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Dr. Norm S.
Dr. Norm S., Board Certified OB/GYN
Category: OB GYN
Satisfied Customers: 11062
Experience:  Over 30 years of experience in OB/GYN practice, including teaching students. Fellow of American Board of Obstetrics and Gynecology.
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Im 42 and trying to get pregnant, my last period was March

Customer Question

I'm 42 and trying to get pregnant, my last period was March 16, I ovulated on cd 11 (March 26). Two days later I started having mild cramps, lots of gas and other weird sensations in my lower abdomen. The following week I started feeling extremely tired and my breasts started feeling a bit sore, got headaches and lower back pains. On April 6 ( 12 days after ovulation and 23 days after my period) I started bleeding, not like my normal period at all, brown on the first day red on the second day and then brown again. Just dripping blood, no tissue and about half as less as my normal period. It lasted 4 days. If my luteal phase would last 16 days I would have had my period April 11. I went to the doctor the April 15. She took a urine test and it came back negative and told me to come back in two weeks. Except for the tiredness the gas and feeling hungry all the time all my symptoms come and go. I took another test this morning and it was negative again. Should I trust this test or could I still be pregnant? Not knowing is extremely stressful for me. Would an ultrasound give a definite answer 3 1/2 weeks after possible conception if my HGC levels are just to low to detect or would a blood test give a definite answer in a week?
I really appreciate some advise.

Iris
Submitted: 3 years ago.
Category: OB GYN
Expert:  Dr. Norm S. replied 3 years ago.
Hello and welcome to Pearl.com.
I amCustomer and I look forward to helping you with your problem today.

I would say that the most likely cause of all your symptoms is that you didn't ovulate this month. An OPK shows when there is a spike in LH levels, but that's not always followed by ovulation. When a woman doesn't ovulate, her ovaries may keep getting stimulated, which can result in high estrogen levels, which can cause most of the symptoms you're having, including tiredness, headache, bloating, gas, as well as irregular bleeding. Not ovulating is fairly common, especially at age 42, when women tend to ovulate less often.

Pregnancy might be possible, but if it is, it's a definite miscarriage, since there isn't enough HCG to cause a positive blood test (which should normally happen about 2 weeks after ovulation if you were pregnant). An ultrasound won't be helpful, since that can't detect a pregnancy until the HCG level is over 1000, which won't happen for 1-2 weeks after a positive pregnancy test. Also, the first sign of pregnancy is usually a missed period, not early bleeding.

I think you can be pretty sure you're not pregnant, and most likely you weren't pregnant. Since you wish to become pregnant, I would see a good OB/GYN who can help figure out if there is any specific reason why you didn't ovulate (stress, weight changes, thyroid problem). If not, the doctor can help to be sure you ovulate regularly in the future. Most women have a hard time getting pregnant at age 42, even if they are ovulating regularly. Best wishes.
Customer: replied 3 years ago.

Thanks for your answer but it's not clear enough for me.


 


Since it is so common to skip an ovulation it would be likely that I have skipped one before and that I would have had these symptoms before, but I have never felt like this. I had a laparoscopy last August and everything looked perfect, had a full range of bloodtests in January and my thyroid function was good. Also my periods are extremely regular. So I'm not saying that I am pregnant but what's going on now is definitely not just a missed ovulation.


 


I didn't get a bloodtest, just a urinetest.


If the bleeding from cycleday 23 to 26 would have been implantationbleeding isn't it possible that my Hcg levels in my urine on cycleday 37 just are not high enough to detect a precnancy without it being a miscarriage?


 


If there was a miscarriage shouldn't there have been tissue or at least the lining of the womb in the blood? It was just blood and no cloths or tissue at all and about half the amount of a normal period.


 


Should I wait another week to get a bloodtest done or get a referral for a ob or should I just wait a couple more weeks to see if my period starts again?


 


Iris


 

Expert:  Dr. Norm S. replied 3 years ago.

10 days after implantation, the HCG levels would always be high enough to cause a positive pregnancy test in a normal pregnancy. With a very early miscarriage, there may not be any tissue visible in the bleeding. However, there will usually be more bleeding than in a normal period. To be 100% sure that you're not pregnant, you could have a blood test for HCG. However, I'm almost positive that it will be negative. It may not be common for you to skip ovulation, and perhaps this is the first time. It is common for women your age. Your periods are usually very regular, but this one is not. That suggests that maybe you haven't skipped ovulation before this. I would recommend that you get a referral to an OB doctor, who can figure it all out, make sure you're not pregnant, and help you in planning a pregnancy in the future. You could wait to see when your period comes again, but you don't have very much time to lose if you wish to become pregnant.

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