Although we started with tubal ligation, we will proceed with this health education in a systematic fashion. The reason we wrote about tubal ligation before anything else is because we received most of the queries pertaining to tubal reversal, the symptoms and other associated areas.

We have decided to cover the vast area of menopause in various educatory sessions in a similar manner and hope to satisfy the curiosity of our loyal readership.

Comprehending Menopause

More than anything else, women need to learn about menopause in a much more detailed way than ever before. Even their male counterparts need to know about this so that they will understand what it is that women must endure.

Menopause is mandatory. Whether you like it or not, it is going to happen. It is nature’s way of relieving the women of their childbearing labor and giving them official rest. You can choose to enjoy this phase of your reproductive life, or worry endlessly because of countless unanswered questions.

Rather than avoiding discussing it, menopause should be embraced with an open heart and mind.

Clinical view of Menopause:

The verbatim definition for a layman:

Menopause is “the permanent cessation of menstruation, occurring usually between the ages of 45 and 55”.

A clinical definition of menopause which you all should know is:

Menopause is one day- the date when 12 months have gone by since your last period.

When you hear people around you, saying that X or Y is going through menopause, what they are actually referring to is perimenopause. Perimenopause is truly the span of transitional years around the last period ever, both before and after. Perimenopause can be understood in 2 phases.

1. Pre-Menopause
2. Post-Menopause

Together, they can be referred to as perimenopause or as the general public sticks to saying, menopause.

Around what age is usually perimenopause and menopause expected?

Where majority of the women undergo perimenopause between 45-55 years of age, variants have been noticed. We have seen as young as 34 and as old as 64 to undergo perimenopause, however such cases are rare.

When explaining about a medical condition such as menopause or perimenopause, we usually stick to the normal age range of the state, and hence in this case we will talk of the 45-55 years bracket.

Exactly how do I know I am in the brackets of Perimenopause?

If you are above 40 years of age, are experiencing a marked difference in your usual menstruation pattern and are having the trademark “hot flashes” and night sweats, it is highly probable that you have entered the perimenopause.

Do not account mood swings for the diagnosis since they alone are a highly undependable factor and have a multifactorial origin.

Is there any way I can delay it?

Menopause is nothing to be ashamed of, or to be delayed. It is as natural a change as menarche, the onset of menstruation. You only need to take care of yourself and your body. This change is important since as you grow older, your body loses the kind of power and energy required for carrying a pregnancy as well as a laborious child birth.

You may hear all sorts of false suggestions to delay menopause, like hysterectomy, tubal ligation, tubal reversal, or hormonal therapy, but this is inevitable and should be anticipated and prepared for, instead of against.

Embrace it instead of fearing it.

Vaginal atrophy can affect women of all ages but it is more common that women between the ages of 40 to 59 will suffer from dryness, itching, and burning related to vaginal atrophy. In the top ten afflicting problems of menopausal women, this is often at the top of the list. It is not expected or predictable. Vaginal dryness is because of many reasons. In younger women, dryness can be caused by birth control pills, surgical treatments (like cystectomy or tubal ligation), emotional issues, and multiple other medical conditions.

Vaginal dryness is often experienced when there is a lack of vaginal lubrication, often caused by a lack of estrogen production. Some will develop female sexual dysfunction which can cause one to dread intercourse and to avoid sex. Intercourse can be very painful. These women may also experience libido problems as well. Hormonal imbalance is also the cause of vaginal dryness, as well as chronic yeast infections, bacterial infections, or some kinds of cleansing of the vagina.

Many couples use condoms and foam or a method that involves a gel of some kind. Birth control pills sometimes do not provide the required level of estrogen and production of testosterone to maintain vaginal lubrication and necessary libido.

To resolve these issues there are many steps which can be followed. Use of a water soluble lubricant like Astroglide may be helpful. Estrogen therapy is useful if there is only vaginal dryness. Women who use vinegar, bubble baths, hand lotions etc can cause this dryness to become more complicated and lead to infectious.  Use of multivitamins or mineral supplements can be useful as well. Balanced diets can and proper nutritional intake can help maintain a healthy lifestyle and reduce some of the complicating issues surrounding vaginal dryness.

