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Is Pregnancy Possible Through Non-penetrative Sexual Activity?

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Posted on Mon, 12 Oct 2015
Question: 22 nd July me and my gf got intimate..no intercourse,no fingering,no genital contact..may have just rubbed her vulva outside vagina(never went inside vagina) with minuscule amount of precum with fingers(more like a spot of precum on my middle finger) if any(it may or may not be precum bt not a handful of precum),that was on 38th day of her cycle..she was due in her periods already then..3 days later she got light and medium period with blood clots and typical smell of blood during period which she gets in her period from 25th July-28th July..after 22nd July no sexual intimacy..she has roughly 34-37 days cycle bt her flow during period varies sometimes normal sometimes light..on 31st july(few days after her july period) she got slight brown discharge once,she said that she got this in some of her earlier cycles too may be old blood of period.. after 22nd July no sexual intimacy,then again on 15th August she got her period(2 weeks early) with light and medium flow and lots of blood clots for 4 days(15-18th August)..that was on 22nd day of her cycle..She took some 10 no of Urine pregnancy Test with Preganews all being negative,latest being 40 days after the sexual act and it came back negative..She has PCOS,earlier had medications,now stopped..cycle length is 34-37 days now bt her flow varies..Her age is 20..after her august period on 16th august she visited a homeopathic doctor who gave her medicines earlier too to regularise periods..He now gave her Calcarea Carbonica which she is taking now..

1)Sir no chance of pregnancy as the urine pregnancy test with preganews showed negative result even after 40 days from the incident?
2)Sir why is the August period(15-18th August) early by 2 weeks?we didnot engage in any sexual act after 22nd July..she got the august period on her 22nd day(15-18th August)..she was under stress,is that the reason?
3)Sir her flow during period varies,she got 2 periods though with reduced flow after 22nd July incident,so no chance of pregnancy at all with that incident on 22nd July?She tested with preganews even 40 days after the incident and got only 1 C line in the kit,meaning negative..
4)May month Period 11-14th May(light and medium flow) XXXXXXX month Period 15-18th June(normal flow),July month period 25-28th July(light and medium flow),August month period 15-18th August(light and medium flow)
5)Sir kindly answer to these questions in details as early as possible..
doctor
Answered by Dr. Nishikant Shrotri (9 hours later)
Brief Answer:
Very remote - for practical purposes, no possibilty of pregnancy.

Detailed Answer:
Dear XXXX,

I have gone through your detailed history for which I must complement you. It is after 9 hours of your first communication I am answering. This is for very simple reason: when you asked it, it was midnight and I was fast asleep, so I was not aware of it. Now in the morning, the first thing I am doing is answering your query.

You seem to be under tremendous stress. Is this stress due to apprehension of possibility of pregnancy or due to her menstrual problem? Anyway, I shall answer all your questions one by one.

1. You got her pregnancy test done 40 days after the sexual relationship you had with her. How many days after the sexual relationship is not important. What is important is how many days after missing the period. In fact she has not missed her period at all. She had quite a many periods after the sexual intercourse you had. So there is no question and no possibility of pregnancy. Still if you want to get it confirmed, you may go for ultrasonography.

2. The appearance of period is not at all related to the act of intercourse. Missing the period is, but not the appearance of period. The frequent periods she is getting is most likely to be due to her hormonal imbalances. Stress also may be blamed for it; however, usually stress delays the menses, still irregularity cannot be set aside. She is a known case of PCOS, which is hormonal imbalance and metabolic disorder. So you do not have to blame the sexual intercourse for the frequent early menses.

