Negative pregnancy test with delayed menstruation: causes

If menstruation does not come at the appointed time, they are delayed, the thought of a possible pregnancy is the first thing that comes to mind for a woman of reproductive age. Usually a home test is bought. If the result is positive, what to do next is relatively clear. But with a negative result, many questions arise. This article will help you answer them.

Why is the test negative?

It doesn't make a lot of difference which test you choose for self-diagnosis after the start of the delay. If there is a pregnancy, then any test with high accuracy determines it after the period has not come. Why? Yes, because the action of all tests is based on the determination of an increased content of human chorionic gonadotropin in urine. The hCG hormone begins to rise about a week after ovulation, when the fetus is successfully implanted into the uterus.

During implantation, the embryo is attached to the endometrium by chorionic villi, the villi are intertwined with the blood vessels of the female body. In order for the corpus luteum, which after ovulation is formed on the ovary from the remnants of the follicular membrane, to continue functioning (this is a prerequisite for the subsequent development of pregnancy), hCG begins to be produced in high quantities. Under the influence of progesterone, menstruation does not occur, and the embryo successfully grows and develops in the uterine cavity.

The level of hCG increases every 48 hours by about 2 times and by the time the delay begins, it is easily determined by test systems in the urine.

Could this be during pregnancy?

If you get one line on the background of the delay, do not rush to make premature conclusions. False negative results are possible. First of all, this is possible if ovulation was later or later implantation occurred. These processes are very delicate, depending on a mass of factors, and therefore pregnancy could occur, but the level of hCG is still low, and the test simply does not catch it.

remember, that in the first week after the start of the delay, the probability of a positive test result after a negative one exists. Late ovulation could be affected by the stresses experienced by the woman during the cycle, chronic fatigue, lack of sleep, hormonal deficiency in the first phase of the cycle, in which the follicle matured more slowly than necessary.

Ovulation can be delayed for a period from several hours to several days. But it usually doesn't happen later than a week. If the follicle does not burst within a week after maturation, then the likelihood that a rupture will occur at all is minimal. Follicle persistence will occur, in such a cycle, conception is impossible in principle.

If we assume that a woman's ovulation is 5 days late, then the implantation will take place about 2-3 days before the date of the expected menstruation. It means that the earliest when the test can identify the second strip is 6-7 days after the start of the delay.

So don't be discouraged. Once you receive one strip, just wait 2 days and retest. If the test remains negative after 8-10 days after the start of the delay, you should visit your doctor. Usually by this time it is already possible to confirm or deny pregnancy based on the results of ultrasound.

Separately, it must be said about the possibility of obtaining a dubious test. If 1 strip is clear, and the second is weak, dull, blurred, they speak of a weakly positive test. This means that hCG is elevated, but its level is lower than necessary for the reagent to be colored more brightly. Just repeat the test after 2-3 days. If it becomes brighter, it is possible that ovulation was delayed for a couple of days or the embryo was implanted a little later than expected. If the strip remains pale, it is worth making an appointment for an ultrasound scan and visiting a doctor. There is a chance of an ectopic pregnancy.

If the embryo is not fixed in the uterus, but outside of it, then hCG will be produced in much smaller quantities and grow slowly. Therefore, the second strip will remain weak. The complete absence of the second strip is also possible. Be sure to pay attention to your health - if there are all signs of pregnancy against the background of a delay, if nausea appears, the lower back hurts, there are discomfort in the lower abdomen, atypical discharge, rush to the doctor out of turn - the likelihood of an ectopic pregnancy is high.

A weak second strip or its absence may indicate a frozen pregnancy. If for some reason the embryo stopped developing and died, then for several more days hCG remains elevated, and then begins to decrease.

Therefore, after a delay, you can first get a weakly positive result (one strip shows bright, the other dim), and then negative (the test will remain with one strip).

Reasons for the absence of menstruation

If your period does not come on time, pregnancy (normal or abnormal) is not the only reason for the delay. If the test stubbornly shows one strip, it is worth considering other possible reasons for the absence of menstruation. They are quite numerous.

