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Taking birth control. Missing period and getting pregnancy symptoms. HPT negative. Prognosis?

Mar 2016
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Practicing since : 2011
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I last had my period on January 26. I started birth control for the first time that Sunday. I had horrific moodiness with it (to the point I felt unsafe around my kids) and went off of it a week later. Two days later on the 6th I had what I assume was breakthrough bleeding which seemed like a normal period. According to my period tracker, if I go by my last real period, my period would be due today. I am not sure if I should could the breakthrough bleeding as my period and track from there for when my next period will be or if it doesn't count.

The past few days, I have been bloated, moody, cramps and breast tenderness.. My husband and I had not been careful this month. I took a pregnancy test tonight and it was negative. My question is, when do I count my period as "late" since I had the breakthrough bleeding? Can the pills be causing hormonal issues now, even after such a short time on it?
Posted Sat, 16 Mar 2013 in Women's Health
Answered by Dr. S Patra 41 minutes later

Thanks for writing to us. I am trying to solve your problem.

First of all, you got withdrawal bleeding (similar to period) on 6th February after stop taking the birth control pill. It is not your actual period date that should be counted for next cycle. But your upcoming period may be delayed due to effect of the pill associated with hormonal imbalance. 1-7 days period due date alteration is normal thing.

It is generally seen that period is delayed by 7-10 days in case of sudden stop taking the pill. If you get missed period more than 10 days, then you may need to consult with gynecologist for further investigation.

Secondly, according to expected due date, you ovulated around 8th February and fertile days were 6th-11th February. So, chance of pregnancy is there if you were involved in unprotected sex. Early pregnancy test is less significant. In general, home pregnancy test gives 95% positive result around period due date or 2 weeks following ovulation. 96-99% positive result is achieved 7 days after due date.

Therefore, I suggest you to wait at least 7 days from due date for getting period and if you do not get it, you must undergo one home pregnancy test with urine or blood test for beta-HCG to confirm/ exclude pregnancy.

Otherwise, your clinical features are mostly suggestive of Pre Menstrual Syndrome (PMS). It has several symptoms and includes abdominal bloating, breast tenderness, weight gain, headache, anxiety/ depression, mood swing, fatigue, dyspareunia, increased appetite, irritability etc. Tender breast is due to the effect of progesterone hormone in luteal phase. PMS is a good sign for ovulatory cycle and indicates to get period shortly.

In exclusion of pregnancy, do the following things to avoid PMS:

1) Avoid salty/ spicy/ junk food/coffee in 2nd half of period. Keep bowel habit regular.
2) Avoid stress/ anxiety/ emotional upset by yoga/ regular XXXXXXX breathing.
3) Control body weight by regular physical exercise (if you are not pregnant).
4) Take healthy diet with more vegetables & drink plenty of water or juice.
5) Use anti depressant medication like fluoxetine to elevate mood & sleep.
6) For breast discomfort, take prime XXXXXXX capsule & wear tight breast support.
7) May need OCP/ Progesterone pill to prevent above symptoms from next cycles.
8) Maintain personal hygiene and need proper sleeping with more relaxing way.

Hope I have answered your query. If you have any further questions I will be happy to help.

Wish your good health and practice safe or protected sex in future to avoid unwanted pregnancy.

Dr Soumen
Above answer was peer-reviewed by
Follow-up: Taking birth control. Missing period and getting pregnancy symptoms. HPT negative. Prognosis? 3 days later
I have never really had pms before, and the cramping was new as well. Still no period and I am still having breast tenderness. I had a procedure on Friday where they did a urine test before hand and I assume it was neg. according toy ovulation date, wouldn't it have been positive by now?
Answered by Dr. S Patra 29 minutes later

Thanks for follow up query.

PMS can only be ruled out after exclusion of pregnancy. According to your ovulation date, your expected due date is around 22nd-24th February. Around due date, positive pregnancy test is achieved only in 95% cases.

Therefore, I suggest you to wait at least one week before proceeding to next pregnancy test by doing blood test for beta HCG (more confirmatory).

In addition, if you still not get your period even after 10 days with exclusion of pregnancy, you have to undergo other investigation like ultrasound scan, complete hormonal assay, blood sugar, thyroid profile etc to rule out causative factors.

In the interim, you follow suggestive measures (described in previous reply) to get some relief. Breast tenderness is due to progesterone hormone. Wearing tight breast support & taking prime XXXXXXX capsule can give some comfort.

If you do not have any clarifications, you can close the discussion and rate the answer.

Take care yourself.

Dr Soumen
Above answer was peer-reviewed by
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