3. The variation in her menstrual flow is naturally again due to hormonal imbalance. Usually, after the menstruation, the increasing Oestrogen hormone starts building up the lining of the uterus (endometrium). After egg release takes place, along with Oestrogen another hormone called as Progesterone comes in the picture. This hormone brings about the changes in the endometrium which will implant and nourish the pregnancy. If there is no pregnancy, these hormones start diminishing and after 10 days of egg release, they are so low that the endometrium cannot be supported. Hence the endometrium breaks and is thrown out with some amount of blood. This is menstrual bleeding.
Now since she is having hormonal imbalance, her levels of hormones are so varying that they cannot support the endometrium and hence the bleeding is taking place in between the cycles. This is not happening due to pregnancy. Please understand that in normal pregnancy, there is no bleeding what so ever. Since she is not pregnant, her all pregnancy tests are going to be negative. Please get rid of this stress.
In PCOS, as the name itself suggests, Polycystic Ovarian Syndrome, the eggs in the ovary mature to various stages but cannot get released. Hence the ovary becomes polycystic. Therefore the chances of pregnancy in PCOS are very remote.

4. I feel the answer to this question is already covered in the previous point. However, I would like to give you some more information to solve one issue in your mind. The brown bleeding comes out is old bleeding. Some times the amount of blood is excessive and cannot come out of the uterus in full pace. So, if some blood is retained in the uterus for some time, it will become brown or dark and shows out subsequently.

5. Yes, I agree that I could not answer you earlier, the reason I have already explained to you.

However, though I have answered l your questions, I would like to give some more (probably unasked or partially asked) advice.

She is a case of PCOS. Has the diagnosis been confirmed by clinical examination, hormonal levels, Laparoscopy and ultrasonography? If so, I would like to view the reports and the images. Will you please upload them?

What treatment of PCOS she is undergoing apart from homeopathy? Please upload all the prescriptions also. I cannot and will not opine on homeopathic treatment. However, I can certainly guide you rationally and scientifically if you upload all the relevant details I have suggested you.

The treatment of PCOS can be mainly divided into:
1. Girl wishing to have regularize her menses and get the pathology corrected. Pregnancy is no concern.
2. Woman wishing to have the pregnancy also in addition.

Most of PCOS cases are infertile due to failure to ovulate. The other presenting symptoms are obesity, hairy, irregular menstruation usually delayed periods and excessive bleeding.

Such conditions can be managed by medicines and/or surgical intervention depending up on the requirement of pregnancy.

I feel your apprehension regarding the possibility of pregnancy has been taken care of. I have explained about the irregularity of her menses in details. After you appraise me about her reports and the images, I can guide you further in management of PCOS.

I hope you are satisfied with the explanation about your current queries. If so, you can post a review and rate me by 5 stars. For any more information, I am always available for you XXXX.

Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Nishikant Shrotri (54 minutes later)
1)Sir she didnot miss the period after the 22nd July act at all..She was already due in her period then..we did the act on 38th day of the cycle..werenot we safe?..she has 34-37 days cycle length..she got light and medium period after 3days from 25-28th July..after 22nd July there is no sexual act whatsoever..then again she got period from 15-18th August with same kind of flow..that was on the 22nd day of her cycle..sir so she is not pregnant at all with that 22nd July event?wl it cause any threat to pregnancy in future unless we again get intimate?..HPT with preganews is negative even after 40 days from the act..we checked it though she had her period bt with reduced flow..kindly answer sir as soon as possible.. Sir i am concerned with the pregnancy..kindly answer sir,so she is totally safe from pregnancy?

2)Sir the PCOS was clinically examined by ultrasonography nearly 1 year back when she had irregular cycle,s the doctor gave her medicines after examining her and ultrasonography..after that her period length got back to 34-37 days..thereafter that gynaecologist himself told that taking hormone medicines may hamper her..so she stopped medicines..bt if there is some problem with her period,that gynaecologist recommended her to the homeopathic doctor,whom she visits..Sir she is obese,overweight,has hair on her faces,these is all due to PCOS i gs..she infact gained 3 kgs..when she visited the homeoptahic doctor on 16th August,she was examined by him and was given Calcirea Carbonica..

3)Sir we didnt have sex,just may have rubbed her outside vagina with minute amount of precum spot that may have gotten in my middle finger..didnot finger inside vagina,nor genital contact,nor intercourse..Sir so there is no threat of pregnancy?Kindly answer Sir..

