“Missed period?”

Dysfunctional uterine bleeding. Seek gyn if continues for 3 mths

It is difficult to tell what is going on but you need to be seen. You can either go to emergency department or GYN.

This is a common issue that many women have happen; what is usually means is hormone imbalance due to not ovulating the month before. It may also mean Estradiol dominance or ‘E’ dominance which means you are making more Estradiol than Progesterone which by definition is hormone imbalance. Many doctors are not aware that they can check your blood levels of these 2 hormones and then know exactly what is happening so that they can help guide you as to what to do about it; they will simply tell you to take pain medication for the cramps, prescribe anti-nausea medication and maybe even order a pelvic Ultrasound (lots of $). Now, a pelvic Ultrasound may tell you about an ovarian cyst (E dominance) or uterine fibroids (E dominance) pressing against other parts of your lower pelvis. Or you may be offered birth control pills to override your abnormal periods; but since you already have had a tubal ligation, you may not want the side effects of the birth control pills (depression, weight gain, acne). And know that you could have this occur again because you are heading toward your 40’s which is perimenopause time when hormone swings are more common and abnormal periods are more common than uncommon. But the only way to know how to manage this time is to check your hormone levels. Ask your doctor to check d21 bloodwork of your cycle (day 1 or d1 is the first day of your bleed) for Estradiol, Progesterone, Total and Free Testosterone. I also go into more detail about the bloodwork you need and more in my book, Full Bloom, Perimenopause, Menopause and Beyond which is available on Amazon. You need to understand what your body is telling you; and knowledge is power, so don’t be afraid to ask for blood testing to help you understand what your body is telling you.

Dr. Victoria J. Mondloch