Women's Health Community

Dear Elizabeth: Thanks for writing. I would really doubt if your symptoms are arising from "post-tubal syndrome". If you have any possible risk of pregnancy, that is the first condition to be assessed. Even reliable contraceptive methods such as birth control pills, and tubal ligations can fail. So it is important to get a pregnancy test done first. This is especially important in your case as you are having pregnancy signs AND a missed period for past two months. A woman who has had a tubal is a great risk (if the tubal fails and she conceives) of having it be an ectopic/tubal pregnancy. Hopefully your test was a recent one and reliable.

If the pregnancy test is negative then the next most common cause of a missed period is not having ovulated that cycle. In a normal cycle, estrogen is produced all month. Estrogen is responsible for building up the lining of your uterus so you have something to shed each month.

In a normal cycle, progesterone production increases following ovulation. Progesterone "stabilizes" the uterine lining in preparation for a possible implantation of a new pregnancy. If you are not pregnant that month the levels of estrogen and progesterone fall, triggering the release of the uterine lining—your period. So, if you do not ovulate, the estrogen build up of the lining continues, but without the usual ovulation associated progesterone. Thus, the hormone levels don't decline, and the lining stays up inside the uterus—your missed period.

If you have been several months without a period, a gynecologist may give you some progesterone in a pill form (eg Provera 10 mg for 5 days). Within 48-72 hours after stopping the progesterone your "progesterone blood level" will fall, triggering the release of the lining that has been building up. Many women report that these periods are very heavy-- as though several months of lining are shed.

Causes for not ovulating are multifold: thyroid problems, pituitary problems, ovarian cysts, physical stressors (eg sudden increases in exercise, crash dieting), emotional stressors (problems with parents or boyfriends/girlfriends, finances), increased body weight, anorexia, rotating shifts at work, etc.

Generally speaking the nausea and vomiting of pregnancy are presumed to start about four weeks from conception. Some other causes of nausea and vomiting are viral, or bacterial, infections in the bowel. Appendicitis, or problems with the gall bladder or pancreas, can provoke nausea. Neurologic conditions such as migraine headaches or increased intracranial pressure can induce nausea. Even severe emotional or physical stressors can make one queasy. Less common are the psychiatric causes including anorexia, bulimia, and anxiety disorders.

Fatigue is also one of the most common symptoms for a myriad of medical conditions as well. Infections, anemia, electrolyte imbalances, low thyroid, diabetes, MS, cortisol abnormalities, cancer, depression, stress, and a variety of medications have all been linked to the symptom of fatigue.

Given the severity of your symptoms you should be checked out (including a repeat pregnancy test). Here is a link to locate low cost healthcare centers in your local area:

http://findahealthcenter.hrsa.gov/Search_HCC.aspx

Yours,
Jane

I had a tubal gation done 17 years ago and I'm experiencing lower back pain that's unmanagable,sex hurts because I can feel pressure or clamps feel like they are being touched. I am having heavy periods each month with terrible stomach and back cramps. I've been to my doctor concerning these issues and they only gave me an ex-ray on the lower part of my back. Obviously, more tests need to be performed to detect the problem but they won't do it. I feel like it has a lot to do with recieving medicaid for my healthcare insurance. This issue has been going on for a year and I don't know what else to do.

These could be symptoms of Post Tubal Ligation Syndrome - http://www.tubal-reversal.net/post-tubal-ligation-syndrome-ptls-symptoms.htm

Someone recently posted here that her doctor removed the "filshie clips" used for her TL because they "have been known to cause pain in some women." Here's that discussion - http://forums.webmd.com/3/gynecology-exchange/forum/27261

Sorry for your troubles!

I would recommend having a hep c test done or a thyroid test.

Go to the er they can not refuse your care.