4)Sir kindlly answer sir at the earliest..i know it is impossibleto get pregnant because she got her period although with less flow,it implies her non pregnant staus with that 22nd July event..bt i am getting anxious..kindly answer sir at the earliest..
doctor
Answered by Dr. Nishikant Shrotri (51 minutes later)
Brief Answer:
You need not have stress of the pregnancy. Manage PCOS rationally.

Detailed Answer:
Dear XXXX,

1. If she had menstrual bleeding after you had sexual intercourse and after that you did not have any more sexual intercourse, there is no possibility that she is pregnant. As I informed you in my previous message, for your mental peace, you may confirm her non-pregnant state by ultrasonography.

One intercourse does not subject the woman for pregnancy for indefinite period. The sperms are active only for 72 hours. So 72 hours after the intercourse, the potentiality to impregnate the woman due to that intercourse cases to exist . After 72 hours, a fresh sexual intercourse only can cause the pregnancy. So please get rid of the stress of the possibility of pregnancy due to the sexual act after which she has got menses. That act will no more be responsible for pregnancy any time in future. For any pregnancy after that, you will have to indulge in separate additional sexual intercourses.

Furthermore, from the history you have provided to me about her reproductory status, it seems that she may not be releasing her eggs. Pregnancy is not possible without egg.

The precum is always in very little amount. It can cause pregnancy if it enters the vagina as it also contains few sperms.

2. Her clinical picture seems to be a classic case of uncontrolled PCOS. I would not stop her medication and management. In addition to medication, she needs to control her diet and do daily regular exercises to bring down the weight. Putting up 3 kgs in weight in one month is not at all a good sign of control.

As I mentioned previously, I would not pass any comment on the homeopathic treatment and the medicines. Please excuse me for the same.

3. Just having precum on your fingers and you handling her vagina has occurred before she go her menses. So please get rid of the thought of possibility of the pregnancy due to that.

Finally, I would like to have some feedback from you. How did you get my information for asking a Direct query? Did I answer any of your previous queries or did some one advise you to?

I hope I have clarified all your queries. If you want any more information or clarification, I am always available for you, XXXX.
Above answer was peer-reviewed by : Dr. Sonia Raina
doctor
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Follow up: Dr. Nishikant Shrotri (34 minutes later)
Sir one of my friends advised me to consult with u and said that Dr. Nishikant Shrotri wl give u the best answer and wl ease ur mind completely thats why i asked by applying direct question to u..Sir i am bothering u with my silly questions..

1)Sir she wl see her gynaecologist for her irregular periods..She wl do USG lower abdomen and upper abdomen in 2 days because of this irregular periods..so if at all there was any chance of pregnancy usg would show it?isn't it sir?

2)Sir she gets varied flow during period sometimes normal,sometimes light..its due to pcos and hormonal imbalance?

3)Sir if at all her future periods gets preponed or postponed or missed with light or normal flow,it doesnot indicate any chance of pregnancy with the 22nd July act?Unless we again get in sexual act,there is no chance of pregnancy?

4)Sir because of the less flow during her July period(25-28th July) after 22nd July sexual act i got concerned,though she has less flows in some of her earlier cycles too..i read about implantation bleeding is also less and sometimes ppl assume it to be period,thats why i repeated HPT with preganews after 40 days and yet got negative because i heard that after Period HPT is negative and after Implantation bleeding HPT is positive..She got negative HPT after so many days from the act..

5)Sir post 25th July period we didnot engage in any sexual activity,bt she got her period on 22nd day on 15-18th August,whereas her cycle length is 34-37 days..She doesnot get periods preponed this is the 1st time,thats why i got scared..Bt the doctor told that sometimes periods gets preponed due to hormonal and mental imbalance..Sir without any sexual activity in that post 25th July period,there is no chance of any pregnancy,isn't it sir?

6)Sir sorry for bothering u so much..i wl be grateful to u forever if u kindly answer to these questions in details..thanx for sparing ur valueable time and answering my questions..thanx a lot sir..:)
doctor
Answered by Dr. Nishikant Shrotri (33 minutes later)
Brief Answer:
No reason to have stress of Pregnancy. Take care of PCOS.

