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"What could a missed period, PMS-like symptoms, but multiple negative pregnancy tests mean?"
I am 33 years old, came off long-term birth control pills in January but have been having surprisingly regular periods since then (28-30 day cycle), though I do have a history of irregular periods. My current period is 5 weeks overdue but all pregnancy tests have come back negative. I have PMS/pregnancy-like symptoms, including: moodiness; weight gain/trouble losing weight despite working out and decent nutrition; terrible, painful acne that is refusing to go away (I always have bad skin but normally Proactive at least makes some differences if I use it diligently; now it makes no difference at all other than completely drying out the little bit of acne-free skin I have left on my face); oily hair; no discharge for the most part, though occasionally clear, stringy discharge for a few days. Could this be a thyroid issue or is pregnancy still a valid option despite the negative pregnancy tests?
There are several possibilities for the symptoms you are describing. One possibility is that you're pregnant, though you're right that most home pregnancy tests these days are very sensitive and should detect the pregnancy within 8-10 days after conception. If you think there is a serious possibility that you are pregnant you should see your doctor and get a confirmatory pregnancy test there. There are also several possible hormonal causes for the symptoms you're describing. Low thyroid could certainly cause weight gain, irregular periods and low energy. Another possibility is an increase in androgen hormones, which could be caused by a condition called polycystic ovarian syndrome (PCOS); interestingly, this is usually treated with birth control, so if you've recently stopped birth control you may be seeing more of those symptoms. There are also other conditions that cause elevated androgens and may be worth getting tested for. It is also possible that you are having irregular periods for other reasons (stress, weight gain, other medications). I would strongly recommend you see your doctor to get a pregnancy test and discuss these symptoms. Your doctor can best recommend if any further work-up is necessary based on your discussion and your physical exam.
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