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March 17, 2010 9:40 PM   Subscribe

How do abnormal periods affect the timing/use of pregnancy tests? (Subtitled: should I be concerned for my girlfriend and I?)

General question: If a woman has abnormal periods for whatever reason, how does that then affect the usage and timing of pregnancy tests (which are generally administered during a specific window of time prior to a missed period)?

More specifically (long alert): my girlfriend has abnormal periods, most likely as a consequence of high stress from college. She had her previous period over a month ago, and the window during which her period for this month should've happened has come and gone. Because she's been away at school, I haven't had intercourse with her since January until two days ago.

Day 1: some intercourse w/o condom, no ejaculation. Day 2: lots of intercourse w/o condom, no ejaculation. I understand the risk of pregnancy without ejaculation is something like 4%, but, given her body clock, isn't it impossible to tell if she's missing a period just 'cause or if she's missing a period because of something more serious (read: baby)? Or, am I just panicking for no reason? I know that Plan B isn't something to just take thoughtlessly, so I'd like to know I have reason for alarm before we elect to buy it.

Thanks : /
posted by the NATURAL to Health & Fitness (23 answers total)
 
Yes, you have reason for alarm. Yes, be concerned. You're having unprotected sex! Get Plan B, and for god's sake buy some condoms while you're there.
posted by sallybrown at 9:47 PM on March 17, 2010 [4 favorites]


As far as I know, the timing of her periods should in no way affect a pregnancy test, which is sensitive to a specific protein that is only present in urine during pregnancy.
posted by coppermoss at 9:55 PM on March 17, 2010 [1 favorite]


I am totally confused by your timeline. So this unprotected sex happened two days ago? If that's the case, pregnancy tests won't tell you squat, irregular periods or not. The problem here isn't that her periods are irregular or missing or whatever, since they would also not be affected two days after intercourse. The problem is unprotected sex, which you need to knock right the hell off if you're not wanting to become parents. Go get Plan B. You can't wait to miss a period or have a positive pregnancy test before you take it; it needs to be taken within 120 hours, and preferably within 24.

I don't mean to be harsh in saying this, but you seem woefully under-informed about conception and contraception. You need to get this cleared up pronto.
posted by LittleMissCranky at 9:57 PM on March 17, 2010 [9 favorites]


Plan B is most effective within 72 hours. Get it now.


Home pregnancy tests only work once enough hCG shows up in the bloodstream- which won't even start until implantation, which will happen up to a week or so after fertilization. (I'm not totally sure of when the hormone levels are high enough for currently available home pregnancy tests to detect them). But it doesn't matter; Plan B works in part by decreasing the odds of implantation.

Short version: you can't wait for a test to be effective. Get Plan B now.

And yeah, it's not something to be taken lightly; so if you don't mind being pregnant, well, don't take it. And yeah with the condoms. Oh, and yeah with the it sucks, so you should be around to help care for her if she gets crappy side effects.

Also a word for your girlfriend: hormonal b.c. has its problems, but one of the frequent benefits is regulation of an unpredictable cycle. There are many many options, including a ton of different pills, the patch, the ring, Depo-Provera, etc. If her university doesn't provide access to well-woman exams (they should) then Planned Parenthood exists for a reason. If she hasn't gone in already because she's worried about parents/anyone else knowing she's sexually active-- well, her unpredictable cycle can be reason enough for any inquiring minds.
posted by nat at 10:00 PM on March 17, 2010


Women can get pregnant roughly seven days a month -- five days before ovulation, and two days after. (If you're trying to get pregnant, it's three days before and one day after, but best to be on the safe side if you're trying to avoid.) The time in between ovulation and menses is called the "luteal phase"; most women have a luteal phase of between 10 and 16 days. 14 is the average.

The efficacy of a pregnancy test actually has nothing to do with the timing of your period, but rather the timing of your ovulation. Virtually all pregnancy tests are accurate 12-14 days after ovulation and later; most "early response" tests are good 10 days after ovulation, and a couple of super-early brands CAN show a positive even earlier than that. The reason that the box talks about days relative to a missed period is that most women don't know when they ovulate.

