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What Could Cause A Missed Period While Breastfeeding The Second Child When A Home Pregnancy Test Is Negative?
Question: Hi Doctor,
my wife is 25 years old, we have two children boy and a girl, 3 and half years, 1 year and half respectively.
both our children were born through C-section as my wife had severe irritable uterus.
the second C-section was necessary as the doctors suggested that the scar from earlier c-section is quite loose, after the surgery of the second c-section the doctor said she had to do c-section on another location on the uterus due to adhesions from previous scar.
at the moment we use condom to avoid pregnancy and hoping to wait atleast two years or three years more for another children.
Our concern, recently my wife didn't have period for atleast 2 weeks her period is usually in the middle of each month but this time she had no period at all. we tried testing for pregnancy but despite trying three times, last one being 2 days ago still it's negative.
Since yesterday started seeing pinkish soft blood in early morning and by the night it got bright red but very soft that she says it can't be period, however today she doesn't have blood again, in the begining we thought that could be the beginning of the period yet it's not getting stronger.
she feels nausea, light headedness and very slight cramps on her abdomen sometimes.
also to note, my wife is still breastfeeding my younger daughter and about 3 weeks ago she reduced the breastfeeding to only night time instead of the day,
1.Could she be pregnant eventhough the all home test even after two weeks of her pregnancy show negative?
2.could this change in period time be because she stopped breastfeeding and thus hormonal changes that's delaying the breastfeeding?
3.could it be ectopic pregnancy?
4. what do you suggest we do
my wife is 25 years old, we have two children boy and a girl, 3 and half years, 1 year and half respectively.
both our children were born through C-section as my wife had severe irritable uterus.
the second C-section was necessary as the doctors suggested that the scar from earlier c-section is quite loose, after the surgery of the second c-section the doctor said she had to do c-section on another location on the uterus due to adhesions from previous scar.
at the moment we use condom to avoid pregnancy and hoping to wait atleast two years or three years more for another children.
Our concern, recently my wife didn't have period for atleast 2 weeks her period is usually in the middle of each month but this time she had no period at all. we tried testing for pregnancy but despite trying three times, last one being 2 days ago still it's negative.
Since yesterday started seeing pinkish soft blood in early morning and by the night it got bright red but very soft that she says it can't be period, however today she doesn't have blood again, in the begining we thought that could be the beginning of the period yet it's not getting stronger.
she feels nausea, light headedness and very slight cramps on her abdomen sometimes.
also to note, my wife is still breastfeeding my younger daughter and about 3 weeks ago she reduced the breastfeeding to only night time instead of the day,
1.Could she be pregnant eventhough the all home test even after two weeks of her pregnancy show negative?
2.could this change in period time be because she stopped breastfeeding and thus hormonal changes that's delaying the breastfeeding?
3.could it be ectopic pregnancy?
4. what do you suggest we do
Brief Answer:
Get serum (blood) quantitative hCG and possibly ultrasound
Detailed Answer:
Hello and welcome,
I've noted your wife's symptoms and C-section history.
The most likely cause of what you are describing is that your wife did not actually ovulate this cycle (ovulation would have occurred at the beginning of the month if she has her periods at the middle of the month). Most likely this was due to changes in breast feeding. During breast feeding, women often do not ovulate. And then when stopping or decreasing breast feeding, the hormones can be irregular for a cycle or two.
If ovulation does not occur, then the timing of the period, the amount of flow and duration of flow can be irregular. This is because there hasn't been the usual amount of progesterone produced and so the lining of the uterus that comes out as period flow isn't typical.
A home pregnancy test is fairly accurate by 7 days after the expected (missed) period.
With an ectopic pregnancy, the HCG does go up, but it can be a delayed rise or not as high of a rise compared with a normal uterine pregnancy so sometimes it is missed my a home pregnancy test - but that is rare.
What I recommend is for her to go in to see the doctor to have a serum (not urine) test, which is a quantitative test of hCG. This will give more information than the urine pregnancy test. In addition, the doctor may also consider ordering a transvaginal ultrasound. But please don't worry ahead of time if possible as it is not uncommon when women make changes in breast feeding for there to be changes in the period too.
Get serum (blood) quantitative hCG and possibly ultrasound
Detailed Answer:
Hello and welcome,
I've noted your wife's symptoms and C-section history.
The most likely cause of what you are describing is that your wife did not actually ovulate this cycle (ovulation would have occurred at the beginning of the month if she has her periods at the middle of the month). Most likely this was due to changes in breast feeding. During breast feeding, women often do not ovulate. And then when stopping or decreasing breast feeding, the hormones can be irregular for a cycle or two.
If ovulation does not occur, then the timing of the period, the amount of flow and duration of flow can be irregular. This is because there hasn't been the usual amount of progesterone produced and so the lining of the uterus that comes out as period flow isn't typical.
A home pregnancy test is fairly accurate by 7 days after the expected (missed) period.
With an ectopic pregnancy, the HCG does go up, but it can be a delayed rise or not as high of a rise compared with a normal uterine pregnancy so sometimes it is missed my a home pregnancy test - but that is rare.
What I recommend is for her to go in to see the doctor to have a serum (not urine) test, which is a quantitative test of hCG. This will give more information than the urine pregnancy test. In addition, the doctor may also consider ordering a transvaginal ultrasound. But please don't worry ahead of time if possible as it is not uncommon when women make changes in breast feeding for there to be changes in the period too.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thanks for your answer Doctor,
i forgot to tell you earlier that my wife had regular period for more than 6 months now, but suddenly it stopped this time and now it's late 2 weeks and half
i forgot to tell you earlier that my wife had regular period for more than 6 months now, but suddenly it stopped this time and now it's late 2 weeks and half
Brief Answer:
Thoughts on this
Detailed Answer:
Thanks for the additional information.
Irregular periods can happen at any time, even if normal periods for 6 months, and given the change in breastfeeding, it can happen then too.
Given that she has a history of 2 C-sections, scarring, and is having some symptoms from her current situation, I do advise that she go in for the serum (blood) hCG as that will give a better picture as to what is going on - a missed ovulation vs an early ectopic pregnancy. So don't delay, she should go in now.
Thoughts on this
Detailed Answer:
Thanks for the additional information.
Irregular periods can happen at any time, even if normal periods for 6 months, and given the change in breastfeeding, it can happen then too.
Given that she has a history of 2 C-sections, scarring, and is having some symptoms from her current situation, I do advise that she go in for the serum (blood) hCG as that will give a better picture as to what is going on - a missed ovulation vs an early ectopic pregnancy. So don't delay, she should go in now.
Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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