Does A Missed Period Mean You’re Pregnant?

Is it possible to have a missed period but get a negative pregnancy test? Does it truly mean you’re not pregnant even if you are having symptoms of pregnancy?

First thing to know is that although this can be distressing; there are only two real possibilities. In the presence of a missed period and negative pregnancy test, either you truly aren’t pregnant or you are pregnant and the test is wrong. 

If you’ve missed a period then the first step is to determine whether you are truly pregnant in the absence of a positive pregnancy test. 

Can I still be pregnant if the test is negative and no period?

Yes it is possible that you may still be pregnant with a negative pregnancy test. Sometimes you can have what is referred to as a false negative. Meaning that you are in fact pregnant and the test is incorrect. This can occur only under certain conditions. 

Cause(s) of a negative pregnancy test but a positive pregnancy are the following: 

1. The test wasn’t conducted under optimal conditions.
   • Meaning you may have taken the test too early in the pregnancy (i.e. before the pregnancy hormone hCG can be detected) 
   • You didn’t do the test properly (i.e. drank too much fluid & diluted your urine and/or didn’t use the 1st urine of the day)

2. The pregnancy test you used was expired or not stored at an ideal temperature.
3. There may be something else wrong [i.e. like the hook effect or you have an ectopic pregnancy that gives a negative test result (seen in 1% of cases)].

If you are having symptoms of pregnancy but keep getting a negative test result, make an appointment to see a primary care physician.  

Cause of a missed period and negative pregnancy test

If you are not pregnant, then the question becomes why is my period late? Or why did my period come 2 weeks late?

There are many possible causes for missing your period beyond the possibility of being pregnant. And the 9 most common causes for missed and/or delayed period are:

1. Travel
2. Breastfeeding
3. Illness
4. Stress
5. Poor Sleep
6. Strenuous Exercise
7. Dramatic Weight Fluctuations
8. Medications
9. Medical Conditions

1. Travel

Travelling can delay ovulation and change your menstrual cycle both before and after an expected period.

But do you know why?

It’s actually due to stress. Afterall not all vacations are stress free. Sure you may be at peace while on vacation but the process to get to and from your destination is not always as peaceful.  

Stress hinders the normal hormonal balance resulting in fight or flight (no pun intended) response. This fight or flight response during stressful times is actually a protective mechanism in acute circumstances. 

Researchers note that disruptions in your cycle helps prevent a pregnancy during an uncertain time (i.e. during periods of acute stress such as flying or traveling). 

2. Breastfeeding

Prolactin, which is the hormone that produces milk while breastfeeding, prevents a woman from ovulating thereby naturally stopping periods. However, not all women may experience this. Some women get their periods irregularly resulting in a missed period from month to month.

3. Illness

It may be surprising to know that an illness (like a cough, cold or fever) can cause a late or missed period. 

This is mainly because your body is using all its resources to conquer the illness which can be stressful. 

This hormonal imbalance signals to your body to delay ovulation to avoid pregnancy during a suboptimal time.

4. Stress

Stress is mediated by the release of cortisol (the stress hormone). When stress is high, it’s because cortisol levels are high. And when cortisol levels are high, estrogen levels are generally lower. This results in delayed ovulation causing a delayed or missed period.

This happens because cortisol and estrogen come from the same building block (or precursor) – cholesterol. So when all the cholesterol is used to produce cortisol during stressful times less estrogen gets produced.

5. Poor Sleep

Disturbances in sleep and/or having poor sleep hygiene can negatively impact hormone production. Women with delayed sleep phase syndrome for example, commonly report irregular cycles.

Aim for 7-8 hours of good quality sleep every night to combat negative effects such as menstrual irregularities.

6. Strenuous Exercise

Working out too much can actually negatively affect your health. It can put unnecessary strain on your body leading to muscle strains, sprains or other types of overuse injuries. Plus it can also cause delayed or missed periods resulting in what’s referred to as exercise induced amenorrhea (no periods). This becomes even more pronounced in those who are of low BMI (i.e. less than 18.5). 

The amount of exercise that can cause a missed period differs from woman to woman. But 2 hours a day without the proper fuel can be hard on the body.

