Missed Period With a Negative Pregnancy Test

negative pregnancy test

Verywell / Katie Kerpel

Missing your period but getting a negative pregnancy test result can create troubling uncertainly: Are you pregnant or not? And if not, why haven't you gotten your period?

First off, don't panic. There are several reasons this may happen, including a false negative result. However, while true false negative pregnancy test results (that are done under optimal conditions) do occur, they are rare.

Some possible explanations for why your test is reading negative despite having missed your period include:

  • You are pregnant, but the pregnancy hormones haven't built up enough yet to be detected. 
  • You are pregnant, but the test isn’t working. 
  • You are pregnant, but something is wrong.
  • You aren’t pregnant, and your period is late for another reason. (This is the most common explanation. More on this below.)

The experience of getting a negative result when you otherwise expect a positive one can be stressful and emotionally challenging. The good news is that most of the time, your uncertainty will be resolved in a few days. You'll either get your period or you'll take another test and discover you are pregnant. Less often, it may turn out that something is wrong—but this is rare. Let’s look at all of the possibilities.

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A Positive Pregnancy Test: Now What?

False Negative Pregnancy Test

A false negative pregnancy test is when the test comes up negative, but you actually are pregnant. The most common reason for a false negative is that you took the test too early.

Even if your period is late according to your typical cycle, you may have ovulated later this month. It's not uncommon to occasionally have an off or irregular cycle. Additionally, your count of when your last period occurred could be a few days off.

No matter how sensitive the test, you won't get a positive home pregnancy test until enough days have passed since ovulation and conception and your body has had time to build up enough of the hormone the test detects.

If ovulation came later this month, you will need to test later. There are many reasons you might ovulate later than you typically do. 

Pregnancy tests look for the pregnancy hormone hCG, which increases as the pregnancy progresses. The range of normal hCG levels in pregnant women vary widely, so it’s quite possible your levels aren’t high enough yet, particularly if you haven't waited for your period to be truly late.

An early pregnancy test may pick up very low amounts of hCG. However, it’s possible you don’t have enough circulating hCG to get a positive result even on a sensitive test. This doesn’t mean anything is wrong. What’s important isn’t how much hCG you have, but how quickly your levels doubles and increases. (That can only be measured with a blood test.)

Another common reason for getting a false negative is not having enough hCG in the urine you test. Early on in pregnancy, you can dilute the hormone concentration in your urine if you drink a lot of water before testing.

This is more likely to happen in very early pregnancy when you take the test later in the day. The hCG concentration is higher when you’ve held your urine for a while. This is why it's recommended to take a pregnancy test in the morning.

Pregnancy Test Errors

A false negative can also occur due to test error. If you wait too long to read the results, you may get a false negative. That said, false positives are more common when reading a test too late.

Make sure you follow the directions of your particular pregnancy test. Read the result within the time window recommended to avoid confusion.

Another possible cause of a false negative is an expired test. Storing the test improperly (like in a damp, hot bathroom cabinet) can also cause it to malfunction.

Rare Causes of Test Malfunction

A rare, counterintuitive cause for a false negative is being too far along in your pregnancy. For example, if your period is months late, a pregnancy test may come up negative. This is called the variant hook effect.

The molecular structure of hCG changes during pregnancy. At-home pregnancy tests are intended for early pregnancy. As a result, they may not react with later forms of hCG.

Another unusual but possible reason for a false negative is if you’re expecting triplets or even twins. In this case, a false negative pregnancy test may be caused by what is known as the high dose hook effect. Ironically, unusually high levels of hCG can cause the test to give a false negative result.

A very rare cause of a false negative is if the hCG hormone in your body doesn’t react with the anti-hCG chemicals in the pregnancy test. If this is the problem, you may need to wait a few more days before you can get a positive result. Or, you may need to have a blood test.

In all of the above situations, a serum pregnancy blood test or ultrasound may be needed to confirm pregnancy.

If you still haven't gotten your period after a few more days, test again. If subsequent tests continue to show a negative pregnancy test result, consult your doctor for further testing.

Rare Causes of a False Negative

In rare cases, an ectopic pregnancy may be the cause of a false-negative test result. An ectopic pregnancy is when the embryo implants somewhere besides the uterus. This usually occurs in the fallopian tubes, but it can happen elsewhere in the body.

An ectopic pregnancy doesn’t develop the way it should and can not develop into a viable fetus. The placenta formation is delayed and this impedes the production of hCG. An ectopic pregnancy can be dangerous as it can cause the fallopian tube to rupture.

If your period is late and you are experiencing severe pain, contact your doctor immediately.

Ectopic pregnancies are rare—occurring in about 1 in 40 pregnancies—but they can be deadly. Of pregnancy-related deaths, 9% are due to ectopic pregnancy.

