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Dr. C.
Dr. C., Board Certified
Category: OB GYN
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Experience:  30 yrs experience, awarding winning educator
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I'm a 39 year old female, returned from a week trip to Morocco

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I'm a 39 year old female, returned from a week trip to Morocco on Saturday 11th April and fell ill the night after, on Monday 13th frequent diarrhea (6 times in 24 hrs), chills, no vomiting, abdominal discomfort. Went to see the doctor the day after and he prescribed Flagyl antibiotics (500mg 3 x day for 10 days) and a probiotic. A week later I was still unwell although diarrhea had decreased/stopped, feeling weak, nausea, funny taste in mouth, and as told to continue the antibiotics. I'm now 9 days late and have no period, last period began on 18 March and had unprotected intercourse on 4th and 6th April. Clearblue test today was negative. I'm bloated, feel weak, no energy, abdominal discomfort and left ovary is hurting/aching, had 2 caramel spots in underwear today. Had ectopic pregnancy back in May 2011 hence no right ovary or tube, live embryo was 8 weeks growing in abdomen when removed. Should I get a blood test done to rule out pregnancy?
Submitted: 2 years ago.
Category: OB GYN
Expert:  Dr. C. replied 2 years ago.
Hi and welcome to the site. My name is***** and I'll be providing your medical information today.

Home urine pregnancy tests are VERY accurate. Even in the case of ectopic pregnancy they will be positive by 10-14 days after conception. Sometimes there can be false negative results very early in pregnancy if a woman has been drinking a lot of water and her urine is dilute. The safest thing to do is to repeat the test using urine first thing in the morning or after refraining for drinking for 8-10 hours. The urine should be dark yellow. Look for a test that is sensitive as low as possible. I believe Clearblue is sensitive down to 25 units which is pretty good. Blood tests are sensitive down to 5 units. But I've never seen or heard of an ectopic pregnancy that produced sysmptoms without having beta-HCG levels of at least 20 units.

More likely, the symptoms and skipped period are due to the stress of your travel and GI illness.

If you still feel concerned, a visit to an urgent care or emergency room for a pregnancy test is easy enough. But most gynecologists would feel quite confident that you're not pregnant with a home test done using the first urine of the morning and read at the proper time (usually 3 minutes).

But remember that the test will not turn positive until about 10-14 days after conception so it is possible that the skipped period is from the stress but if you've had sex within the past 2 weeks, could be pregnant from that and have a negative test still. I hope that's not confusing.

Stress from travel or illness can delay ovulation, cause a skipped period and throw the hormones off enough to cause a variety of symptoms, some of which are similar to early pregnancy.

The bot***** *****ne is that if the test is negative using first urine of the morning, the skipped period is not from a pregnancy if using a test sensitive to 20-25 units of beta-HCG.

Please reply if I can clarify anything or provide more details. I want to be sure you have the most helpful information for your situation.
Customer: replied 2 years ago.
Thank you, ***** ***** cause my ovary to ache and feel twisted, could it be a cyst, I have suffered with them previously on this remaining ovary when I had two rounds of ICSI last year. Can the bloating and abdominal discomfort through infection affect the ovary. I'm worried since my last ectopic caused internal bleeding for 3 weeks and nothing came out, it was only when they opened me up they discovered what had happened.
Expert:  Dr. C. replied 2 years ago.
Various things could cause that area to ache. For example, if stress caused a delay in ovulation, then yes a cyst would form since the egg didn't release. The other thing is that the ovaries are surrounded by bowels. So often, pain coming from the bowels feels like it's arising in the ovaries. The sensations can be very hard to tell apart. Bloating and abdominal discomfort in the bowels can cause the bowels to press on the ovaries as well.

But if the urine pregnancy test was done properly and is sensitive down to 20-25 units, it's not pregnancy related. Home tests are actually very accurate, more accurate than people realize. Just diluting the urine will cause false negatives. It's actually not possible to have a ruptured ectopic without a positive pregnancy test.

I hope this has been reassuring. Let me know if I can explain anything more completely for you. I want to be sure you have the most helpful information for your situation.
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