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Missed periods after tubal ligation. What should I do?

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I am 43 years old and had a tubal ligation approximately 16 years ago at the age of 27. I have missed my period this past month and still had the symptoms I normally have just not bleeding...this is the 2nd time this has happened in the last 18 months or so...
Posted Sun, 11 Nov 2012 in Menstruation and Miscarriage
Answered by Dr. Asra Ishtiaq Ahmed 1 hour later
Hello there.

Thanks for writing to us.

The reason for missing a period are many but considering your history I feel in you it is due to perimenopause.
Perimenopause or menopause transition is a condition that begins several years before menopause, when the ovaries gradually begin to produce less estrogen. It usually starts after 40 years of age. The average length of perimenopause is four years, where in you can have symptoms like menstrual irregularity, delayed periods, hot flashes, breast tenderness, worsening of premenstrual syndrome( mood swings, irritability, bloating, fatigue, cramps ), vaginal dryness, discomfort during sex, urinary complaints like stress incontinenece, Mood swings and difficulty in sleeping.
I would like to know if you have any of these as diagnosis of perimenopause is based on your symptoms. Blood tests to check hormone levels may also be beneficial, but they may be difficult to evaluate due to erratic fluctuations of hormones during this period. Ultrasound can show thinned out endometrial lining.

Menstrual irregularity should alarm you when your periods are very heavy, or accompanied by blood clots, your periods last several days longer than usual, you spot between periods or you experience spotting after sex or your periods occur closer together as they indicate abnormal bleeding. Also if you miss your periods for 12 months at a stretch and then start bleeding again , it is considered abnormal.
Potential causes of abnormal bleeding include hormonal imbalances, pregnancy, fibroids, blood clotting problems or rarely cancer.

The treatment to have periods in perimenopause is to use a progesterone tablet for withdrawal menses. This has to be taken only after visiting a gynecologist for a physical and XXXXXXX examination and after an ultrasound report.

I hope I have answered your query.

Take care.

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