Periods Intolerable Since Tubal Ligation

September 19, 2022 Response by  

Question

I am 32 years old and live in Nebraska in a small town where there isn’t a single OB GYN that uses NAPRO technology. I have been having issues for some time now, and all they want to do is put me on birth control pills. I think that is going to just cover up the problem rather than take care of it. So, I am hoping you can help me.

Let me start from the beginning….

When I was in high school, about the age of 14, I was sent home from school because I was on my monthly cycle, pale in color, had cold sweats, low blood pressure, and I felt like I was going to faint. Since that time, it has only happened 1-2 times more.

When I was 18, I had my first son, I was put on birth control pills after that. The pills regulated and shortened my period. My flow and everything was the same every month. Then, I lost my healthcare and couldn’t afford the pills, and my cycle went all out of whack. I started having brown discharge for a few days after my cycle was over,also my sexual desire declined dramatically. That wasn’t much of a problem, so I just dealt with it. Then, I had my youngest son, and because I always have said that I only wanted two kids, I had my tubes tied (not sure if it was a tubal ligation or tubal occlusion). Since then I have had severe cramps every month (which get worse each time), my flow has changed (before, I would have heavy flow only on the second and third day; now I have heavy flow the second, third, and fourth day), the brown discharge starts about a week before I start my monthly cycle, then I have my cycle, then brown discharge after my cycle for about a week, and my sexual desire for my husband is still down. My monthly cycle this month is the worst it has ever been. I was nauseated, and had loose stool the first few days, as well as very severe cramps all the way through the fifth day. I am hoping you can help me, I don’t know what else to do.

Answer

If you do not have many resources this is what I would do to help the premenstrual spotting and pain with your periods.

See if you can learn a method of NFP and identify ovulation. Then for ten days each month you will use a medication to raise your progesterone for ten days, in the premenstrual period. Use one pill a day starting three days after ovulation and finish twelve days after ovulation. The best pill would be progesterone 200 mg, used vaginally. Have your doctor write a prescription for thirty tablets of 200 mg progesterone. It will be good for three months, and with three refills enough for one year. If you cannot identify ovulation, use the progesterone from day 18-27 of your cycle.

For pain with your period I would get prescription Naproxen 500 mg or over the counter Aleve. Use this twice a day from the very beginning of your period through the end.

I hope this will help you.

Mary Davenport, MD