It is very uncommon to have a big variation in luteal phase length without there being a solid underlying reason, like taking fertility medications or something. It is much more common to have a variation in ovulation date. So really, your chances of pregnancy here depend on whether she's actually ovulating or not -- irregular periods can also be a sign of anovulation.

Either way, if the expected date for her period has been and gone, it's probably too late for Plan B; ECP needs to be taken within 5 days of intercourse, and 3 is better. If you take an early pregnancy test 14 days after the suspicious intercourse, you can trust the results. And if you would be anxious enough to avoid pregnancy to take ECP to make sure, for God's sake use a condom or some other form of birth control. This is triply important if her cycles are irregular.

Either way, pick up a copy of "Taking Charge of Your Fertility," for more information on how she can track her ovulation.
posted by KathrynT at 10:05 PM on March 17, 2010 [3 favorites]


It is way too early for a pregnancy test to be at all useful. However, you and your girlfriend have been engaging in some extremely high risk behavior. You don't want babies and you've been having unprotected sex and so you need to get to a pharmacy and get Plan B.

Also, holy shit, wear a condom. Alternatively, get tested with your girlfriend and then get on some damn birth control. Or you know, your girlfriend should start planning on dropping out of college. Saving up for some onesies. There's a reason why there are like a hundred million after school specials about the perils of relying on pulling out: it doesn't work.
posted by Tha Race Card at 10:06 PM on March 17, 2010


her unpredictable cycle can be reason enough for any inquiring minds.
Ah, I realize I should have been more careful-- for any inquiring minds except her doctor. She needs to tell the doc the truth, but absolutely no one else needs to know.

There's a reason why there are like a hundred million after school specials about the perils of relying on pulling out: it doesn't work.

Plus it's no fun (well, not as an always thing). This is a fixable problem, so fix it.
posted by nat at 10:10 PM on March 17, 2010


Here, read this Scarleteen article on pregnancy testing.

Your girlfriend needs emergency contraception, and you need to keep educating yourself on safe sex practices and resolving to use them when you have sex. It's awesome that you came to the hive mind and asked, but we can't do all your reading for you. Start with Scarleteen and move on to books like the above-recommended Taking Charge of Your Fertility, get some condoms, and work out an approach that works for the two of you without compromising your health or your relationship.
posted by fairytale of los angeles at 10:13 PM on March 17, 2010


Let me amend my previous statement about it being too late for ECP. If you had sex a couple of days ago, then yeah, get Plan B. How irregular are her cycles anyway?
posted by KathrynT at 10:18 PM on March 17, 2010


Everyone stop with the "OMG, you're irresponsible" crap. If you're just concerned with pregnancy prevention, it's simply not true. Withdrawal is almost as effective as condoms, and this holds true for typical as well as perfect uses for both.

If you're worried about pregnancy, she can take a test. You can test fourteen days after the sex in question, no matter what kind of periods she has.
posted by Violet Hour at 10:21 PM on March 17, 2010 [3 favorites]


One more thing (man I should be better organized!) to be sure you know: Plan B is USELESS after a positive pregnancy test. It won't do anything to end a pregnancy, it will only prevent one.
posted by KathrynT at 10:32 PM on March 17, 2010


I know that Plan B isn't something to just take thoughtlessly

I'm not sure what you mean by this. Are you worried about it making her nauseous? It's basically a bigger dose of the Pill, not an abortion pill like some people claim.
posted by emilyd22222 at 10:56 PM on March 17, 2010 [1 favorite]


The emergency contraceptive pill can have pretty unpleasant side effects. Specifically, it can cause violent nausea. Except, can't actually vomit for at least an hour (the version I once took said four hours) or your body won't absorb all the medicine. And then you'll have to take it again. It's not fun.

