Could this be a miscarriage?

Patient

Q: I am a 20 year old female.
Sometime in October I had my last menstrual cycle. In November I took a pregnancy test that came out negative. It is now December and I still have not had a period.
Very recently, I went to the restroom and had really dark blood that lasted for a day.
I have a friend that just had a miscarriage and experienced the same symptoms as I am having.
I've had abdominal cramping and side pain on both sides of my stomach, I've constantly been hungry but other than that, I've been fine. Is it possible that I could be pregnant even though I had a negative pregnancy test? What should my next step be? Is this the beginning to a miscarriage?

Symptoms:  Abdominal cramping, side pain
Doctor

A:   Hello,
it would be best to reconfirm again with the urine pregnancy test for any chances of delayed conception. If the test is negative and the pregnancy is ruled out then it is possible that you are experiencing what is called premenstrual syndrome in form of abdominal cramps and bloating , indicating that your menses should start in few days. However it is advisable ,it the menses don't resume in 3-5 days then you may visit your physician for a transvaginal ultrasound to look for the endometrial thickness which if found to be more than 10mm , then you may opt for a withdrawal bleed with progestins to resume your menses.
Following that , you may maintain a menstrual calendar for next 3 months to evaluate the change in the pattern of your menses which in absence of pregnancy could be possibly due to stress induced. A pattern study of at least 3 months can give a fair idea to arrive at a diagnosis.

I hope i have answered your query in detail,
wishing you good health,
regards

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