[23F] Missed period with negative pregnancy test and recent miscarriage

Patient Description

A 23-year-old female reports a missed period with the last menstrual period on July 12, 2024. She is actively trying to conceive and has had unprotected intercourse with the same partner. She has taken a pregnancy test, which was negative. The patient has not experienced any breast soreness, which she finds unusual. She had a miscarriage in June and has not had any follow-up appointments or tests since then. She has not experienced any unusual bleeding or spotting since the miscarriage. Recently, she has been experiencing nausea and vomiting for a couple of days, changes in appetite, and food aversions. She also reports feeling unusually fatigued. The patient has no pre-existing conditions or chronic illnesses and is not currently taking any medications.

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Arora's Assessment

What might be happening

Based on the information you've provided, here are some possible explanations for your symptoms:

Missed Period and Negative Pregnancy Test

  1. Early Pregnancy: It's possible that you are pregnant, but the pregnancy test was taken too early to detect the hormone hCG. Sometimes, it takes a few days to a week after a missed period for the levels to be high enough to show a positive result.
  2. Hormonal Imbalance: Stress, significant weight changes, or other factors can cause hormonal imbalances that might delay your period.
  3. Post-Miscarriage Changes: After a miscarriage, it can take some time for your menstrual cycle to return to normal. This could be affecting your current cycle.

Nausea, Vomiting, and Fatigue

  1. Early Pregnancy Symptoms: Nausea, vomiting, and fatigue are common early signs of pregnancy.
  2. Stress or Anxiety: Emotional stress, especially after a miscarriage, can cause physical symptoms like nausea and fatigue.
  3. Gastrointestinal Issues: Sometimes, gastrointestinal problems can cause nausea and vomiting.

Possible STI Concerns

  1. STI Symptoms: While you haven't mentioned specific symptoms of an STI, it's important to consider this possibility if you have concerns. Some STIs can cause symptoms like unusual discharge, pain during intercourse, or pelvic pain.

What you can do

Missed Period and Negative Pregnancy Test

  • Retake the Pregnancy Test: Consider retaking the pregnancy test in a few days to a week. Sometimes, it takes a little longer for hCG levels to be detectable.
  • Consult Your Doctor: Schedule an appointment with your healthcare provider to discuss your missed period and negative test. They may recommend a blood test for a more accurate result.

Nausea, Vomiting, and Fatigue

  • Stay Hydrated: Drink plenty of fluids to stay hydrated, especially if you're experiencing vomiting.
  • Eat Small, Frequent Meals: Eating smaller, more frequent meals can help manage nausea.
  • Rest: Ensure you get plenty of rest to help manage fatigue.

Possible STI Concerns

  • Get Tested: If you suspect you might have an STI, it's important to get tested. Early detection and treatment are crucial.
  • Practice Safe Sex: Use protection to reduce the risk of STIs.

General Tips

  • Track Your Symptoms: Use MDandMe to journal your symptoms, track your progress, and get insights. This can be helpful information to share with your healthcare provider.
  • Follow Up on Miscarriage: If you haven't had a follow-up appointment since your miscarriage, consider scheduling one to ensure everything is healing properly.

What you should look out for

  • Severe Pain or Heavy Bleeding: If you experience severe abdominal pain or heavy bleeding, seek medical attention immediately.
  • Persistent Nausea and Vomiting: If your nausea and vomiting persist or worsen, consult your healthcare provider.
  • Unusual Discharge or Pain: If you notice unusual discharge, pain during intercourse, or pelvic pain, get tested for STIs.

Remember, while I can provide information and suggestions, it's important to consult with a healthcare professional for a formal diagnosis and treatment plan. If you have any more questions or need further assistance, feel free to continue the conversation.

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5 mo ago

People Also Ask


Can a negative pregnancy test still mean I'm pregnant?

Yes, a negative pregnancy test can still mean you're pregnant if the test was taken too early. It may take a few days to a week after a missed period for hCG levels to be high enough to show a positive result.


What are common reasons for a missed period besides pregnancy?

Common reasons for a missed period besides pregnancy include hormonal imbalances due to stress, significant weight changes, or other health factors. Post-miscarriage changes can also affect your cycle.


How long does it take for menstrual cycles to normalize after a miscarriage?

It can take several weeks to a few months for menstrual cycles to normalize after a miscarriage. It's important to follow up with your healthcare provider to ensure everything is healing properly.


What are some ways to manage nausea and fatigue if I'm not pregnant?

To manage nausea and fatigue, try staying hydrated, eating small and frequent meals, and getting plenty of rest. If symptoms persist, consult with a healthcare provider for further evaluation.


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