Detailed Answer:
Dear XXXX,

I believe thet no query asked by the patient is silly. Since the patient has not understood certain aspects or is in stress, he/she asks the queries. You have all the right to ask me any number of and any sort of queries. You are not bothering me. I shall be happy to answer each one of your queries.

1. Yes, ultrasonography will rule out or diagnose the pregnancy. Further more it will guide her about her PCOS also.

2. In PCOS, there is hormonal imbalance and hence the irregularity of the menses. It needs to be actively treated. Please try to understand and make her also understand that the hormonal disturbances if not treated well in time might become irreversible. So please do not ignore.

3. & 4. This query is well answered previously. Please get out of the stress of pregnancy.

5. When there is no sexual intercourse after her menstrual period, the question of pregnancy does not arise at all. Now you can breath comfortably.

6. Any number of questions of any sort from you are welcome, XXXX.

I hope I have satisfied you completely. If so, you may post a really good review and rate 5 stars for me. If you want any more information, I am always available for you, XXXX.



Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Nishikant Shrotri (27 minutes later)
ok sir thanx a lot..its been really nice to have some knowledge about these type of things..

1)Sir we did the act on 22nd July(38th day)..she has 34-37 days cycle..so on that day there wl be not an egg to cause pregnancy,isn't it sir?..Sir as u said that sperms can survive for 72 hrs and ovum can only for 24 hrs..So just for taking into baseless logic,if the flow from 25-28th July have not been her period,40 days since the last episode of sexual act is long enough to be detecable for HPT in case of pregnancy and if there had been any pregnancy HPT would have showed it already by now cz its been 40 days..so no chance at all of pregnancy?

2)What is implantation bleeding and when does it occur and nature of flow?Sir if the flow from 25-28th July had been implantation it would have shown positive HPT by now..as it tested negative it was her period though with less flow only?

3)Sir does pregnancy occur with the same scenario like me?no fingering inside vagina,no genital contact,no intercourse,no ejaculation on or near vagina..just a minute amount of precum on my middle finger rubbed on external vagina..

4)Sir both the flows on 25-28th July and 15-18th August had blood clots and was for 4 days light and medium flow and tested negative on HPT..so that was her period only and not any other bleeding?

5)Sir thanx for being so cooperative and helpful and reassuring me..so i shouldnot take any stress regarding pregnancy due to that act on 22nd July because she got period though with less flow after that?

Kindly answer to these questions in details...this is the last time am bothering u..thanx a lot sir..:)
doctor
Answered by Dr. Nishikant Shrotri (13 minutes later)
Brief Answer:
Please take off the idea of her pregnancy from your mind

Detailed Answer:
Dear XXXX,

1. I have been repeatedly convincing you that there is no practical chance of pregnancy due to this sexual act.

2. Implantation bleeding is not seen in every woman. In fact it is observed in occasional cases. When the fertilised egg is trying to attach to the uterine lining, some amount of bleeding takes place which is few drops to spotting. This is called as implantation bleeding.

3. Unless the semen or precum enters the vagina, there is no chance of pregnancy.

4. This is her irregular period due to hormonal imbalance.

5. Just drown your stress of her pregnancy due to this sexual act in the Arabian sea and be happy.

I hope I have answered all your queries to your satisfaction. Still if you want any more information, I am always available for you, XXXX.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Nishikant Shrotri (9 days later)
Sir sorry to bother u again..again she got her periods on the 22nd day of the new cycle(5th-9th September),this time its heavy with lots of clots..she visited her gynaecologist on 7th September who she sees her since 2005..He checked her internally and said as she has pcos this can happen..he didnot prescirbe her any medicine,he just asked her to regularly exercise for 40-45 mins and control diet..her age is 21,weight-66 kgs,bp-110/70..she took medicines 1 year back for 4 months to regularise her period..earlier her period length was 45-50 days,so she took medicines for 4 months to regularise it..so the doctor told that these hormone medicines can affect her in the long run,so he didnot prescribe any medication,just asked her to regularly exercise and control diet..on 8th September(4th day of her period),48 days after the sexual act she took blood hcg test,it showed less than 0.1miu/ml..the woman who took her blood asked her about her last menstrual period which is 5th September..sir my question is doing blood hcg during her period didnot affect the results?..kindly answer sir to these in details..i am attaching the report,kindly see..
doctor
Answered by Dr. Nishikant Shrotri (1 hour later)
Brief Answer:
No pregnancy

Detailed Answer:
Dear XXXX

Nice to have your follow up again.

