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What Causes Delay In Periods Post Non Penetrative Sex?

Posted on Mon, 24 Nov 2014

Question: Hello Doctor. My friend's periods were due on 23th. Its been 10 days now but they haven't happened. We are both worried if there's a possibility of pregnancy. We had non-penetrative sex on 14th. There was no contact between sexual organs as such. I might have had some pre-ejaculate which touched her lower buttocks. Being paranoid, she rushed to washroom and washed it off with plain water. We have been in relationship for 4 years but no sex as such. Her hymen is still as it is, we never had any penetrative sex. Besides, she is having a little tender, a little swollen breasts than usual. She's has been off appetite for past couple of days, but does not have any nausea, constipation or frequent urination. Also she has been under quite a stress lately because of studies. At the same time, she had highly varying sleeping schedule last month, sometimes depriving sleep too much and sometimes sleeping a lot. Now, we're really scared. We did two home preg tests (Elder and Piramal, one on 31, other on 3rd-today) but both turned out to be negative. She's afraid to visit a doctor. I fear she's taking a lot of stress as a result. We dont know what to do. Please guide.

Answered by Dr. Nirja Chawla (2 hours later)

Brief Answer:
Pregnancy unlikely. Maybe hormone related.

Detailed Answer:
Hello XXXXXXX
Let's place the facts together:
1. Period delayed by 10 days.
2. Sexually active but the activity is essentially foreplay with no sec organ contact. subsequent to semen on buttocks, washed off immediately.
3. Pregnancy test on 3rd is negative.
I presume this was done on first morning sample of urine. If not, then please do so.
Most likely it will be negative.
Just in case it's positive you will need to get a Trans-vaginal ultrasound to confirm pregnancy, check age of pregnancy and rule out tubal pregnancy. Then decide whatever you wish to do in consultation with your local doctor.

4. Hypothyroid. Late or delayed periods could be connected to this medical disorder. Therefore check FT4 and TSH values by a blood test to see if hypothyroid is under good control or not. Your friend may need to have her dose titrated by her doctor to achieve control.

5. The mention of stress- stress is one of the biggest causes of delay of menstrual period. You may be aware of the delay in periods near exam times. so it could be just nothing other than an episode of delayed period due to current stress which will sort out.

6. Check breasts for nipple discharge. If it's there it could mean a hormonal problem. This is very common. Nothing to be alarmed about. However, it will warrant a visit to your local doctor.

7. Breast soreness usually indicates the presence of a hormone after egg release. It's possible that there is an impending period - i.e. a period is going to come over next few days. Then all sorts out anyways. It will still be a delayed period. So you will need to work on the guidelines above to determine the cause.

Hope this answers your queries and gives you guidelines on how to proceed. Relax. Even the worst is not the end of the world.
Take care.

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Nirja Chawla (2 hours later)

Yes Doctor, the tests were done with the first morning urine sample, both times. She even drank very less water the previous night to ensure higher concentration.
She has been having loss of appetite for 3-4 days and mild acne breakout for some time. Is it normal? Though there has been no fatigue, dizziness, nausea/morning sickness or any spotting.
Before seeking your advice, I had tried surfing online for answers. I was barged with information like, negative home preg tests are unreliable, pre-ejaculate can lead to a pregnancy etc. Is it a cause for worry?
Do we really need to take a blood test (PAPP-A) or the one you talked about, even though home tests gave negative result? Should we wait and take home preg test again after some time?
Her TSH levels are under control as per tests done in last month. And, there has been some discharge from breasts. It happens before her menstrual cycles sometimes.

[I missed out on some points related to her medical history mistakenly. I have added them to the history. Please check.]

Answered by Dr. Nirja Chawla (7 hours later)

Brief Answer:
pregnancy kits are very reliable

Detailed Answer:
As I stated in my brief answer, home pregnancy testing kits are very reliable and can pick up pregnancies sometimes even before the missed period

Above answer was peer-reviewed by : Dr. Bhagyalaxmi Nalaparaju

Follow up: Dr. Nirja Chawla (19 hours later)

Alright. Thank you Doctor. There's another development. My friend noticed some bleeding today. She thought it might be the onset of her cycles. But it was very little, appeared like spotting. Should we be worried?

Answered by Dr. Nirja Chawla (17 hours later)

Brief Answer:
Further work up should be done.

Detailed Answer:
No, XXXXXXX this spotting of blood is nothing to worry about. It may mean the start of a period as I thought may happen over next few days. She did complain of pre-menstrual symptoms like soreness of breasts.

My suggestions now with this further development:
1. Tomorrow morning or latest day after morning - 6th or 7th morning, empty stomach, get the following tested in a blood sample - FT4, TSH, FSH, LH and Prolactin. Review the reports with your doctor.

2. Between 10th to 13th November get a transvaginal ultrasound to rule out Poly Cystic Ovarian Syndrome, which is an important cause of delayed periods.

3. Always keep a menstrual record of the start dates of periods.

Review with your doctor with the above reports who will also examine for excessive hair growth, Breast discharge, weight, height and Blood Pressure.
All the best. Regards.
Dr Nirja Chawla

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj

Follow up: Dr. Nirja Chawla (2 days later)

Thank you very much Doctor. Your advice has been really helpful. Her periods did start as you had said. We plan to get the tests done soon to diagnose the problem. :)

Answered by Dr. Nirja Chawla (4 hours later)

Brief Answer:
Best wishes...

Detailed Answer:
Take care....

Note: Revert back with your gynae reports to get a clear medical analysis by our expert Gynecologic Oncologist. Click here.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari