Am I Pregnant? How to Know If You Should Be Worried

Your period is late.  The more you think about it, the more you convince yourself that you’re definitely pregnant. Even if your period isn’t late, the risk of pregnancy weighs on you like that bad hangover from last weekend.  Turn off “16 and Pregnant” because it’s not helping. But before you start confusing drinking too much the night before with morning sickness, and your undying need for a pint of ice cream with cravings, it’s best to know the facts. 

The symptoms of early pregnancy are extremely similar to the symptoms of your menstrual cycle, which is why you can’t be totally sure of either until you take a test.  Sore or enlarged breasts, bloating, nausea, and fatigue are all common to both.  Just because you really wanted those cheese fries does not mean you are three weeks along or eating for two (though if you really want them, go for it, girl).  It’s common for PMS to heighten your appetite, and believe it or not, worrying about pregnancy will only make it worse.  Stress can absolutely cause you to miss a period, so to avoid confusion, calm down.

To prevent any further freak-outs, here are eight sex scenarios that will help curb your nerves, rated on a scale from one to five—one being “chill out” and five being a potential Juno situation.  On the bright side, Ellen Page looks super cute with a baby bump, and you can always take a test or see your doctor to know for sure. 

I always use a condom, but my period is late.
Worry Level: 1

Our bodies don’t always run like clockwork.   Sometimes they miss the alarm, oversleep, and are late for class.  Just because your period is late doesn’t mean you have to worry as long as you’ve used protection.

“Only two out of 100 women whose partners use condoms consistently and correctly for a year will become pregnant,” says Dr. Vanessa Cullins, Vice President for Medical Affairs at Planned Parenthood Federation of America, who also explains that stress, illness, excessive exercise, and not enough food could throw off your menstrual cycle, causing your period to come late or not at all.

Condoms alone are 98-percent effective when used correctly; however, it’s possible for them to tear or slip off during intercourse.  This is why it’s a good idea to use a backup. If you’re worried that a condom isn’t enough protection or just want to ease your mind, add an additional method of birth control to your sex regimen, like the Pill. 

I don’t always take my pill at the same exact time.
Worry Level: Varying

At 10 p.m. every night, my best friend’s cell phone alarm rings. No matter where we are, she runs to the bathroom, rummages through her too-big purse to find her small pack of birth control, and takes her pill with a swig of water (or a vodka tonic if we are at the bar, though I can’t recommend that). If she misses her alarm or forgets her pills in another purse, she panics, whines, and makes us go home to get them.  Sometimes, I find myself wondering, “Why can’t she just take it when she gets home.  Does she really need to take it right then, at the most inconvenient time, when this totally hot guy just bought me a drink?”  The answer is sort of.

“Pills with estrogen and a progestin (combined hormone) need to be taken every day, but not necessarily at the exact same time every day,” says Cullins.  “Progestin-only pills have to be taken within three hours of the same time every day.”

A package of birth control pills contains three weeks of active pills and one week of reminder pills.  If you miss a pill, here’s what to do:

If you are taking a combination pill (progestin and estrogen) and...

  • Miss one or two active pills at the beginning of your pack, take the pill as soon as you remember, and take the next pill at the regular time.  Use a backup method of birth control for a week. 
  • Miss one or two active pills at any time other than the beginning, take the pill as soon as you remember, and take the next pill at the regular time. You do not need to use a backup.
  • Miss three or more active pills in the first two weeks of your pack, take the pill as soon as you remember, take the next pill at the usual time.  Use a backup method of birth control for a week.
  • Miss three or more active pills in the third week of your pack, throw the pack away and start a new pack.  You must use a backup method of birth control for a week.
  • Miss one to seven reminder pills, throw away the missed reminder pills and take the next pill at the regular time.  Since reminder pills do not contain hormones, you do not need to use a backup, but should continue to take the remaining pills to stay in the routine so you don’t forget it when it counts.

If you are taking the progestin-only pill and...

  • Miss your pill by three hours, take the pill as soon as you remember.  Take the next pill at the regular time, and continue to take the rest of the pack on schedule.  Use a backup method for 48 hours after taking the late pill.

I take the pill diligently, but don’t use condoms.
Worry Level: 2

Just because you can’t see it, doesn’t mean it’s not there.  Even if you are on the pill that gives you only four periods a year, as long as you take it diligently, you do not need to use a backup method of birth control to prevent pregnancy (STD’s, of course, are another story). 

On the other hand, the effectiveness of your birth control pill can be compromised by certain medicines, including antibiotics, St. Johns Wort, some anticonvulsants, some medications for mental illness, some medicines for HIV, and certain antifungals taken orally for yeast infections.

“Women who take these medications should check the package insert or talk with their health care providers or pharmacists for information specific to the medications they take,” says Cullins.

If you are on any medications that can compromise your birth control, it’s crucial to use a backup.

I’m on the pill, but I’ve gained weight, feel sort of sick, and am spotting.
Worry Level: 1

Nausea and weight gain are common symptoms of pregnancy, but what you may forget in the heat of worrying about your next period is that they are also common symptoms of, well, life.  A number of things could cause nausea or weight gain—a poor diet, PMS, stress, nerves, vitamins, and even a really, really bad date. While most women do not gain weight on the pill, putting on a couple of pounds can easily occur when you’re stressed out or not paying much attention to your diet or routine. It’s not necessarily an indicator of early pregnancy, as long as you’ve been taking your pill as directed.

“By the time a pregnant woman would experience weight gain and nausea, she would have missed having her period, which is a stronger sign of pregnancy,” says Cullins, also noting that some women do experience nausea in the first three months of using their pill, but it usually goes away after that.

