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Not on birth control. Had unprotected sex. HPT negative. Having irregular period, breast symptoms. Thoughts?

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So this is probably going to sound absolutely ridiculous but I am at my wits end, and honestly am beginning to get scared. I'm a 25yo white female and in graduate school. I have never been pregnant before and am in a monogamous relationship ( same partner 6 years). I am not on birth control ( extremely strong family history of breast cancer) and did not tolerate paragard well. Last normal period was 1/22/13. 26 day cycles. My boyfriend and I had wine-tasting-induced unprotected sex, on vacation, and he ejaculated inside me on 2/2/13. I normally ovulate on cycle day 13.....which would have been 2/3/13. So naturally we were both quite concerned especially when the sides of my breasts began to hurt and they became fuller, I also began to get very tired, and nauseous. Period should have started on 2/17/13 and didn't, negative test. On 2/18 in the middle of the day I started to feel strong cramps which are normal the first day of my period but they only lasted half an hour I had brown and light pink "bleeding" which filled 1 regular tampon over 8 hours and then became spotting on and off for 2 days. kept having negative tests so I went to the OBGYN on 2/25 because I started to have a lot of pressure and what felt like cramps in my ovaries switching sides. Negative urine, negative qualitative blood test. Went back on 3/7 because I had gone from a 34C to a 34DDD in a month and still had cramps/pressure , wasn't examined but had blood drawn normal thyroid, negative quanitative. So at this point I was like ok not pregnant, nothing is wrong with me, maybe its just law school or something. And neither my dr nor the PA seemed concerned about my breasts so I figured everything was fine. They are both aware that mom, grandmother, aunt, and 2nd cousin have had breast cancer. So then on 3/12 I had some very odd bleeding without cramps which started after sex, I thought it was my period but odd because it was 4 days early and there were no cramps. the color was reddish purple ( it sounds disgusting but it was the color of mixed melted strawberry and chocolate ice cream) again quite light lasted maybe 3 days with occasional bright red spotting the last day. My breasts have stayed enlarged this entire time and now the areolas are darker, nipples are red and there are very clear rings around both areolas that were not present before. And back pain/frequent urnation started ( not a uti I have the azo test strips). But all of this I could have found benign explanations for. Then I for some reason pinched the nipple of my right breast and a sticky clear whitsh yellow fluid came out and the same think happened with my left. This has never happened before and I have felt the discharge from the right once or twice without squeezing since then. All of my urine tests have been negative until this point about 3 weeks ago when I thought I started to see very faintly positive results on some of the cheap pregnancy dip sticks. so I purchased name brand ones all different types/brands EPT seems to be giving me a thin but noticible + about 60-75% of the time but its off center. Clear blue/first response have all been negative( digital and regular) but, after returning from school on tuesday a first response that was negative had a thin line in the test area ( which had never happened before. I'm not sure if these are all evaporation lines or actual positives but I am seriously concerned something is wrong either way. I do not think this is a phantom pregnancy because I don't "believe" I am pregnant and I don't know how I could possibly will my breasts to grow two sizes or cause the other breast changes. . I am taking the bar in july so it's not like I badly want to be pregnant, because this is not good timing but would be fine if I was. I'm a law student, all I do is look at evidence, and draw logical conclusions. I just don't know what else these types of breast changes, period changes, and other physical symptoms, together, could logically indicate other than pregnancy, but I can't possibly be pregnant because you don't get periods while pregnant. I have never had any of these symptoms before or felt like this before. My thyroid is normal, I do not have PCOS, I am not overweight or underweight. NO STDS or history of STDS. No ovarian cysts. No UTI. I feel ridiculous going back to my OBGYN and paying another $50 copay. and going to a new dr seems ridiculous because if the urine test comes back negative my symptoms are going to get dismissed again. I'm practical, I understand the role unessecary DR visits have in the astronomical cost of healthcare, and am just trying to figure out if a wait and see approach is best or if anything like this has ever been documented before. I want to just chalk this up to something benign but also desperately do not want to end up on "I didn't know I was pregnant XXXXXXX as the girl who gave birth in the middle of the bar exam or miss a cancer diagnosis or something along those lines. Do you have any advice? I have not had sex since February because we are both law students and chose to attend law schools 2000 miles apart.
Posted Sat, 11 May 2013 in Women's Health
Answered by Dr. Timothy Raichle 3 hours later
Hello, I would be happy to help you with your question.

You have given quite a bit of information, so I am going to dramatically simplify this as:

1. You are 25 year old female not on birth control
2. You had unprotected intercourse on about 2/2
3. You had a negative blood pregnancy test on 3/7 (indicating that you are NOT pregnant from the episode of intercourse on 2/2)
4. You have had some irregular bleeding since then
5. You have had breast symptoms and evidence of galactorrhea

Here are my thoughts:

1. There is no such think as a phantom pregnancy - you are either pregnant or you are not
2. You are not going to bankrupt the country by seeking care - remember, someone is paying for your health insurance and it is your right to seek care.
3. Elevated prolactin levels could explain irregular cycles, breast symptoms, and galactorrhea

Here is what needs to happen:
1. You need to return to your OB/GYN
2. You need them to perform an exam, including a pelvic exam
3. You need an ultrasound of your uterus to evaluate the abnormal bleeding
4. You need labs redrawn, including a quantitative HCG level (just to be sure) and a prolactin level

I hope that this helps. Please ask if you have any followup questions.
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