I have seen her hCG report. It is very negligible. The guideline also mentions that it is in the non-pregnant range.

I am more concerned bout her PCOS. She needs to get it treated. Your doctor has very rightly told her about the weight reduction. Please follow his advice. Only diet control will not be helpful for her, considering her weight. She has to do exercises. I have advised about the exercises in my previous communications. Please follow it. She has to do dedicated exercise, not just pass time exercise. Moreover, ask her to take Metformin tablets 1000 mg daily in two divided doses - after breakfast and dinner. This will help her bring down some weight.

Moreover, if she is bleeding very heavily, she has to control the bleeding actively with the help of hormones; otherwise she will land into anaemia further leading to more bleeding. This vicious cycle has to be broken. Please take some Gynaecologist's advice about this. Currently, I would advise her to be on birth control pills regularly. They will help to regularize her cycles and also minimize the bleeding.

XXXX, irregular heavy menses is a peculiarity of PCOS. When it comes to PCOS with infertility, it is easier for us. Pregnancy helps to control it. However, for adolescents, the pregnancy is not the intension. So regularization with other measures mentioned above is the only choice.

And XXXX, please stop worrying about her pregnancy now. It is more than proved number of times that she is not pregnant. Now please take care of her PCOS and heavy bleeding.

I hope you have got the required information. If you want to ask anything more, I am always available for you, XXXXXXX
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Nishikant Shrotri (15 minutes later)
yes sir thank u..i wl follow ur advice..just wanted to know that doing blood hcg during her periods didnot affect the result,isn't it sir?.. sir why did the woman who took her blood asked her LMP which she said 5th September and the test was done on 8th September,did it have any connection with the result?..sir does bhcg remain in blood even if not pregnant?she has less than 0.100 miu/ml,why it is not 0?..sir now with no sexual act will this level remain same or increase or decrease?..sir she visited her gynaecologist on monday,he told her that nothing simply can help her if she doesnot decrease her weight..so he advised her to regularly exercise vigorously for 45-50 mins and control diet and not to eat junk foods..Sir actually her flow during period varies,as the last 2 times she didnot have proper flow,this time it was heavy along with cramping on day 1 and 2..this trend is followed in earlier cycles to..sir so no nothing to worry about pregnancy unless we again get intimate and no need to do usg for this issue?..kindly answer sir..
doctor
Answered by Dr. Nishikant Shrotri (2 minutes later)
Brief Answer:
Forget about hCG

Detailed Answer:
Dear XXXX,

hCG is a hormone produced in the body. Mainly it is produced during pregnancy by tissue which in future is going to form placenta. However, there are other hCG like hormones in a very low concentration which will show even during menses. Please take this hoodoo of hCG from your mind.

Now concentrate on her PCOS.

I hope I have given you satisfactory explanation.

If there is anything ,ore, I am always available for you, XXXX.
Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
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Follow up: Dr. Nishikant Shrotri (58 minutes later)
ok sir i will follow ur advice..

1)Sir how can i get over the stress completely though i know that there is no chance of pregnancy at all but its playing in my mind sometimes..

2)Sir actually in internet and in this healthcare portal too some doctors tell that periods can occur even when pregnany thats why i got confused..one woman even told that she got her period and in next month she got to know that she was pregnant..these type of things made me stressed..

3)Sir so i can rely on a single Blood hcg value to completely rule out any kind of pregnancy and there is no need to do usg on this count?And no need to repeat blood hcg again ever?

4)Sir as she is doing regular exercise,so can it delay her periods?..as i read that over exercise can delay periods..can u specify some exercises..

5)Sir without any sexual act now will that level remain same or increase or decrease to 0?wont it be 0miu/cc?Sir as per my knowledge in non pregnant blood bhcg value is 0-5 but in this report its written <2.5 means not pregnant..why is this conflicting?

