Brief Answer: Detailed answer below. Detailed Answer: Hello XXXXXXX and welcome, It seems that you have severe abdominal pain followed by mild bleed and the periods. This time you had an irregular period. You want to know if there is any possibility of pregnancy. The only issue that I am not sure about is why you think you cannot have kids. Are you not active sexually or use contraception regularly. Kindly clarify on this. As of now: there are a few ways to diagnose pregnancy: 1. urine or blood tests 2. examination by a doctor and hearing the babies heart beat 3. ultrasound visualization of the baby The common symptoms are missed periods, nausea, vomiting and frequency of urination. You are not having any of these. There is a condition called chemical pregnancy where blood tests are positive but no signs are there as it is too early and then an abortion occurs just at the time of the expected period. So pregnancy may not be detected by symptoms. In your case, the only way to know it is get a blood pregnancy test done just before the next expected period or at the time of symptoms to see if there is a pregnancy. Other reasons for pain and bleed are fibroids [ common non cancerous uterine tumors], cervical or endometrial polyps [ caused due to excess estrogen hormone], adenomyosis [ enlarged uterus due to in growth o fits lining], pelvic infections, ovarian tumors, endometriosis [ uterine lining is shed inside the abdomen and cause pain. Non gynecologic causes are also many ranging from gastroenteritis, appendicitis, kidney stones and so on. So you will need to see a doctor and get an examination, it would be preferable if you go when the symptoms are severe. An ultrasound will help to rule out the cause along with examination findings and then proper treatment can be started. I understand that you are in pain and also worried. Please do not worry as these causes are common and can be treated. Hope this satisfies your query. Thanks for using HCM. Feel free to ask any more questions that you may have. Dr Madhuri Bagde Consultant Obstetrician and Gynecologist

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Brief Answer: This episode may be a miscarriage Detailed Answer: Hello and welcome back, The chances that it is a miscarriage are low but not zero if you have been sexually active and not used contraception. I am not sure about what happened 4 weeks ago, was your periods due at that time and was MISSED and then you had bleeding after 2 weeks for 7 days? In this case a miscarriage cannot be ruled out. But it will hold true for only this episode and the earlier ones are not explained by this. A blood HCG test will help in this case if done early [ as it seems that already it is more than 7 days since the bleeding stopped so levels may have gone down]. If you have never missed your periods [ you have said that for the past year you had similar episodes but periods were regular] then chances of it being an miscarriage are very low. The only chance is a chemical pregnancy or if the periods were confused with implantation bleeding that occurs during periods. I have already said that there is a condition called chemical pregnancy where miscarriage occurs before the periods are missed. So it may fall in that category. The only way to know this is by a blood test for HCG level. If these are raised then it is likely to be a pregnancy and abortion. However it is rare for repeated abortions to occur and the patient not being able to recognize it. So this is the reason I am also thinking of other possibilities than abortion like fibroids, polyps etc. A blood HCG test and ultrasound will clear all the doubts and help determine the cause. The reason I advised a blood test at the time of symptoms is that you mentioned that the pain was 4 weeks ago then 2 weeks later bleeding for 7 days. So it seems that now since 7 days no bleeding. Hence blood test may come negative even if there was a pregnancy if the abortion was a complete one. So kindly see a doctor, discuss all the issues and then get tests done. Please feel free to ask if you are not able to understand some points as the explanation is fairly prolonged as the history is peculiar. Hope this answered the query, I am here to help if there are any more questions. Dr Madhuri

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