ask dr leigh: all about pregnancy tests
By | March 16, 2009
Q: It’s been a week now of being nauseous every day and particularly tired and confused midday, and two pregnancy tests that are negative. The nausea is not horrible, but it is constant. I’m getting a bit worried. I feel just like I felt when I was preggers, but with being on the pill to suppress my menstruation 24/7, I can’t use the missed period as an indicator of when prego tests should be accurate. I guess I am trying to figure out when to rule out pregnancy!
A: so many of us suppress our menses, due to endometriosis, migraines, etc, that this is, unfortunately, not an unusual problem. as you know, hormonal birth control has an inevitable tiny failure rate, even when used exactly as directed.
your physical symptoms may be reliable. they are thought to usually appear around 3 weeks after fertilization. the mayo clinic has an article about them here.
the common wisdom is that urine pregnancy tests become positive 2 wks after conception. however, “your results may vary” – a 2004 study in the journal of ob & gyn, looking at 18 brands of pregnancy test, with 5 different concentrations of urine, six times each, found that “at the time of the missed period… these tests would detect only about 16 percent of pregnancies.” false negatives are relatively common, in my experience.
most doctor’s offices just use similar urine pregnancy tests to screen for pregnancy. if you need to find out what’s going on as early as possible, you could get a blood test. you’d have to pay for for a clinic visit plus a lab fee.
if you are not in a hurry, you could wait a couple more weeks and try a home test, using first-morning (concentrated) pee.
so what would you do in the meantime? take good care of yourself! keep taking your birth control pills – there isn’t any evidence they’ll harm a fetus. i recently had a patient who was convinced she was pregnant, with sore breasts, nausea, and fatigue; she had several negative home pregnancy tests, and a negative blood test, too. during all this testing, she stopped using her nuva ring, out of fear it could harm a fetus – and guess what happened then? she’s due sept. first.
the nausea and fatigue you’re experiencing are annoying, and can really slow you down, but even if they’re not due to pregnancy, they’re also not likely to require medical attention. they could be caused by, for example, a mild stomach bug, stress, or post-stress letdown, etc… they’re likely to go away by themselves, either way, with self-care. you can treat them, as you know, with good nutrition, more sleep, moderate exercise, and a calm mind. you can take this opportunity to revisit your feelings about fertility in general, your body in particular, pregnancy, and birth – is the universe directing your attention in this direction for reasons other than purely physical? what are you learning from this crisis?
let me know how it goes.
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