6)Sir 7 weeks after the act is a long enough time for blood hcg to pick is she got pregnant by the act,as her level is so low she is not pregnant due to that act..

7)Sir doing blood hcg during the periods didnot affect the results,isn't it sir?..and sir the woman who took her blood asked her about LMP so she told about 5th September and the test was done on 8th September..does the LMP have any connection with the result?

8)Sir so if her coming periods get altered or missed with less or normal flow its not due to that act..isn't it sir?

Sir i am asking the same questions again and again just for reassurance..sorry for my stupid questions..kindly answer sir..
doctor
Answered by Dr. Nishikant Shrotri (13 hours later)
Brief Answer:
You need counsellor's help

Detailed Answer:
Dear XXXX,

Let me reply to your queries point wise:

1. For this you have to take the help of some good counsellor.

2. Getting some bleeding during pregnancy without any risk to the pregnancy is a very rare incidence. However, the negative pregnancy test should rule out this possibility also.

3. If you start thinking this way, there will be no end to this. At the most the diagnosis of this test may be endorsed by ultrasonography done 8-10 days after the missed period. If there is no missed period and the pregnancy test is negative, there is no indication for ultrasonography confirmation.

4. Regular exercises will not delay periods.

5. hCG is secreted by chorionic tissue. There is no conflict. Each laboratory has its own standards and cut off points. On the net, you get general information which is not specific to any laboratory.

6. This query has been answered number of times. I will not repeat the same answer. You can find it in previous messages.

7. The answer to this query is the same as mentioned in answer 5. In non pregnant state, there is no hCG production. Whether done during menses or other time makes no difference. The low levels you get are due to the laboratory standards and the chemical reagents they use. You need not go into the details of this. Your purpose is served by negative results.

I hope you will be satisfied with these answers. Please stop thinking too much on this problem now.
Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Nishikant Shrotri (10 days later)
Sir she did pelvic usg abdominal just as a routine..i have attached the report..kindly see sir..Its done on 18th September(2months since the sexual act)

1)What is meant by uterine cavity is empty?

2)Sir what is meant by uterus is anteverted,normal in size and echo pattern?

3)What is meant by midline echo is seen normal 6.7 mm?..Is it endometrial thickness of 6.7 mm?..3 days earlier it was 6 mm(she did usg whole abdomen,there it was written 6mm on 15th September),now its increased to 6.7 mm?..so no harm in that?..No definite focal parenchymal lesion is seen,what does it mean?

4)is her uterus normal in size as she is not pregnant?Is it normal in size and shape and it indicates absence of pregnancy?..3 days earlier scan it was
7.1 cm*2.6 cm*3.7 cm,now its 6.5 cm*3cm*4cm..is it normal?

5)No pelvic/abnormal SOL is seen and no fluid in pouch of XXXXXXX .what does it mean?What is meant by adnexas are free?..ovaries length?

6)What are the findings of the report?So pregnancy completely ruled out as usg pelvis abdominal was done after 2 months from sex?..2months after the act is a long time to be detecable in a transabdominal pelvis usg though i know that tvs is better..but at least abdominal usg should have detected in case pregnancy is there?..so no chance at all with that event 2 months ago?

Sir kindly answer to these in details..
doctor
Answered by Dr. Nishikant Shrotri (10 hours later)
Brief Answer:
Diagnosis of PCOS confirmed

Detailed Answer:
Dear XXXXXXX

Here are the answers to your questions:

1. Uterine cavity is usually empty. It means there is no pregnancy nor any tumour in the uterine cavity. This is normal.

2. Anteverted means bend forward. This is the normal position of the uterus. It has no tumour in it. There are no soft tissue lesions or disease noted.

3. It is the endometrial thickness with cavity. It goes on increasing during the cycle as the endometrium increases. It decreases after menses as it is thrown out.

