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Heavy menstrual after tubes tied
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ncreel posted:
I had a baby 4 months ago and had my tubes tied, this is my second menstrual cycle, the first menstrual lasted about the same as usual, which was 3-4 days and not a heavy flow. My menstrual in the past has always been very light. I received my menstrual yesterday morning and it has been really heavy flow, i had to change my tampon every 1-2 hours and also a pad, this is my second day and it seems like it's a little lighter flow, but not much. My ob office is closed until Monday and just need to know if this is normal flow or should i go to the emergency room??? Please Help :crying:
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J_Harrison_Hohner responded:
Dear ncreel: You have at least two confounding factors going on. First you are still four months postpartum and may not have resumed regular ovulations. This can definitely prompt some variations in timing and amount of bleeding. Second you had the tubal ligation four months ago. A more distant possibility would be an infection of the lining of the uterus. I would urge you to contact your OB's office and report the heavy bleeding episode. If you have pelvic pain or a fever they will likely want to see you for an exam. They may also ask you to watch and wait through another cycle(s) whilst keeping track of the timing and intensity of the bleeding. If your bleeding continues in the amount of a fully filled maxi pad every 1 to 1.5 hours for six hours then you might consider calling your OB/GYN's office and talking to the MD taking weekend call. If no one is available to speak with you then urgent care or ER may be needed for that type of continued very heavy bleeding. Women with tubals often wonder what effect the surgery might have on their cycles. Here is a good citation from the National Library of Medicine site: N Engl J Med. 2000 Dec 7;343(23):1681-7. The risk of menstrual abnormalities after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. Peterson HB, Jeng G, Folger SG, Hillis SA, Marchbanks PA, Wilcox LS; U.S. Collaborative Review of Sterilization Working Group. Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341-3724, USA. Comment in: * N Engl J Med. 2000 Dec 7;343(23):1724-6. BACKGROUND: The existence of a post-tubal-ligation syndrome of menstrual abnormalities has been debated for decades. We used data from the U.S. Collaborative Review of Sterilization to determine whether the likelihood of persistent menstrual abnormalities was greater among women who had undergone tubal sterilization than among women who had not. METHODS: A total of 9514 women who underwent tubal sterilization and 573 women whose partners underwent vasectomy were followed in a multicenter, prospective cohort study for up to five years by means of annual telephone interviews. All women were asked the same questions about six characteristics of their menstrual cycles in the presterilization and follow-up interviews. Multiple logistic-regression analysis was used to assess the risk of persistent menstrual changes. RESULTS: The women who had undergone sterilization were no more likely than those who had not undergone the procedure to report persistent changes in intermenstrual bleeding or the length of the menstrual cycle. They were more likely to have decreases in the number of days of bleeding (odds ratio, 2.4; 95 percent confidence interval, 1.1 to 5.2), the amount of bleeding (odds ratio, 1.5; 95 percent confidence interval, 1.1 to 2.0), and menstrual pain (odds ratio, 1.3; 95 percent confidence interval, 1.0 to 1.8) and to have an increase in cycle irregularity (odds ratio, 1.6; 95 percent confidence interval, 1.1 to 2.3). Among women who had had very heavy bleeding at base line, women who had undergone sterilization were more likely than women who had not undergone the procedure to report decreased bleeding (45 percent vs. 33 percent, P=0.03). CONCLUSIONS: Women who have undergone tubal sterilization are no more likely than other women to have menstrual abnormalities. Yours, Jane


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