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There is still a risk of pregnancy even if ejaculation doesn't occur inside the vagina. Pre-ejaculate fluid, also known as "pre-cum," can still contain sperm and lead to pregnancy. Get a test done to confirm about pregnancy.

If a person has symptoms such as tiredness, nausea, and breast tenderness because they missed a period then she can be pregnant and this would mean that the egg has attached itself to the lining of her womb. One should confirm this by testing using their early morning urine sample since it is more concentrated thus likely giving correct results.

You might be suffering from Polycystic Ovary Syndrome often mentioned as a possible cause of irregular or missing periods and pain in the lower abdomen area. One of the most common symptoms of PCOS is pain, as well as irregular periods. This is caused by the imbalance of estrogen and progesterone, some hormones that the ovaries produce. For the treatment of PCOS, engage in exercise, lose weight, and follow a healthy diet.

External hemorrhoids or piles can occur during or after pregnancy due to the increased pressure on the rectal veins and hormonal changes. Hemorrhoids often improve with time and self-care measures such as a high-fiber diet, hydration, and creams. 

No, TB tests and X-rays are not the methods used to detect pregnancy.