7. Dramatic Weight Fluctuations

As mentioned above, women with a BMI of 18.5 or less may suffer with what is known as anovulatory cycles. This means that they do not ovulate resulting in missed and/or absent cycles. 

Losing weight rapidly can also cause a missed period as your body adjusts to the hormonal changes taking place. 

Being overweight or obese can also result in a delayed or missed period. It affects your menstrual cycle because of increased body fat stores leading to a hormonal imbalance. You may also produce more estrogen the heavier you are resulting in irregular periods.

Note that it is also possible to be of a normal BMI and still miss a period if you diet and/or change your eating habits regularly.

8. Medications

Certain types of medications like birth control pills, blood pressure pills and NSAIDs can all affect your menstrual cycle. 

They can cause missed or delayed periods as well produce lighter cycles. 

Speak with your doctor if you are experiencing this while on any of these medications.

9. Medical Conditions

Chronic conditions like diabetes or celiac disease can lead to delayed or missed periods. Other conditions such as thyroid disorders and PCOS (polycystic ovary syndrome) also cause late or missed periods due to hormonal imbalances.

Note that there are plenty of reasons why missing your period does not have to cause worry. For example if it is due to travel or an acute illness. Once you come back from travel and get back to your regular routine, your period will also likely become regular. Same with an illness. Once it’s resolved, your period should go back to normal.

It is not bad if your period is 2 weeks (even 3 weeks) late. Especially if this is the first time it’s ever happened. It is more of a concern once it starts to become a pattern.

The best thing to do is to work with your doctor to figure out why your period was late or why you missed it completely.

How many days after a missed period should you worry?

The number of days after a missed period that could be a cause of concern really depends upon if you’ve been sexually active or not. 

If you’ve not been sexually active, then it’s best to figure out what the cause of your missed period is to help alleviate some worry. Work with your doctor to figure out why you are having a delayed and/or missed period.

If however you have been sexually active and are concerned about a pregnancy, then it’s best to take a pregnancy test to rule it out. 

When to take a pregnancy test after missed period

For a sexually active individual, the best practice would be to take a pregnancy test 1-2 weeks after a missed period. This time period will allow for hCG levels to build up in your body and be detected in the urine. And it will help avoid a false negative result which can occur in early pregnancy.

For women who have regular cycles which are very predictable, they can try to take the test 1-3 days after their missed period. 

But once again, to err on the side of caution, best to take a test 7 days after your missed period.

How long after the missed period can you test negative?

Generally the length of time between a missed period and a positive pregnancy test will differ from women to women. Some women may be able to take a test 1 day after their missed period and get a positive result. And some may not even test positive until 3 weeks after.  

But on average most women test positive 7 days after their missed period. 

Meaning they can still test negative 6 days after their missed period!

How common are false-negative pregnancy tests?

Pregnancy tests were first introduced in 1976 and they’ve evolved a lot since then. Nowadays many pregnancy tests claim to be 99% accurate and some claim to be able to detect pregnancy as early as 1 day after a missed period. 

But as discussed above, there are reasons why a pregnancy test can still give you a false negative result.

Researchers determined that upto 5% of pregnancy tests can give you a false negative result.

How do you treat a late period? 

If you’ve taken a pregnancy test and it’s truly negative, having a missed period may still be of concern to you. This is especially true if you have a regular, uncomplicated cycle.

The treatment will depend upon the cause of the missed and/or late period. 

For example, if it was due to stress then you may want to examine why you’ve been more stressed over the past month. Then figure out ways to better cope with the stressors you encountered (i.e.try  journaling, meditate, practice yoga, engage in more self care activities etc.).

Another example could be from medical conditions such as hypothyroidism. It can cause your cycle to become irregular and you may end up missing a period. In this instance, you would need to see a doctor so that they could properly diagnose you. 

Note whenever you are in doubt to speak to your doctor. And to remember that experiencing one to two irregular periods in one calendar year is not unusual. It does not indicate that something is wrong or that you should be worried. Instead take a deep breath and figure out what the cause of it may be.