Ovarian dysfunction. This may be a failure that occurred within the current cycle, or a pre-existing polycystic ovary disease. In any case, the cycle is disrupted, because the sex glands do not provide normal ovulation, a normal second phase, and therefore an imbalance of estrogen and progesterone occurs at the hormonal level, which leads to the absence of menstrual bleeding. This condition definitely needs to be examined by an endocrinologist-gynecologist. Otherwise, prolonged amenorrhea and infertility may develop.
Neoplasms - uterine fibroids, tumors of the fallopian tubes, ovaries, appendages. Many tumors are capable of self-production of hormones, and again there is an endocrine imbalance that slows down the onset of menstruation.
Inflammatory gynecological diseases - they can be anything. It is not difficult to guess about the presence of such ailments - the discharge is unusual, abundant or very scanty, greenish or bloody, gray, with an unpleasant odor. The basal temperature is above 38 degrees, the body temperature may be increased, there are unpleasant and painful sensations in the pelvic organs, in the vagina.
Oral contraceptives - by themselves, these drugs suppress ovulation. It just doesn't happen. Taking hormonal contraceptives for too long has a depressive effect on the condition of the gonads. After a woman stops taking OK and begins to plan for conception, it takes at least 2-3 months to establish a normal menstrual cycle, and therefore delays in menstruation in this "setting" period, like the early arrival of menstruation, changes in the duration of menstruation can occur.
Previous abortion or miscarriage - after such interventions, the woman's body also needs about 1-3 cycles to establish normal ovarian function. The hormonal background is changed, the body has suffered a real endocrine "shock", and therefore menstruation can be delayed for a considerable period.
The reason may lie in age-related changes. - Menstrual irregularities are considered normal for adolescents and girls under the age of 20, as well as for women over 40 on the eve of menopause. It's about the level of sex hormones. In the first category of the fair sex, they are still not enough, and in the second - not enough, and therefore the phases of the cycle can be shorter or longer.
Stress and overexertion - I mean both excessive physical exertion and strong emotional upheaval. The fact is that both with intense physical work and with severe psychological stress, a woman begins to produce adrenaline. The stress hormone partially suppresses the production of sex hormones necessary for the normal duration of the follicular and luteal phases of the menstrual cycle.
Dramatic weight loss or dramatic weight gain - such events are almost always associated with a subsequent change in hormonal levels. Therefore, delays in menstruation and ovarian dysfunction are possible. The exact reason will help to establish the endocrinologist-gynecologist, who will definitely prescribe a blood test for a hormonal profile.

With all these situations, there are no menstruation, they are delayed, do not come on time, but the tests remain negative. The probability of getting a weakly positive test is only if a woman has tumors that produce hCG, and these are usually malignant tumors.

What to do?

So the delay has begun and the test is negative. The plan of action in this case should depend on the accompanying symptoms and sensations. If a woman feels pregnant, her chest hurts and swells, morning sickness appears, the perception of taste and smell has changed, it is worth waiting and repeating the test, observing all instructions. It is better to test it on morning urine, which is more concentrated and dense in terms of the content of components, do not overexpose the strip in urine, evaluate the results within the period specified by the manufacturer, no later than.

If you have neither the strength nor the patience to wait, you should contact any clinic and do a blood test for hCG - this is a more accurate method, which, in addition to the fact of pregnancy, will help to understand whether it is abnormal or normal - with an ectopic pregnancy, the growth of hCG in dynamics is slow, the indicators are below normal, and with a frozen pregnancy, a quantitative decrease in the concentration of chorionic gonadotropin is observed.

The analysis is taken in the morning, on an empty stomach. In the evening it is better not to eat fatty foods, not to drink alcohol. Venous blood is taken, the analysis results will be ready on the same day or the next - it depends on the workload of a particular laboratory. There is no reason to doubt the results of laboratory tests after a delay, because even with late ovulation and implantation, when urine tests still cannot detect hCG molecules, the hormone is determined very clearly in the blood.

You can wait and visit the ultrasound office for a 10-12 day delay. If there is a pregnancy, by this time not only the presence and size of the ovum in the uterine cavity is already determined, but also the baby's heartbeat. 2-3 weeks after the start of the delay, pregnancy is determined by gynecologists during a vaginal examination according to the characteristic obstetric signs - softness of the cervix, its mobility, growth in the size of the body of the uterus.

All these measures are permissible if you feel good, do not complain of pain, temperature, abnormal discharge from the genitals. If you experience pain, abnormal discharge on the background of a delay, you need to call an ambulance. It is possible that the pregnancy was, but was interrupted, and the rejection of the ovum begins. There may be an ectopic pregnancy, which poses a serious risk to a woman's life.

In all these cases, the woman needs to be taken to a hospital with an operating surgical department as soon as possible. If pregnancy is not confirmed by ultrasound, blood tests also do not indicate an "interesting" position, further examination for amenorrhea is prescribed by the gynecologist. It includes an ultrasound of the ovaries, blood tests for hormones, smears, and blood tests for infections, including sexually transmitted infections.

Treatment will depend on the pathology identified. The forecasts are favorable.

In most cases, menstrual failure can be successfully "corrected" with hormonal drugs, normalization of lifestyle. A woman should sleep enough, not be nervous, eat full and balanced, monitor her weight, keep a menstrual calendar, live a regular sex life (its lack can also cause ovarian dysfunction).

In case of questionable test results (bright first stripe combined with a very pale second) after a delay, a visit to the doctor and examination are required. Usually, first of all, a blood test for hCG is recommended in dynamics (after 48 hours), as well as an ultrasound of the pelvic organs.