Patient: Around 4-5 days ago I started getting some random mild cramping in my lower abdomen and vaginal area like when im about to get my period. I have a bit of lower back pain, not bloated, My cervix is low, firm, and open. I get a bit of whitish to clear tacky clumpy mucus discharge (no weird smell, sometimes white, sometimes slightly greenish, increased amount this morning) but generally dry down there (sorry for description). My period have been missing for almost 2 months now (last started June 27 til July 3). My partner has had a vasectomy 8 years ago and confident he can’t get me pregnant. I’ve taken 7 hpts ever since I missed my last period (counting 30 days from the one before that, 1 week-ish apart each, first response and clear blue, latest one this morning) and all tests were strong negatives. I have a history of irregular cycles, only had 2 periods since Feb this year, and been irregular too before that, but never more than 45 days long delay…it was only since feb cycle starts 50-60 days apart. I have no other symptoms…boobs not sore, no excessive discharge, no nausea, etc. aside from occasional bloating and constipation, but its nothing out of the ordinary. i know my chances of getting pregnant is unlikely and i don’t feel pregnant..im just really worried about my missing periods.. is this normal before starting a period ( a few days cramping) or should I be worrying? what are the odds of pregnancy? is this a sign of an ovarian cyst?
Doctor: Since your partner had vasectomy, the chances of getting pregnant is really low, perhaps <1%. Adding to the fact that all 7 of your home pregnancy tests are negative, it is very unlikely you’re pregnant. There are factors to be considered before entertaining disorders of the reproductive system. Common causes of menstrual irregularities include unhealthy weight (over- or underweight), stress, and diet. If these factors are found out not to be the cause of menstrual irregularities, other conditions like PCOS (polycystic ovary syndrome), fibroids, thyroid dysfunction, and other hormonal disorders should be investigated. These may require ultrasound, blood tests and other procedures. It is also not uncommon to have cramping before a period; you may take Ibuprofen (Advil) or mefenamic acid for that. I do hope I have enlightened you somehow and take care always.