upon arrival, I was asked to take a urine test first.
After that, the doctor examined me and said I was not pregnant, then immediately recommended an injection to induce my period.
I was told to wait for my period to come and return for a follow-up, or if it still hasn't arrived after 10 days, I should come back for another consultation! This is my first time visiting this clinic (I changed to a nearby one because I moved).
Previously, at another clinic, after the urine test, the doctor would also perform a transvaginal ultrasound for confirmation, but this clinic did not do an ultrasound.
I want to ask if this procedure is correct.
My husband and I are newlyweds, and we are currently using the withdrawal method.
I know the chances of becoming pregnant are very low, but since we didn't use a condom, I'm still worried about the possibility! I want to confirm whether I am pregnant this time so that I can start preparing my body for pregnancy.

H, 20~29 year old female. Ask Date: 2016/01/22

Dr. Cao Guotao reply Obstetrics and Gynecology

Hello, the ultrasound is meant to check for any tumors that may affect menstruation.
It is normal to take or receive a menstrual induction injection after a urine test.
Performing an ultrasound provides an additional service, and both clinics are correct.
Wishing you good health.

Reply Date: 2016/01/22

More Info

When it comes to delayed menstruation, especially when it has been 14 days late, it is important to approach the situation with a clear understanding of potential causes and the appropriate steps to take. Your experience of taking two home pregnancy tests that returned negative results is a good first step, but it does not always rule out pregnancy, especially if the tests were taken too early or not according to the instructions.

In your case, visiting a doctor is the right decision. However, the approach taken by the physician you consulted raises some concerns. It is standard practice for healthcare providers to conduct a thorough evaluation when a patient presents with delayed menstruation. This typically includes a urine pregnancy test, which you already completed, but it should also involve a more comprehensive assessment, especially if the delay is significant.

The absence of a transvaginal ultrasound (TVUS) in your evaluation is noteworthy. While not always necessary, an ultrasound can provide valuable information about the state of your reproductive organs, help rule out conditions such as ovarian cysts, and confirm whether there is any early pregnancy that might not be detectable through urine tests. It is particularly important if there are any other symptoms present, such as pelvic pain or unusual discharge.

The recommendation to administer a medication to induce menstruation (often referred to as a "menstrual induction shot") is a common practice when pregnancy has been ruled out and there are no underlying health concerns. However, it is essential to ensure that this approach is appropriate for your specific situation. If your menstrual cycle is irregular or if there are other underlying health issues, it may be necessary to investigate further before proceeding with hormonal treatments.

In terms of your concerns about pregnancy, it is understandable to feel anxious, especially after recently getting married and being in a situation where pregnancy is a possibility. If you are not using contraception and are sexually active, it is wise to consider a more reliable form of birth control if you are not ready for pregnancy. Additionally, if you have concerns about your menstrual health or fertility, discussing these with your healthcare provider can help you make informed decisions moving forward.

If your period does not arrive within the next 10 days after the injection, returning to the doctor for further evaluation is crucial. This follow-up could include additional tests, such as blood tests to check hormone levels, which can provide more insight into what might be causing the delay.

In summary, while the steps taken by your doctor are somewhat standard, it is essential to ensure that a thorough evaluation is conducted, including the possibility of an ultrasound if necessary. If you feel uncomfortable with the care you are receiving, seeking a second opinion from another healthcare provider may provide you with the reassurance and comprehensive care you need. Remember, your health and peace of mind are paramount, and you have the right to advocate for your health needs.

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