Spotting is another side effect of the Pill.  Even if you are not on the Pill but spotting occurs, it is not necessarily implantation bleeding (spotting that occurs when a fertilized egg is implanted into the uterus).  There are many reasons for spotting including hormonal fluctuations, vaginal dryness, and more seriously, a miscarriage.

If you started to take the Pill and continue to feel sick past the first three months or continue to spot, consider talking to your doctor.  The pill’s side effects are different for every woman, and what might cure your best friend’s acne could cause nausea, spotting, and bloating for you.  

I’m a virgin, but we fooled around.

Worry Rating: 3.

Even though you haven’t taken the plunge into full-on sex, you still need to be careful. 

“If spilled semen got on [your] vulva or into [your] vagina, you could become pregnant,” says Dr. Cullins.
 
Though semen cannot swim through clothes and only has a lifespan of about an hour if it’s outside of the body, its lifespan greatly increases when it’s inside of you, so make sure it avoids all contact with your vagina.  Accidents happen, and if you have reason to worry, you might want to consider Plan B One-Step, an emergency contraceptive available that’s available over-the-counter if you’re over 17.  Plan B One-Step is one pill, taken in one dose.

If you’re not having intercourse, the risk of pregnancy is minimal, but you’re still at risk for sexually transmitted diseases as long as you’re sexually intimate with your partner.  This is why it’s important to make sure you and your partner are tested and use a condom, even for foreplay.

I used the pull-out method or had unprotected sex.
Worry Level: 5

Okay, it’s time to freak out.  There are lots of reasons why you could have had unprotected sex—you were drunk, you just like it, he pulled out, you were on your period so you thought you couldn’t get pregnant, you forgot to bring a condom, you were timing your schedule and knew you weren’t ovulating—none of these are good reasons.  If you’re not protected, and you don’t want kids, don’t have sex. Really, just don’t do it.  This is why:

A woman ovulates about two weeks after her period starts.  In other words, this is when the unfertilized egg travels from the ovaries to the uterus.  If it encounters any sperm while it’s in the fallopian tubes, you could become pregnant. If not, hello Aunt Flow.  Since sperm can live up to a week inside of you, and the unfertilized egg can survive up to two days after ovulation, you can become pregnant even when you’re not ovulating and even if you have not had sex during ovulation (like when you’re on your period). Pre-cum can frequently contain sperm, which is why the pull-out method is ineffective.

We’re human; our bodies don’t run on the same clock we set our watches to and things can always happen, so it’s important to always be prepared. 

“I was always really careful with my boyfriend, but on the Fourth of July things got a little crazy,” says Jessica*, a college student. “We had sex, and we couldn't remember if we'd used a condom or not. The next month, my period never came. I freaked out about it for weeks, afraid to admit pregnancy was a possibility by buying a test.”

Jessica finally caved and bought a test, which came up negative, but her period was nowhere in sight.

"I finally got my period three months later,” she says. “Turns out I wasn't getting it because of stress and not eating enough.”

When your parents send you off to college, you’re warned to always lock your dorm room door so someone can’t come in while you are sleeping, never walk alone late at night, and never take a drink from a stranger.  Unprotected sex is like the door you forgot to lock and that mysterious drink; despite the risk of pregnancy and your obvious worrying, you’ve potentially invited in dangerous STIs.

To protect yourself, always carry a condom with you if you think you are going to have sex and are not on the pill—this way, not having a condom is not an excuse. If you have had unprotected sex, take the morning-after pill, which is available at your local drugstore, Planned Parenthood, or even your campus’s health clinic.  This pill must be taken within 72 hours of having unprotected sex—the sooner the better.  If you have unprotected sex (or even might be having it in the future) it’s important to get tested and you might want to consider Gardasil, a series of shots that can protect against certain strains of HPV and cervical cancer.

What do I do now?
Thinking you are pregnant is one of the most nerve-wracking experiences someone can go through.  If you think you are, try your best to stay calm; did your nerves help you score that cute date or a good grade on that French test? Nope, you forgot all the things you were supposed to say. 

If you’ve exhausted your options (like you used a condom, it broke, and then you took Plan B One-Step) but are still worried, take an at-home pregnancy test. They cost between $10 and $20 and are available at your campus’s health clinic, local drugstore, or Planned Parenthood.  Bring a friend or your boyfriend for support if you are nervous, but remember you might get a false negative if you take the test too soon (like before your missed period depending on the test).  The First Response Early Result Pregnancy Test ($18.09 for two) was rated the best at home pregnancy test by CBS News because it can detect the smallest amount of pregnancy hormones and is easy to use.  If you are not sure how to read the test, here’s the deal:  if you wait the specified number of minutes, and a line appears across the screen, it’s positive.

Don’t panic if the test reads positive—false positives do exist.  Set up an appointment with your doctor immediately, and she can tell you for sure.  Planned Parenthood can fill in where your campus health clinic is lacking, though most campus health centers provide condoms, STI-testing and treatment, birth control, and even gynecological exams and pregnancy tests. Not only do they offer those things along with breast exams, pap smears, and HPV exams, but they also have information on all pregnancy options.  Some of them even offer prenatal care, make adoption referrals, and perform abortions.  To find a Planned Parenthood near you and make an appointment, call 1-800-230-PLAN or visit Planned ParenthoodRemember, to ensure a safe sex life, grab the bull by the horns and take a proactive approach.  Use protection (with a backup if you’re nervous) and get tested—and remember, no matter what the result is, you always have options.

Sources:
CBS News
Dr. Vanessa Cullins, Vice President for Medical Affairs at Planned Parenthood Federation of America
College girls from all over the country
Positive.org
Webmd.com