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An_248489 posted:
Hi, My BF and I had sex on the 10/4/12 I was suppose to start on 10/09/12 and now today I started spotting not like a period but pinkish today is 10/17/12 I Took a HPT but is was neg could I still be pregnant??
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Jane Harrison Hohner, RN, RNP responded:
Dear An: If your last intercourse was 10/4, a sensitive urine pregnancy test should be accurate 14 days from that (ie 10/18). To be absolutely sure a follow up test can be done 21 days after possible conception (eg 10/25). Pregnancy should be ruled out first.

If the pregnancy test is negative then the next most common cause of a missed period is not having ovulated that cycle. 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.

In a normal cycle, progesterone production increases following ovulation. 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 do not 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 period.

There can be many causes for not ovulating: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with parents or boyfriends/girlfriends, money), increased body weight, anorexia, rotating shifts at work, etc.

Lastly, everything I have just shared with you pertains to women who are NOT using a form of hormonal birth control. If you are using birth control pills/patvch/ring/shot you may miss a period for an entirely different reason. Once pregnancy has been "ruled out" (because even reliable methods fail) one can usually assume that the missed period is "normal" or "OK". Unlike the scenarios discussed above, women on hormonal contraception have both estrogen and progesterone available. If the synthetic progesterone is dominant, it can artificially make the uterine lining very thin. So the woman misses her "Pill period" or it is very much lighter than normal.

If your pregnancy test turns positive, if you miss another two periods, or you begin to have very erratic bleeding, you should see your GYN or local family planning clinic.

Yours,
Jane