What causes lower abdominal pain after missing periods?

Question

Hello doctor,

I usually have my period on the 28th every month. It is regular, but last month, I missed my period. There was very little bleeding in my underwear that looked like implantation bleeding. So, I thought that I was pregnant because I had all the symptoms, such as breast tenderness, tiredness, frequent urination, pain during urination, cramping, some pain-like feeling in my lower abdomen, etc. But I did not do the pregnancy test and did not inform anyone.

urse with my partner on the 12th of this month. The next morning, I had pinkish bleeding and severe pain in my lower abdomen. This bleeding was not like my period, but I used a pad nevertheless. In the last four days of bleeding, each day I changed only one pad, whereas in my regular cycle, more bleeding occurs. On the 14th, I visited a doctor. She tested me for pregnancy, but the pregnancy test was negative. She suspected a urinary tract infection, too. Now, I am really confused. I am really scared.

Please help me.

Answer 1

Hello,

Welcome to icliniq.com.

The symptoms that you have mentioned are, of course, seen in pregnancy, but they are not exclusively seen in pregnancy. In pregnancy, the progesterone hormone rises, which causes the symptoms that you mentioned. If you have not had an ovulation this month, then there will be some hormonal imbalance. You should never diagnose pregnancy with these symptoms. The best method is a home urine pregnancy test, the most confirmatory being serum beta hCG (this can diagnose the smallest of pregnancy anywhere in the body). As your urine test has come back negative, pregnancy has been ruled out completely. There is no need to confirm unless you are not satisfied or want further confirmation.

Every lady can, once in a while, have an anovulatory cycle. So, the endometrial thickness keeps increasing over these days. Once the thickness is too much, it will start falling off as clots or thick masses, in a darker color. As these clots or excessive blood try to get expelled through the small cervix, there will be pain, as the cervix is sensitive to this dilation. Once the bleeding reduces or stops, the pain gradually disappears. Just relax and do not panic. You are absolutely fine. The other causes for no ovulation have to be thought of:

Any sudden increase or fall in weight?
Any recent significant mental or physical stress?
Any thyroid or prolactin abnormality?
Any recent use of hormones to alter the periods or contraception?

Do not worry. The next cycle will be fine and will be on time, one month after this episode of bleeding. But, next time onward, if you ever miss your period, just have a home urine pregnancy test any day after the expected date of your period. It is only because you waited so long that the thickness increased so much to create so much pain.

I hope I have clarified your query. Do write back if you have any more queries.

Thank you.