Having said that, if your girlfriend might be pregnant, and she does not want to be pregnant, she should take Plan B RIGHT NOW. Don't even hesitate. Get thee to a pharmacy, stat. Since you are both equally responsible for her pregnancy scare, you get to spend the next 36 hours bringing wet cloths for her forehead and holding back her hair as she hurls.

Once she feels human again, you two can have a chat about how you're going to start using contraception.
posted by embrangled at 12:56 AM on March 18, 2010


While Violet Hour may have referenced one person who agrees with her theory, most people don't. Withdrawal is NOT an effective birth control method.

According to Planned Parenthood, condoms are roughly twice as effective as withdrawal, both of which are less effective than the pill.

Also, n-thing that Plan B will not terminate a pregnancy, it will only prevent one.
posted by indienial at 4:37 AM on March 18, 2010 [1 favorite]


Also, Plan B may not have noticeable side effects. Just depends on the taker.
posted by chesty_a_arthur at 5:15 AM on March 18, 2010 [2 favorites]


More specifically (long alert): my girlfriend has abnormal periods, most likely as a consequence of high stress from college. She had her previous period over a month ago, and the window during which her period for this month should've happened has come and gone. Because she's been away at school, I haven't had intercourse with her since January until two days ago.

Just a note that while some doctors might call a longer cycle abnormal, it's not, always. I'd really recommend a copy of Taking Charge of Your Fertility so that you can both better understand her cycle, combined with some sort of charting, if she's not already. After I went off the pill, I was initially a bit freaked out that my cycles came once ever 35 days or so, rather than once every 28 days. But a few months of charting showed me that that's normal, for me--which helps me not stress every. single. month. when my period is "late."

A 4% risk means that one out of every twenty five couples is going to become pregnant using withdrawal as birth control. Is this an acceptable number for you? It wouldn't be for me, and I'm older and married! Yes, get emergency contraception if sex was only two days ago, but more important, start using some sort of contraception--particularly if you or your partner hasn't been tested for STDs yet.
posted by PhoBWanKenobi at 5:38 AM on March 18, 2010 [1 favorite]


Mrs. Advicepig had a very irregular cycle, and we'd have freak outs on both our parts repeatedly even though we were using condoms. Hormonal birth control has really saved our sanity. Partly because you don't worry about it having unnoticeable punctures, and partly because her cycle has become like clockwork. It also lessened her cramps.
posted by advicepig at 7:02 AM on March 18, 2010


Aside from echoing what everyone else has said here about being more responsible with contraception, I'd like to particularly put a spotlight on you, the guy. Why is it that you're engaging in sex without a condom, yet you're considering some form of (emergency) hormonal birth control for her? That could lead to less-than-fun changes in her body and how it works, even for only a day or two.

Never mind the fact that if your non-method slips up, however much you might profess to support her, she's the one who gets to modify her behavior, barf all the time and carry a bowling ball insider her for most of a year, even before the worries of choosing how the resulting baby might be raised.

Contrast that with the MINISCULE commitment it takes for you to cover your wang, including the fact that you can make that decision in a matter of seconds and have no lingering effects once the deed has been done, and that's not really a fair trade, is it?

ARGH. PEOPLE.
posted by Madamina at 7:03 AM on March 18, 2010 [2 favorites]


PhoBWanKenobi, condoms also carry a 2-3% failure rate, even when used perfectly.

I use withdrawal as my only method of birth control, but my partner a) knows what he's doing, b) is very good and very careful, and c) is very practiced. I've never really had a pregnancy scare, but then again, I track my cycle with FAM so I know when I'm fertile, when I'm not, and when I should be expecting my period depending on when I ovulated.

Withdrawal is, essentially, as effective a birth control method as condoms. Pre-ejaculate has been shown to contain NO sperm. Withdrawal done poorly is, of course, a recipe for disaster, as is any kind of imperfect use of birth control. This is obviously only reflective of pregnancy prevention, not STD prevention.

