3 weeks late, cramping and spotting

Patient

Q: Missed period at the end of last month. Beginning of this month, took two tests, both negative, but have not taken another after two weeks following missed period. Cramping on right side for 3 weeks, nightly nausea, tender breasts, mood swings, slight discharge from vagina. Today, more cramping along with traces of blood when I use the restroom. Any thoughts on what is going on? Also. I have a history of pcos

Symptoms:  Cramping, spotting, late period, tender breasts
Doctor

A:   Hello,
Thanks for contacting askthedoctor.com for an opinion.
As you mentioned that you already have a history of PCOS and oligomenorrhea ( irregular menses) have been a constant feature for your cycles, it is still imperative to rule out pregnancy before contemplating other causes of a missed period.
I suggest you to take a repeat urine beta hcg based pregnancy test to rule out pregnancy confirmatively. The symptoms( abdominal cramps, tender breasts , nausea, headache, mood swings ) which you are experiencing presently are possibly that of premenstrual syndrome or PMS ( these are similar to the early pregnancy symptoms ) ,but pregnancy test is negative in case of a premenstrual syndrome.

If your bleeding has already started then the flow may increase in a day or two. The cramping and pain in lower abdomen if unbearable can be controlled by anti-spasmodics ideally which can be procured on a physician prescription.

However , PCOS is a syndrome complex which needs to be fully evaluated with a hormonal profile and an ultrasound pelvis to look for polycystic ovaries. There are signs of hyperandrogenism ( hirsutism) and irregular menses in form of delayed menses ( oligomenorrhoea).If you are planning a pregnancy then the hormonal status has to be corrected and causative factors of PCOS have to be evaluated and treated by a physician. PCOS is a major cause of infertility in obese women . This may require treatment with low dose oral contraceptive pills for atleast 6 months before cycles are regularized and chances for pregnancy are improved thereupon.
So it is advised that you may consult your treating physician for a complete evaluation and further necessary treatment.

I hope i have answered your queries in detail.
Wishing you good health ,
Regards

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