Dr. Robert W. Vera, M.D.

https://www.cdc.gov/ncbddd/folicacid/about.html

This link should answer your question.

Dr. V

This is a common problem. Menstrual problems like the one described is usually diagnosed as dysfunctional uterine bleeding and the cause is usually anovulaton. To be brief, the timing mechanism for regular timely periods is ovulation. If there is no or irregular ovulation, the periods are irregular, light, or sometimes very heavy. Anovulation has various causes and the patient would need an exam and laboratory work up in order to find a cause. Anovulation, if left untreated for months to years, can be dangerous as it can stimulate abnormal cell growth in the uterus and this could lead to precancerous or cancerous changes.

There is not enough information to make a diagnosis. Likely causes:

1. Anovulation...a common hormonal aberration that causes the ovary not to ovulate, thus preventing normal menstrual cycles.
2. Complications from the tubal ligation...causing adhesive disease that may cause sticking or binding of the intestines causing cramps and pain.
3. Pain and cramps could be caused by pelvic infection.

Again, there could be other explanations, but there is not enough information here to make a diagnosis.

I do not have the statistics at hand, but a number of pregnancies start out as twins and only one survives to term. A twin may be “absorbed” by the mother’s body very early in the first 3 months of pregnancy. This situation is not uncommon. Genetic abnormalities occur more frequently in twins and this may be one reason why one twin does not go on to survive. There may be other reasons. This can be followed by ultrasounds to give you more information.

This is Dr. Robert W. Vera. I am a gynecologist. Menopause in the United States occurs at age 51. Still having periods at age 53 is not common, but it occurs. Saying this, the periods in the perimenopause should not be characterized as you have described, that is, hemorrhage with passage of clots and associated with pain. This is abnormal. Hormones may be a part of it, but there may be other associated problems. These may include fibroids (i.e., iomyomas), endometrial polyps, and/or cancer (endometrial cancer or cervical cancer). A diagnosis must be made. This should start with a good pelvic examination, possible ultrasound of the pelvis, pap smear or biopsy of the cervix, and an endometrial biopsy. Most of these, except, perhaps, the ultrasound, can be done in the gynecologist's office. I would not hesitate in getting all this done. In the meantime, I would go to the pharmacy and ask the pharmacist for some good over-the-counter iron pills you could start taking daily to help avoid severe anemia, which would complicate your care, especially if you need surgery. Again, do not hesitate in finding a good gynecologist or gynecologic oncologist in your area and setting up an appointment within a few weeks.

Because the menstrual cycle is dependent on your overall health as well as reproductive issues, there are many conditions that can affect it. Delayed periods are usually a hormonal problem, usually because the ovaries are not ovulating. Not ovulating, again, can be caused by a number of issues and some of the more common ones are being overweight, being underweight, thyroid problems, increased prolactin (a hormone that can be abnormally produced), and stress. Of course, the most common reason for not having a period is pregnancy, but you seem to have ruled that out. I would see your doctor to see if any of the other issues I mentioned may be in play.
Other issues involve genetics and without more information or an examination, I can't really address this.

Doxycycline, Vibramycin brand name, can be given for infections of the cervix, which is in the vagina. Also, glands like the Bartholin’s gland, is slightly in the vagina, and if infected may respond to Doxycycline. Infections of the cervix that may respond to Doxycycline include gonorrhea and chlamydia. Vaginal infections caused by bacteria generally respond to different antibiotics like Flagyl, generic name Metronidazole.

Maybe the reagent on the test strip is old. Try again in a week with a new testing product.