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Can stress actually impact pregnancy test results, causing false negatives? Although the test itself does not come under the influence of stress, it can have an effect on the reproductive hormones that affect ovulation and menstruation. This affects test accuracy as the proper timing for pregnancy testing is compromised. Learn more about the link between stress and false negative pregnancy test results as you read on.
Various aspects of our health can be affected by chronic stress, including metabolism, mood regulation, and hormonal balance. Thus, it’s easy to associate stress with getting inaccurate test results, even in a home pregnancy test.
False negative pregnancy tests, for example, are sometimes assumed to be connected to high levels of stress. However, there is no direct evidence that stress alone can cause a false negative. It can play a role indirectly through its impact on hormone regulation and the menstrual cycle, though.
For instance, when you experience chronic stress, your body releases high cortisol levels, the stress hormone released by the adrenal glands. Elevated cortisol may interfere with the balance of reproductive hormones (1). This interference may lead to the following:
When your ovulation is late, it may throw your assumptions regarding your menstrual cycle schedule out the window. Hence, even though you conceive successfully, implantation may not occur within your predicted timeline. This may lead to low levels of hCG on the expected date of your period. This will turn your test into a false negative if taken too early.
Did You Know? Human chorionic gonadotropin (hCG) is the primary hormone screened in a typical pregnancy test. While a urine home test is the most accessible and affordable option, an hCG blood test, especially the quantitative type, is deemed more detailed, increasing the rate of accuracy.
Stress can cause your cycles to be irregular, in turn making it hard to predict when to take the test with a high likelihood of accuracy. It can also bring about confusion, as irregular menstrual cycles may mimic some pregnancy symptoms (2).
Although often assumed to be a contributing factor, stress has less impact on false negative pregnancy test results than other conditions.
When testing for the presence of hCG, the hormone commonly screened in pregnancy kits, the urine sample has to be in an ideal state that allows accurate reading. Factors such as the following may impact the test itself and lead to errors, such as false negatives:
Testing too early, even if you have conceived, may not give enough time for the hCG levels to surge to detectable levels. Thus, this is considered the most common culprit for false negative pregnancy test results (3).
hCG levels may not be detected in urine until a few days after implantation usually occurs. This may span between 6-12 days past ovulation. Therefore, it is recommended that the best time for the most accurate results is at least on the first day of a missed period.
Drinking excessive fluids before the test can dilute your urine and impact the saturation of hCG, leading to a false negative. The American Pregnancy Association recommends using first-morning urine for pregnancy tests as it’s typically the most concentrated (4).
Conditions common in females, such as PCOS (polycystic ovary syndrome) or hypothyroidism, may lead to an irregular cycle. These conditions make the exact date of ovulation hard to estimate, which can result in false negatives if the test falls on the wrong date.
Some medications may interfere with the results of pregnancy tests. For instance, diuretics can increase the rate of urine production and might dilute the concentration of hCG in the urine (5). In turn, the test may appear negative when it is not, especially if taken too early in pregnancy. Disclose any medication you’re taking when consulting your doctor regarding your test result.
If you suspect that you are pregnant despite getting a negative pregnancy test result, it is advisable to wait a few days before you try testing again. This is especially the case with women who have an irregular menstrual cycle because their ovulation or implantation may vary, which results in low levels of hCG during the start of pregnancy. This will lead to a false negative pregnancy test result.
If the second test is negative and you still believe that you might be pregnant, it’s high time to consult your doctor. You will get more specific advice concerning your condition and medical history.
In addition, you may be advised to take a pregnancy blood test to get a closer look at your hCG levels. Pregnancy blood tests are usually more sensitive than a pregnancy urine test, especially early in the pregnancy.
Your doctor may also confirm other possible causes of your missed period or symptoms. Keep in mind that there is no better source of tailored and accurate information than a healthcare professional in such situations.
Also Read: HCG Pregnancy Tests: Blood Test vs Urine Test
False negatives, although possible, are not particularly common. Many home pregnancy tests boast that they are around 99% accurate when taken correctly and at the right time. Otherwise, false negatives may appear. If you believe you may be pregnant after getting a negative test result, try waiting a week and then retesting, or speak with your healthcare provider.
For your peace of mind, consult your doctor regarding having negative pregnancy tests despite experiencing common pregnancy symptoms, especially missed periods for a long time. Although it’s possible that this unusual condition is due to a false negative test, it may have other causes as well, which include stress that can affect the normal secretion of hormones. Your gynecologist can help correct these problems accordingly.
Carrying twins can sometimes cause false negatives, though these are rather rare. During early pregnancy, two embryos won’t stimulate the production of sufficient hCG to trigger the pregnancy test indicator. As the pregnancy progresses, hCG levels elevate. Thus, testing around this time will most certainly detect the pregnancy correctly.
While stress does not directly interfere with the result, it most often affects hormonal balance and menstrual cycles, which might indirectly result in a false negative test. If you think you are pregnant and it shows negative, then try again after a few days or have further confirmation from the doctor.
1 Giglberger M, Peter HL, Kraus E, Kreuzpointner L, Zänkert S, Henze GI, Bärtl C, Konzok J, Kirsch P, Rietschel M, Kudielka BM, Wüst S. Daily life stress and the cortisol awakening response over a 13-months stress period – Findings from the LawSTRESS project. Psychoneuroendocrinology. 2022 Jul;141:105771. doi: 10.1016/j.psyneuen.2022.105771. Epub 2022 Apr 19. PMID: 35489313.
2 Poitras M, Shearzad F, Qureshi AF, Blackburn C, Plamondon H. Bloody stressed! A systematic review of the associations between adulthood psychological stress and menstrual cycle irregularity. Neurosci Biobehav Rev. 2024 Aug;163:105784. doi: 10.1016/j.neubiorev.2024.105784. Epub 2024 Jun 29. PMID: 38950686.
3 Wilcox AJ, Baird DD, Dunson D, McChesney R, Weinberg CR. Natural limits of pregnancy testing in relation to the expected menstrual period. JAMA. 2001 Oct 10;286(14):1759-61. doi: 10.1001/jama.286.14.1759. Erratum in: JAMA 2002 Jan 9;287(2):192. PMID: 11594902.
4 American Pregnancy Association (n.d.). Pregnancy Tests. Americanpregnancy.org. Retrieved August 21, 2024, from https://americanpregnancy.org/healthy-pregnancy/are-you-pregnant/pregnancy-tests/
5 McCullar KS, Abbaspour S, Wang W, Aguirre AD, Westover MB, Klerman EB. Timing of diuretic administration effects on urine volume in hospitalized patients. Front Physiol. 2024 Jan 23;14:1208324. doi: 10.3389/fphys.2023.1208324. PMID: 38321985; PMCID: PMC10844419.
