Women's Health Community

Dear mthrof1: If you have been having unprotected intercourse you really need to rule out pregnancy first. Some women with erratic bleeding patterns can conceive near by a bleeding episode. In your specific case, the presence of pregnancy-type symptoms really mandates that a reliable pregnancy test be obtained. Sometimes a very sensitive pregnancy test can even pick up the remaining traces of HCG (pregnancy hormone) from a miscarriage.

If your pregnancy test is a clear negative, the most common reason for a menstrual pattern like you have described is not having an ovulation last month. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month. The good news is that you have enough estrogen to make a lining that does usually shed.

In a normal cycle, progesterone production increases following ovulation and release of an egg.. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period.

So, if you didn't ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed/late period. Alternatively, the built up lining can begin to shed on its own creating erratic bleeding patterns which are usually "too-light" or super heavy and prolonged.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with spouse or boyfriends/girlfriends, money), increased body weight, anorexia, rotating shifts at work, etc.

Bilateral breast tenderness can be a very early sign of pregnancy, appearing as early as two weeks after conception. This is thought to be related to increasing levels of hormones such as estrogen. In a month without an ovulation, not only can a menstrual period be missed, but there can be breast tenderness as well. This is similar to the increased breast tenderness experienced by some women when first taking postmenopausal hormone therapy.

Bottom line, since you are having pain on the left side of your uterus and the nausea I would urge you to get the pregnancy test doen by your GYN or local family planning clinic. If the test is negative they can widen the search for other causes of your symptoms (eg ovarian cyst, kidney stone, bowel problem).

Yours,
Jane