4. Yes it is absolutely normal and non-pregnant uterus.

5. SOL is acronym of Space Occupying Lesion. It means that there is no tumour present. Pouch of XXXXXXX is the space between the uterus and the rectum. In different pathologies, fluid or blood gets collected in it. It is not showing any such thing. So nothing to worry. The ovaries are enlarged since they are Polycystic. She needs to undergo treatment for PCOS. Adnexa are the areas by the side of the uterus. They are free means there is no infection nor endometriosis nor cancer causing any adhesions.

6. The report has already mentioned the diagnosis at the end. She is having PCOS; otherwise there is no abnormality found in ultrasonography scan. Not even a pregnancy too.

I hope you are convinced with the answers. You may post a good review with 5 star rating for me.
Above answer was peer-reviewed by : Dr. Vinay Bhardwaj
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Follow up: Dr. Nishikant Shrotri (8 hours later)
1) Sir what are adnexas?is it fallopian tube?

2)Sir in case of pregnancy,uterus size never remains normal?..it gets enlarged and bulky?

3)Sir is endometrial cavity same as uterine cavity?..its empty means no gestational sac is present inside the cavity,which means no pregnancy?

4)In July and August period her period flow was less,that means endometrial thickness was less in those 2 cycles?..and in September its heavy which means,her endometrial thickness was more?..So period flow is directly proportional to endometrial thickness?

5)What is the range of endometrial thickness during a cycle?..Her endometrial thickness on the 14th day is 6.7 mm,is it normal for a nonpregnant women?..

6)Sir endometrial thickness increases with pregnancy?..apart from pregnancy if the thickness increases and naturally it doesnot slough off during period,what will it indicate?

7)Sir just for reassurance again asking,Pelvic transabdominal usg would have atleast given a hint regarding pregnancy that too 2 months after the sexual act if at all there was any chance of pregnancy with the act,though usg tvs is better..but still usg transabdominal would have atleast given a hint in case there was pregnancy,so no chance of pregnancy at all with that act?

8)Sir sorry for bothering u XXXXXXX times..i wont disturb u any more sir..kindly answer sir in details..I will be grateful to u forever..thanku sir..thanx a lot..:)
doctor
Answered by Dr. Nishikant Shrotri (1 hour later)
Brief Answer:
Please get out of the phobia of pregnancy.

Detailed Answer:
Dear XXXX,

Here are the answers for your questions:

1. Please refer to my answer no. 5 of previous communication in which I have already explained you what is adnexa. Adnexa represents the area on both the sides of the uterus. It contains fallopian tubes and ovaries with fibrous tissue.

2. You are right; however, pregnancy is not the only cause for increasing the uterine size. There are number of other pathological conditions which may cause the uterus to be bulky. Now please do not ask me name of all those conditions.

3. You are right.

4. You are correct.

5. Normal range of endometrial thickness is from few mm to around 18 mm when ovulation takes place. It is thin endometrium.

6. It indicates that the egg is not released and the endometrium is growing unopposed.

7. You are perfectly right.

Now may I ask you one question? Are you appearing for MD Gynaecology examination?

And lastly, please take my advice; you need a counsellor's help to get rid of your stress of probable pregnancy to your girl friend.
Above answer was peer-reviewed by : Dr. Neel Kudchadkar
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Follow up: Dr. Nishikant Shrotri (1 hour later)
No sir,i am not appearing for any medical examinations..i am a btech engineer..i am keen to know thats why i asked you about the clarifications..Actually i like to learn about things..thanku sir for u kind and valueable help..thanx a lot..thanx for all the reassurance..thanku sir..:)..Sir she started exercising regularly as per your and her gynaecologist's advice to reduce her weight and controlling diet to get her mesntruation cycle regular..thanx sir..its been a nice experience discussing with u the doubts and fears in my mind of pseudo pregnancy which u banished from my mind..thanku..:)
doctor
Answered by Dr. Nishikant Shrotri (12 hours later)
Brief Answer:
Settle peacefully

Detailed Answer:
Dear XXXX,

Please concentrate on your Btech currier.

Take help of some counsellor whenever you are in stress.

Wish you all the best in your life.
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Prasad
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Dr. Nishikant Shrotri

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Is Pregnancy Possible Through Non-penetrative Sexual Activity?

