Suspect pregnancy since January with below details - Missed Menstrual.


Q: Suspect pregnancy since January with below details -
Missed menstruation - June (should have been around June 8th)
Previous menstruation start dates - Jan 1 (normal 4 days), Jan 28 (light 3 days), Feb 26 (light 3days), March 22 (light 3 days), April 18 (light 3 days), May 13 (light 3 days).
Quantitative HCG test results are less than 1.20 done on - 23rd Jan, 10th Feb, 16th Feb, 22nd Feb. HCG levels are told to be negative since all have been less than 1.20 and no further tests have been done.
Vaginal discharge during mid of Jan with slight blood spotting triggered the concerns of implantation bleeding though further HCG tests came in negative pregnancy range.
Since Jan 28th menstrual duration has decreased to 3 days from usual 4 days and discharge is light too.
In June, it is more than 30 days and so far menstruation has not started.
Is it due to pregnancy or some form of it like cryptic pregnancy?
What needs to be done now to understand issues?

Additional information - take teczine daily for urticaria related skin allergy.

Symptoms:  Vaginal watery discharge, periods have not come even after 30 days from last menstrual perios

A:   Hello,
Thanks for the query to ATD for an opinion,
As seen and understood by your menstrual history, your menstrual cycle has been 26-28 days and bleeding is generally 3-4 days. This month it has just been 2 days over your natural period cycle, so still you have 5 days before a urine pregnancy test can be undertaken for ruling out any pregnancy if you have been sexually active or you may get at the serum beta hcg test again to rule it out as of today.
A delay of 2 days is not alarming at all as most often the delay in absence of pregnancy is more likely to be stress induced and menses usually return within 10 days post missed period once stress levels reduce. So you can ideally wait for 2 weeks post missed menses if the serum beta hcg test is negative, to allow your menses to return. If the menses do not return naturally by 2 weeks post missed menses, then you may opt for a withdrawal bleed with progesterones.
I hope i have answered your query in detail,
Wishing you good health,

Comments / Follow Ups

Patient: Thank you, please note that the last sexual activity was non penetrative dry sex on Dec-29-2015, boyfriend was wearing shorts while I was not clothed and no ejaculation was noticed. Do I need to go for more pregnancy tests even after 5 months or wait 10 more days for menses to return naturally. Please advise.
Doctor: If you think that you may have bene pregnant since december, then you are absolutely wrong, The fact that you had your jan menses itself was proof enough that you were not pregnant and to top that you had your serum beta hcg levels which were less than 5ng/dl or < 3IU, which negates pregnancy completely.

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