Subscribe to our newsletter
I have no periods but a negative pregnancy test
Although a major sign of pregnancy is amenorrhoea, this may be related to something other than pregnancy. Similarly, a negative pregnancy test does not mean that there is no pregnancy. It is common for a pregnancy test taken too early to be negative. Therefore, it is important to consider several parameters and follow different paths to determine what could explain amenorrhoea without pregnancy or the false result of a pregnancy test.
What is amenorrhoea?
With each menstrual cycle, the body of a woman who has reached puberty prepares for a possible pregnancy by producing different hormones with specific roles. The gonadotropins (FSH and LH) stimulate the ovaries to produce oestrogen, androgen and progesterone.
These hormones produce the following effects:
- The endometrial cells proliferate.
- The dominant oocyte matures, is released and the corpus luteum is formed.
- The endometrium changes through decidualisation and prepares to receive a fertilised egg.
In the absence of fertilisation, the production of oestrogens and androgens decreases. The endometrium detaches from the uterine walls, and menstruation begins. In a normal cycle, menstruation occurs 14 days after ovulation.
Amenorrhoea can be simply defined as the absence of menstruation in a woman of childbearing age. Two main types of amenorrhoea exist: primary and secondary amenorrhoea. Primary amenorrhoea is the absence of menstruation from the age of 15 in a woman with normal growth and secondary sexual characteristics.
Secondary amenorrhoea is the absence of menstruation for a period of three cycles after the occurrence of regular menstrual cycles. Determining secondary amenorrhoea in a woman depends on the regularity of her menstrual cycle. For a woman with an irregular menstrual cycle, assessment for secondary amenorrhoea begins after an absence of menstruation of approximately 6 months.
What are the causes of amenorrhoea?
The first and most frequent cause of amenorrhoea is pregnancy. In a fertile woman with regular periods, the absence of menstruation immediately suggests pregnancy. Thus, it may appear strange to have a negative pregnancy test when you are experiencing secondary amenorrhoea.
However, secondary amenorrhoea can be caused by several factors related to the physiology and psychology of the woman suffering from it. Among these causes, we can cite the following:
- Discontinuation of contraception: After stopping oestrogenic contraception, it is common to experience amenorrhoea that can last for months. This is due to the hormonal changes occurring when the pills are stopped and a transition occurs to natural production of oestrogen and progesterone. The transition can last several months and lead to irregular cycles.
- Early menopause: Early menopause is the permanent cessation of menstruation in a woman before she is 40. Secondary amenorrhoea caused by early menopause can be confused with pregnancy-induced amenorrhoea. Blood tests are necessary to confirm the diagnosis.
- Breastfeeding: This is called lactational amenorrhoea or post-partum amenorrhoea. This is anovulatory amenorrhoea; menstruation is absent because the ovaries do not produce fertilisable oocytes. The child's suckling leads to nipple stimulation, which acts on the hypothalamus-pituitary axis, resulting in the absence of ovulation.
- Surgery on the uterus or abortion: Voluntary termination of pregnancy may cause secondary amenorrhoea for some time. The same applies to uterine surgery. When the abortion is medicated, it usually takes 4 to 6 weeks before periods return. If amenorrhoea occurs following uterine surgery, it is best to consult a doctor quickly.
- Stress: Stress, anxiety, a violent psychological shock or a state of depression can cause an absence of periods. In this case, we refer to amenorrhoea of psychological origin. Gonadotropin production is controlled by the hypothalamus and pituitary gland. These two parts of the brain can be influenced by the brain regions where emotions originate. When these areas are disturbed, it is possible to observe prolonged absence of menstruation.
Is it possible to have a negative test while pregnant?
It is possible to have a negative test during a pregnancy. Pregnancy tests are not 100% reliable, and it is possible to have a positive pregnancy test when you are not pregnant or vice versa. Pregnancy tests are based on a detection mechanism for the pregnancy hormone (beta-HCG hormone). The corpus luteum starts to secrete this hormone after implantation of the fertilised egg (about 7 days after fertilisation). Certain antibodies react to the presence of this hormone in the urine through an immunological process. If the HCG level is not sufficiently high in the body, it is difficult to detect, and the test gives a negative result even though there is a pregnancy.
The main reason for this is the timing of the test. If you take the pregnancy test at the beginning of the pregnancy, the HCG hormone may not be detected by the device. Moreover, the test may give a false result simply because it has reached its expiry date or has not been stored properly. It is therefore advisable to consult a doctor for confirmation. Generally, a negative test does not necessarily mean there is no pregnancy.
How should a pregnancy test be taken to ensure its reliability?
It is important to take certain precautions to ensure the reliability of a pregnancy test.
First, you should read the instructions carefully and follow them exactly. Generally, pregnancy tests are easy to use, and the instructions are clear. To ensure the reliability of your pregnancy test, you should perform it in the morning when you wake up, as morning urine is more concentrated in HCG. Therefore, it is easier to detect the hormone.
Patience is also required to optimise the reliability of pregnancy tests. The longer the amenorrhea state, the higher the level of HCG in the body. An early pregnancy test reduces the chances of a reliable result.