Another rare but worrisome cause of false negatives is gestational trophoblastic disease (GTD), more commonly known as a molar pregnancy. GTD is a rare type of tumor that forms from a developing embryo. In less than 1 in 100 cases, a healthy baby can form in a molar pregnancy. Usually, however, a molar pregnancy ends in miscarriage.

GTD causes extremely high levels of hCG. As mentioned above, elevated levels of hCG can throw off an at-home pregnancy test and give a negative result. GTD is a tumor, but it’s rarely cancerous. Treatment involves having a D&C. If pregnancy hormone levels remain high, chemotherapy may be needed.

Other Reasons Your Period Is Late

The most common reason for a late period and a negative pregnancy test is that your period is simply delayed this month...and you’re not pregnant. Having one or two irregular cycles a year is nothing unusual. There are a number of reasons this can happen, including:

  • Breastfeeding
  • Hormonal birth control
  • Illness
  • Poor sleep
  • Too much exercise
  • Travel
  • Very high stress

Lifestyle Changes

If excess stress or illness comes just before ovulation, it could throw off your entire cycle. If you’re breastfeeding and your cycle has recently restarted, you can expect your periods to be irregular for while as your body adjusts. This can make it difficult to know exactly when your period is late.

If you’re in your 40s and your period is late, you may be entering perimenopause. But don’t assume you can’t be pregnant. Test anyway!

Did you just stop birth control pills? Remember that birth control affects your natural cycle and impedes ovulation. After taking hormonal birth control, it can take a few months for your body's hormones to acclimate and normalize. It’s not uncommon for the first few cycles to be slightly irregular.

While it's a bit less likely, you can get pregnant in the very first month after stopping birth control. Don’t assume you can’t be pregnant. Test anyway.

Fertility Treatment

Another possible cause for an off-cycle is fertility treatment. If your cycles are typically short, fertility drugs like Clomid (clomiphene) may extend your cycle length. If you just went through an IVF, IUI, or injectable cycle, this can also throw off your expected period date.

You likely know when you ovulated if you were monitored during treatment. You can consider the “ovulation day” to be:

Count 14 days from whatever your “ovulation day” was. If 14 days haven’t passed, your period isn’t "late" yet.

Irregular Cycles and Amenorrhea

Pregnancy isn't the only reason you may not get your period for an extended length of time. While most women experience menstruation on a fairly regular schedule, for some, irregular timing is the norm, making it hard to know when a period is actually late. Other times women may miss a period (or more) altogether. The absence of menstruation is called amenorrhea.

What Is Amenorrhea?

The clinical definition of amenorrhea is not getting your period for three or more cycles in a row. This condition can come and go in a woman's life depending on multiple factors— most commonly, pregnancy and menopause.

Some other possible reasons for a late period—or for not menstruating for several months—include:

  • Being severely under or overweight
  • Breastfeeding
  • Chemotherapy and radiation treatments
  • Excessive exercise
  • Hormonal imbalance (like PCOS or thyroid issues)
  • Medications such as some antidepressants and blood pressure treatments
  • Problems with the hypothalamus or pituitary glands
  • Scar tissue in the uterine lining
  • Some forms of birth control (sometimes this is an intended result)

Don't assume that you can't get pregnant if you're not getting your period. Depending on the cause of your lack of menstruation, you could ovulate again at any time. Consequently, you could get pregnant and not realize it since you won't miss your long-lost period.

When to Call Your Doctor

If your period is one to two weeks late, and you still are getting negative pregnancy tests, a visit to your gynecologist for a pregnancy blood test is recommended.

If your periods are frequently irregular, talk to your doctor about when they’d like you to call. Depending on your circumstances, many doctors will want to induce a "period" if you go more than two or three months without menstruating.

Also, if your cycle used to be regular but has become irregular, or your periods are irregular for more than three months after stopping birth control, you should see your doctor. Irregular cycles can be a risk factor for infertility.

Call Your Doctor Immediately

Contact your doctor immediately and/or go to the emergency room if you have a late period along with any of the following symptoms:

  • Severe abdominal or pelvic pain
  • Nausea or vomiting
  • Fainting or extreme dizziness
  • Shoulder pain
  • Any of the above in combination with sudden vaginal bleeding

These may be signs of an ectopic pregnancy.

A Word From Verywell

A missed period combined with a negative pregnancy result can be confusing but there are a number of explanations. Most often, if you aren't pregnant, your period is just a bit late. If you are pregnant, it's likely you didn't wait long enough before taking the test.

Regardless of the cause, don't ignore worrisome symptoms. The sooner you get things evaluated, the sooner you can know what’s going on and receive proper treatment, if any is needed.

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Article Sources
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