The NATURAL, calm down, take a deep breath. Are you positive that you did not ejaculate inside her, or near her? If so, it's likely that she's not pregnant. Her cycle length this month, though, suggests that she ovulated late, if she ovulated at all, which ups the risk that you might have had unprotected sex while she was potentially fertile. That's no good, especially if you're not in any way an expert at the withdrawal method.

It's been too long, IMHO, for Plan B to give you any peace of mind. The effectiveness thereof drops rather sharply after 72 hours, unless by "two days ago" you mean you last had unprotected intercourse yesterday, in which case, go go go to a pharmacy and get the pill. It might have side effects, keyword: might but they're mild and you'll be able to feel a little more relaxed.

If her period still doesn't come in the next week, she should take a pregnancy test. Repeat as necessary, until period shows, her OBGYN figures out if there's an issue, or, god forbid, she discovers she's pregnant (IMHO, extremely unlikely). Use a method of birth control you are BOTH comfortable with in the future: withdrawal does not seem to be it.
posted by lydhre at 7:08 AM on March 18, 2010


PhoBWanKenobi, condoms also carry a 2-3% failure rate, even when used perfectly.

Sure, but that's still halving your risk. Condoms also have the benefit of protecting from STDs and can be reassuring psychologically--while practice can improve success rates with most birth control (but particularly condoms and withdrawal), with condoms you're not relying wholly on skill during a heated moment. It sounds like OP and his girlfriend need psychological reassurance of some sort.

Pre-ejaculate has been shown to contain NO sperm.

This is true--however, sperm can stay in the ducts and urethra after ejaculation, and OP had at least one instance of repeated sex this weekend. If you're relying on withdrawal solely, be sure to pee and wash up between the time when you ejaculate and go at it again.
posted by PhoBWanKenobi at 7:31 AM on March 18, 2010


(Oh, and the failure rate for imperfect use of withdrawal? 27%, as opposed to 15% for imperfect use of condoms. That's a large margin of difference, though using either improperly is risky [cite].)
posted by PhoBWanKenobi at 7:34 AM on March 18, 2010


lydhre: "PhoBWanKenobi, condoms also carry a 2-3% failure rate, even when used perfectly.

I use withdrawal as my only method of birth control, but my partner a) knows what he's doing, b) is very good and very careful, and c) is very practiced. I've never really had a pregnancy scare, but then again, I track my cycle with FAM so I know when I'm fertile, when I'm not, and when I should be expecting my period depending on when I ovulated.
"

If you're using FAM, you're *not* using withdrawal as your only method of birth control, particularly if you're using FAM to predict fertility and avoiding intercourse during that time. I've used FAM to both avoid and achieve pregnancy, but when I really didn't want to get pregnant, but didn't want to give up intercourse during fertile periods, I used a reliable form of birth control, like condoms.

Withdrawal alone fails twenty seven percent of the time - that's a 1-in-4 chance of becoming pregnant in a given year; realistically, how many people truly fall into the "perfect use" group? In teens (and I suspect the NATURAL is at least on the borderline of being in that group), the failure rate increases to thirty-one percent. Is that risk, particularly when becoming pregnant is at stake, really worth it? Get a box of condoms. And use them.

Meanwhile, the NATURAL, your girlfriend should test in about 14 days; if that's negative, one more test a week later should confirm that she isn't pregnant.
posted by Lulu's Pink Converse at 9:14 AM on March 18, 2010 [2 favorites]


Nnthing the suggestion for Taking Charge of Your Fertility. Every woman should know when she's most fertile and it's really easy to chart and kind of fun to know exactly when you are most fertile and exactly when to expect your period.

Urine pregnancy tests really aren't accurate until just before your expected period or 14 days after ovulation, basically.

Interesting fact: if you are several *months* pregnant (you'll know you're pregnant by then if you know your body at all, you'll often be showing), you will test *negative* because the hormone that is tested for is not measurable by then. However, you are still pregnant, of course-- but this can be a problem for people who don't realize that they are pregnant right away and test after the time when the tests are accurate. That's a false negative that can really be a problem!
posted by Maias at 10:11 AM on March 18, 2010


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