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scratching my head, need some advice.
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unsure posted:
Ok, so the first day of my last period was 9/6/12. it lasted 4 days.
I ovulated 10/01/12. my luteal phase is 11 days my cycle is usually 37-38 days so i was expecting my period to start on 10/13/12. on 10/11/12 i was having some uterine cramping and i spotted when i wiped at 6pm, it was bright red and that was it for that day. the next day 10/12/12 i woke up and i had blood dripping into the toilet then spotted only when i wiped. had no bleeding during the night. woke up 10/13/12 had some blood when i wiped. spotted all day again and onlly when i went to the bathroom. 10/14/12 woke up and there was no blood on the tp. then went to the bathroom about 45 mins later and the spotting had started again. the spotting was not as much this day. 10/15/12 just spotted a few times when wiping in the morning then it stopped. the whole time i was spotting it was bright red, no old blood. 10/16/12 went to the doctor and had a test done for BV and it was positive. she said there was still some blood so she had to send it away to get checked. I noticed the fishy smell on 10/12/12 the day after i started spotting. and the few days leading up to the spotting i had been having hot flashes, and my left breast was a bit swollen. these symptoms went away after i started spotting. im not sure if that was my period or implantation bleeding. i am on cd44, 18dpo and 6 days late for my period. i have taken a few pregnancy tests and got a blood test on 10/15/12 but i feel that may have been to soon to detect the hcg. i have never had pms symptoms. never spotted before my period, never had a pain in my boob, never had hot flashes, never had uterine cramping with my periods or before. So im not sure if im pregnant or not. the doctor didn't seem to care when i told her about what was going on with me. Just needing some advice and wondering if this sounds like i could be pregnant but no hcg in my urine yet to get a result? thanks for your time.
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unsure responded:
also forgot that the week of my ovulation i got a ton of upper back acne. like a ton. ive had break outs on my back before but never like 20 or more at one time. Also seems like the fine hairs on my back are growing longer..its very embarrassing. it has not been to bad as of lately. i have been keeping benzol 10% on it. also have had really no appetite since 10/15/12. And i was very emotional (crying), early in the week of the 10/7/12. im still emotional but not nearly as bad.
 
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Jane Harrison Hohner, RN, RNP responded:
Dear unsure: Just a couple of clarifications (lots of information to sort through). You had a confirmed ovulation on 10/1 (so a conception would have occurred around here). In that case a urine pregnancy test should give you a correct answer by today--and a blood test on 10/15 would likely have shown some HCG as the blood test detects down as low as 5 units of HCG. Thus, pregnancy seems less likely if you in fact ovulated 10/1.

You mention a 37-38 day cycle, but only an 11 day luteal phase. I'm assuming that you have done some kind of testing (eg progesterone blood levels) or perhaps basal body temperature charting to get the 11 day interval. If this is the case then most assuredly a pregnancy test would be accurate at the time of your anticipated/missed period of 10/13.

If the pregnancy test is correct, the missed period and very erratic bleeding pattern is suggestive of a missed ovulation. Spotting can arise when just modest amounts of the top layer of uterine lining begin to slough off.

There can be MANY causes for missing an ovulation: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with boyfriends/girlfriends, money worries), 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.

Increased acne and unwanted hair growth may have a hormonal cause as well. Usually this reflects an increased production of male hormones. Most commonly increased male hormones are apparent around ovulation after the LH surge, or if the women has chronic ovarian cysts/non-ovulation (eg "PCOS").

Bottom line, if your natural-for-you cycle does not reset itself after two to three months, or if you develop pelvic pain (eg ovarian cyst), go back to your GYN for follow up. If you are having unprotected sex you could get pregnant before your next natural period arrives--so it is always good to recheck a pregnancy test.

Yours,
Jane


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