Apr 9, 2020 6 min read

Q. I have a problem. I have a girlfriend at school. We live in different states and our college closed for the semester because of the pandemic. Yesterday, she called to tell me her period is 3 days late. She always starts on the Tuesday of the fourth week of her cycle. We were really, really careful. I don’t understand how this could be. I know there are failure rates for birth control and condoms, but if you use both, shouldn’t that increase your odds of protection? Plus, she’s really, really fit. She exercises all the time and her body is healthy. Shouldn’t that help?

I can’t go to her and she can’t go to me. Her dad does all the shopping so she can’t tell him she wants a pregnancy test. She can’t even tell him she needs sanitary napkins or tampons. Her family doesn’t talk about things like this. My family is so open. My mom is supporting me right now, not judging me.

How can I help her? I want to marry her someday. If she’s pregnant, my mom says she’ll help us raise the baby and we can stay in college. I know it would be tough, but I wouldn’t mind having a baby with her someday. Just not now.

19-year-old

Mary Jo’s Response: One of the many challenges through which I’ve supported young adults is a pregnancy scare like the one you describe. You were right to reach out. Let’s consider possibilities before you begin planning for a future that may not happen.

I’m fairly confident you’re aware of the way bodies work, but I’m going to review some basic facts for you.

One of the signs of pregnancy is a late or missed period, true, but there are other reasons for a delayed cycle.

1. Miscalculation: A healthy period cycle is 21 to 35 days. That’s a wide range. You mention your girlfriend’s period starting on the Tuesday of the fourth week of her cycle. I’m afraid the day of the week is probably just a coincidence. Menstrual cycles are not calendar bound. In other words, the cycle follows the rise and fall of her hormones and responds to the chemical signals given to her body.

The first day of a period is called “Day One.” By counting off the days and looking at patterns, a person can make an intelligent guess about when next period will start. Most conception, when an egg is fertilized by a sperm, happens 12 to 14 days before the next period. This is tricky. Since biology textbooks say periods are 28 days apart, many people assume days 12 through 14 of the cycle – right in the middle – are fertile days. It’s only after the next period begins that an ovulation time, when the egg is released, can be ascertained.

She may simply be off a few days by an inaccurate account. Her period may not be late at all. Keeping a record of each cycle is important. Most people’s cycles are not perfect 28-day cycles.

2. Stress: Stress can throw off hormones. A change in daily routine, a major life event, or any other stress can alter a cycle and make a period late. I’m guessing your girlfriend is stressed – not only did she need to leave your college abruptly because of an unprecedented shut down over a pandemic, she is forced to return to a home where she feels unable to express herself. Every fall I receive frantic texts from former high school students whose periods are late because of the adjustment to their first year in college.

3. Weight: A more than 10% drop in healthy weight for your girlfriend’s body could alter her cycle. Extreme exercise can also stop or delay periods, although that is rare in a person with a typical exercise regimen. Being fit and healthy are not methods of birth control.

4. Birth Control: You don’t say what type of hormonal birth control your girlfriend uses. If she started something like an estrogen/progestin birth control pill in the last six months, her cycle may be irregular. Other types of birth control, like an implant or an IUD, can also cause missed periods. She should connect with the health care provider who prescribed the birth control.

You ask if using both condoms and hormonal birth control increase the odds of protection. Of course. When I taught in the Netherlands, the young people there called choosing both methods of protection “Double Dutch.” You’re correct, there are failure rates for any contraceptive, but it does sound as if you’ve been careful. If you used both methods correctly, the chance of a pregnancy is small.

Your separation probably adds to any stress she’s feeling. I’m sure she’s anxious. I wish she could talk with a trusted family member. I’m pleased your mom is supporting you, which allows you to support your girlfriend.

Since your anxiety – and hers – is so high, taking a pregnancy test might help. You could also wait a bit.

It sounds as if purchasing a test for your girlfriend might be a challenge in the midst of this pandemic. Does she have local friends who could buy her one and leave it in a safe place?

Once she takes the test, she may still need support, even if its negative. She may be anxious until her period starts. Give her my cell number. I will be happy to talk with her. Please keep in touch. One way or the other, you sound like a mature person. Try to relax and be calm for yourself and for her. Good luck.

Have a question? Send it to Dr. Mary Jo Podgurski’s email podmj@healthyteens.com.