Brief Answer: Very remote - for practical purposes, no possibilty of pregnancy. Detailed Answer: Dear XXXX, I have gone through your detailed history for which I must complement you. It is after 9 hours of your first communication I am answering. This is for very simple reason: when you asked it, it was midnight and I was fast asleep, so I was not aware of it. Now in the morning, the first thing I am doing is answering your query. You seem to be under tremendous stress. Is this stress due to apprehension of possibility of pregnancy or due to her menstrual problem? Anyway, I shall answer all your questions one by one. 1. You got her pregnancy test done 40 days after the sexual relationship you had with her. How many days after the sexual relationship is not important. What is important is how many days after missing the period. In fact she has not missed her period at all. She had quite a many periods after the sexual intercourse you had. So there is no question and no possibility of pregnancy. Still if you want to get it confirmed, you may go for ultrasonography. 2. The appearance of period is not at all related to the act of intercourse. Missing the period is, but not the appearance of period. The frequent periods she is getting is most likely to be due to her hormonal imbalances. Stress also may be blamed for it; however, usually stress delays the menses, still irregularity cannot be set aside. She is a known case of PCOS, which is hormonal imbalance and metabolic disorder. So you do not have to blame the sexual intercourse for the frequent early menses. 3. The variation in her menstrual flow is naturally again due to hormonal imbalance. Usually, after the menstruation, the increasing Oestrogen hormone starts building up the lining of the uterus (endometrium). After egg release takes place, along with Oestrogen another hormone called as Progesterone comes in the picture. This hormone brings about the changes in the endometrium which will implant and nourish the pregnancy. If there is no pregnancy, these hormones start diminishing and after 10 days of egg release, they are so low that the endometrium cannot be supported. Hence the endometrium breaks and is thrown out with some amount of blood. This is menstrual bleeding. Now since she is having hormonal imbalance, her levels of hormones are so varying that they cannot support the endometrium and hence the bleeding is taking place in between the cycles. This is not happening due to pregnancy. Please understand that in normal pregnancy, there is no bleeding what so ever. Since she is not pregnant, her all pregnancy tests are going to be negative. Please get rid of this stress. In PCOS, as the name itself suggests, Polycystic Ovarian Syndrome, the eggs in the ovary mature to various stages but cannot get released. Hence the ovary becomes polycystic. Therefore the chances of pregnancy in PCOS are very remote. 4. I feel the answer to this question is already covered in the previous point. However, I would like to give you some more information to solve one issue in your mind. The brown bleeding comes out is old bleeding. Some times the amount of blood is excessive and cannot come out of the uterus in full pace. So, if some blood is retained in the uterus for some time, it will become brown or dark and shows out subsequently. 5. Yes, I agree that I could not answer you earlier, the reason I have already explained to you. However, though I have answered l your questions, I would like to give some more (probably unasked or partially asked) advice. She is a case of PCOS. Has the diagnosis been confirmed by clinical examination, hormonal levels, Laparoscopy and ultrasonography? If so, I would like to view the reports and the images. Will you please upload them? What treatment of PCOS she is undergoing apart from homeopathy? Please upload all the prescriptions also. I cannot and will not opine on homeopathic treatment. However, I can certainly guide you rationally and scientifically if you upload all the relevant details I have suggested you. The treatment of PCOS can be mainly divided into: 1. Girl wishing to have regularize her menses and get the pathology corrected. Pregnancy is no concern. 2. Woman wishing to have the pregnancy also in addition. Most of PCOS cases are infertile due to failure to ovulate. The other presenting symptoms are obesity, hairy, irregular menstruation usually delayed periods and excessive bleeding. Such conditions can be managed by medicines and/or surgical intervention depending up on the requirement of pregnancy. I feel your apprehension regarding the possibility of pregnancy has been taken care of. I have explained about the irregularity of her menses in details. After you appraise me about her reports and the images, I can guide you further in management of PCOS. I hope you are satisfied with the explanation about your current queries. If so, you can post a review and rate me by 5 stars. For any more information, I am always available for you XXXX.