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Dr. Andrew Rynne
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Dr. Andrew Rynne

Family Physician

Exp 50 years

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Had Unprotected Sex, Taken Ella. Negtive Pregnancy Test. Sore Nipples, Yellow Discharge

I had unprotected sex with my husband on the 18 jan. I went to the doc on 21 jan (almost 72hrs after) to get the morning after pill (Ella).. my last period ended on the 12 jan and I calculated my next period should be on the 3 feb. It has been 10 days and I still do not have my period. I took 3 test which all came out negative. One on the 5 feb, one on the 8 feb and one on the 12 feb using the first morning urine . I m having sore nipple and lots of yellow discharge but no sign of pregnancy. Could I be pregnant or having an ectopic? Please advice. Thanks
Mon, 18 Feb 2013
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OBGYN 's  Response
Hello,
Three consecutive negative pregnancy tests rule out the possibility of a pregnancy. Also, you seem to be having 22-23 day cycles.In such a situation, your ovulation time would be around 10 days after the first day of the last menstrual period,i.e., around 20th Jan. Though you had intercourse during the fertile period, as you had the pill within the stipulated time, you are safe. As the pill contains high doses of hormone, your natural hormonal balance will be disturbed and as a result, your cycles tend to get disturbed for a few times. Soreness of the nipples could be due to the pill. Yellow discharge indicates infection and you should see a gynecologist for further evaluation and management. Take care.
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General & Family Physician Dr. Luchuo Engelbert Bain's  Response
Hi,
and thanks for your question. Its early to think of an ectopic pregnancy now. Thinking of a pregnancy is a possibility in this case. The type of contraception you employed is called emergency contraception, which is effective only in 95% of cases. This therefore implies that there is a possibility of pregnancy, although the chances are slim in your case.
It shall be a good idea to do a more sensitive pregnancy test. This is one that is dine using blood instead of urine in a good laboratory. An ectopic pregnancy shall depend first on positive pregnancy, on an inadequate decrease rate of Beta HCG on serial BHCG measurements and on a suspicion of an ectopic pregnacy based on other indicators (pain, bleeding, hisytory fallopian tube infection).
I would first suggest that you get a new pregnancy done in a specialized lab using blood to either confirm or rule out pregnacy, before further investigations could be done.
Thanks and best regards,
Luchuo, MD.
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OB & GYN Specialist Dr. Dr. Soumen Patra's  Response
Hello,
According to your expected due date (3rd Feb), you ovulated around 19-20th January. You did unprotected sex on fertile days or unsafe period (18th Jan). So there is quite chance of being pregnant in spite of late taking morning after pill (always to be taken within 72 hrs for highest efficacy).

First of all, you need to do a blood test for beta hcg & USG lower abdomen to exclude intrauterine pregnancy. Brownish yellow discharge with late period may indicate implantation bleeding.

In exclusion of pregnancy, other reasons for delayed period are ovarian cyst, hormonal imbalance, stress/ anxiety, thyroid problem, wt gain/extreme loss, irregular eating habits etc. Vaginal infection is also to be ruled out.

Do some investigations to rule out underlying pathology like thyroid profile & other hormone assay, blood sugar & prolactin level etc. One vaginal swab test & urine examination are required. So consult with your doctor and take suggestive measures.

Avoid stress/ tension, take healthy diet with iron supplements, control body wt and maintain genital hygiene properly. Sore nipple is due to effect of progesterone. Wear tight breast support.

Take care yourself.
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Had Unprotected Sex, Taken Ella. Negtive Pregnancy Test. Sore Nipples, Yellow Discharge

Hello, Three consecutive negative pregnancy tests rule out the possibility of a pregnancy. Also, you seem to be having 22-23 day cycles.In such a situation, your ovulation time would be around 10 days after the first day of the last menstrual period,i.e., around 20th Jan. Though you had intercourse during the fertile period, as you had the pill within the stipulated time, you are safe. As the pill contains high doses of hormone, your natural hormonal balance will be disturbed and as a result, your cycles tend to get disturbed for a few times. Soreness of the nipples could be due to the pill. Yellow discharge indicates infection and you should see a gynecologist for further evaluation and management. Take care.