WOMENS-HEALTH Messages for August, 2000: Re: Post Tubal Ligation Syndrome

Re: Post Tubal Ligation Syndrome

From: D. Ashley Hill, MD (anonymous@obgyn.net)
Thu, 31 Aug 2000 22:56:36 -0500 (CDT)

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Previous message: Robin: "Re: I've got a diagnosis..alllergic reaction post..."
In reply to: Martha2Mary: "Re: Post Tubal Ligation Syndrome"

At Thu, 31 Aug 2000, Martha2Mary wrote:

>Putting all that aside, do you have any suggestions on how my problems
>can be best treated? So far I have tried some kind of hormonal pill that
>I had to start on day 19 (?) of my Cycle, and take 3 times a day for 7
>days, which did lengthen my short cycle, but was too cumbersome in that
>it had to be started on a specific day and taken three times a day. Six
>weeks ago, on the advice of my GP, I went on the Depo Provera injection,
>as I was told that this may balance my hormones a bit, but as I sit here
>and type, I have been bleeding for the past 3 weeks, and cramping off
>and on during that time. So far, that is not working....

In general, the evaluation for irregular menses involves blood work (thyroid and prolactin levels) and, if these are normal (which they usually are), a prescription for the birth control pill. This usually works. Some women, however, will not respond to this. In those cases it might be useful to look inside the uterus, either via a saline vaginal ultrasound or via hysteroscopy, to rule out a polyp or fibroid as the source of heavy and irregular bleeding.

In my experience depo-provera is one of the worst medications to give when evaluating/treating a patient with irregular menses. Nongynecologists seem to love the stuff, but most gyns I know would prefer to prescribe medications that are shorter term, so that they can be discontinued if they don't work. One of the most common side-effects of depo-provera is daily spotting, caused by an endometrium that is too thin. Treatment is by a 7-10 day course of estrogen pills, which usually stabilizes the uterine lining. After that most patients will respond to birth control pills with excellent results. Good luck with everything.

--
David Ashley Hill, MD
Associate Director
Department of Obstetrics and Gynecology
Florida Hospital Family Practice Residency
http://home.cfl.rr.com/dahmd

My apologies, but due to time constraints I am unable to answer private e-mails.

Previous message: Robin: "Re: I've got a diagnosis..alllergic reaction post..."
In reply to: Martha2Mary: "Re: Post Tubal Ligation Syndrome"

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