Delayed Menstruation: Causes and Concerns for Women

Menstrual delay

Hello, doctor.
I would like to ask about my menstrual cycle, which is approximately 28 days.
My last period started on the 1st of last month.
I had intercourse with my boyfriend on the 19th; initially, we did not use protection, but we used a condom for the rest of the time.
This month, my period is now seven days late.
I took a home pregnancy test a couple of days ago, which showed negative results.
Yesterday, I visited a gynecologist, took another test, and had an ultrasound.
The doctor currently determined that I am not pregnant and suggested that it might be due to hormonal imbalance, so they prescribed medication to induce my period.
However, I still have not gotten my period.
Over the past few days, I have experienced cramping similar to menstrual pain, but it comes and goes, and I have noticed a small amount of brown discharge.
Previously, I had some pain in my lower right abdomen, but it was infrequent.
I would like to know if there is still a possibility of pregnancy or if there are other factors affecting my menstrual cycle.
Thank you.

Alice, 20~29 year old female. Ask Date: 2016/02/06

Dr. Lü Lizheng reply Obstetrics and Gynecology

If the time since intercourse has exceeded 18 days, the pregnancy test results can generally be trusted, indicating that pregnancy is unlikely.
It is more likely to be irregular menstruation that has not yet stabilized, which could explain the irregular bleeding.
Consider continuing to regulate the menstrual cycle.
Sincerely, Dr.
Lu Li-Cheng, Taoyuan Hospital.

Reply Date: 2016/02/06

More Info

Delayed menstruation can be a source of concern for many women, especially when it deviates from their regular cycle. In your case, with a typical cycle of around 28 days and a delay of seven days, it’s understandable to seek clarity on the potential causes and implications.

First, it’s important to note that a missed period can occur for various reasons beyond pregnancy. While you mentioned that you had unprotected intercourse initially but used condoms thereafter, it’s reassuring that both home and clinical pregnancy tests returned negative results. This significantly reduces the likelihood of pregnancy, especially if the tests were conducted correctly and at the appropriate time.

Hormonal imbalances are a common cause of delayed menstruation. Factors such as stress, significant lifestyle changes, weight fluctuations, and even changes in your environment can impact hormonal regulation. For instance, if you have experienced increased stress or changes in your daily routine, these could contribute to hormonal fluctuations that disrupt your menstrual cycle. Additionally, conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders can also lead to irregular periods.

The presence of abdominal pain and brown discharge can be indicative of several things. Brown discharge often signifies old blood, which can occur at the beginning or end of a menstrual period. However, if this discharge is accompanied by pain, it may warrant further investigation. The pain you described in your lower abdomen could be related to ovulation, hormonal changes, or even conditions such as endometriosis, especially given your history of endometriosis.

The medication prescribed to you, often referred to as a "progestin" or "menstrual induction" medication, is intended to help regulate your cycle and induce menstruation. It’s not uncommon for it to take some time for your body to respond, and the effectiveness can vary from person to person. If you have taken the medication as prescribed and still do not experience menstruation, it may be advisable to follow up with your healthcare provider for further evaluation.

In summary, while the negative pregnancy tests and the prescribed medication suggest that pregnancy is unlikely, it’s essential to consider other factors that could be influencing your menstrual cycle. If the delay continues or if you experience worsening symptoms, such as severe pain or unusual discharge, it would be prudent to seek further medical advice. Regular monitoring and open communication with your healthcare provider can help address any underlying issues and restore your menstrual health.

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