Many women who don’t want to have babies for the rest of their lives permanently they go for tubal ligation surgery. After tubal ligation women experience many side effects in which hormonal changes are the one most common. But with the change in life circumstances, some women want their own babies they want to reverse the process. Many will elect to undergo a tubal reversal. Other than having their own babies, women will proceed with a tubal reversal for many reasons. Women who undergo the process of tubal ligation may experience irregular and painful periods, vaginal dryness, menstrual related problems, trouble sleeping, hot and cold flashes, loss of libido, early onset menopause, mood swings, palpitations etc To resolve some of these issue they seek out a tubal reversal. While tubal reversal my not be the best solution for these problems, some women find that a tubal reversal procedure may help them feel more psychologically sound. Many will attribute a tubal reversal with the resolution of some of these complaints.

Episiotomy is a surgical incision into the area between the vaginal area and anus. It may help speed delivery by letting the vagina open wide enough for childbirth. To facilitate the childbirth, doctors may place this small cut and this may prevent the vagina from tearing in an irregular line. Episiotomy requires stitches to close and heal the vagina. After episiotomy, it is important to clean the episiotomy area to prevent infection.

To get relief from the pain of an episiotomy, many women will take pain killers. The use of ointments, sprays, and warm tub baths are also suggested for pain relief. The episiotomy stitches dissolve and do not need to be removed. Normally, an episiotomy is healed up within 4 weeks, but the pain can remain for some longer time. Unfortunately, many women have this pain for a longer period of time. Many don’t have time, or feel too embarrassed to report this to their doctors or to get a check up.

The reason for prolonged pain could be that the mother is a breastfeeding mom. Due to breast feeding, the estrogen level in the vagina is below the required level. This may cause the vaginal dryness and pain in the episiotomy area. Many creams and vaginal massage can resolve minor episiotomy issues.

This is a problem which is usually resolvable through medical treatment. If painful intercourse is the problem, and you don’t obtain relief from these basic medical treatments, a more intensive treatment like surgical reversal or repair of episiotomy may help.

Heavy menstrual bleeding and clotting are common problems for many women. When women need to change three pads or tampons every hour, then they may be losing too much blood and they urgently need to be checked by their gynecologist. A complete pelvic exam and ultrasound will be performed. This may be the indication of some serious problem as well. It may be just a hormonal change that has occurred after a major surgery like a hysterectomy, or a minor surgery such as a cystectomy or tubal reversal.

It could be due to polyps in the lining of the uterus or fibroids within uterus or condition where the walls of the uterus become thick because of gland growth from the lining. This is called adenomyosis.

Fibroids in the uterus are tumors. These tumors are by far the most common kind tumor of the uterus. The symptoms of fibroids are pelvic pain, increased menstrual cramps, increased menstrual flow, blood clots, irregular or painful periods, urinary frequency, constipation, and bloating

If your periods are on the heavy side but repeat in a regular pattern on a cyclical basis, that would be considered normal for you. Or, if you have some irregularities in your flow that dissipate the following month, there is probably nothing too serious going on.

Often bleeding can be reduced by either the birth control pill, the Mirena IUS (a progestin IUD) or, if necessary, surgery to remove the polyp or fibroid. There are also procedures in which the lining of the uterus is destroyed with heat freezing or laser (endometrial ablation) that can decrease or stop bleeding.

After tubal reversal surgery, you will become very eager to start planning your pregnancy. You will dream of holding your cute new baby in your arms. You will start planning to welcome the new member of the family. This is very natural.

After tubal reversal, there are some points to keep in mind. When women get the good news that they are pregnant, they must take good care of themselves, and even some extra care as compared to the normal pregnancy. They must also track their cycle carefully as the chance of a tubal pregnancy or a miscarriage can occur. An early appointment with their physician is very important for tubal reversal patients.

After tubal reversal, if pregnancy is not achieved after a few months, don’t get too upset or worried. In the practical study of patients, pregnancy can occur on average from 6 months to a year. These results are related to the fertility of both parents.

After tubal reversal, some patients are interested in making sure that the reversal has not healed incorrectly and that their tubes are still open. A HysteroSalpingoGram (HSG) is a good method of evaluating the success of a tubal reversal. HSG should be done by an experienced doctor.

Dr. Morice and his team provide the excellent surgical care that maximizes the chances of a successful tubal reversal. Dr. Morice is an experienced expert in performing tubal reversal surgery with Microsurgical Tubal Reanastomosis (MTR) techniques.

For a tubal reversal procedure, many factors must be considered: the age of women, the length of the remaining fallopian tube segments, the damage caused by the tubal ligation process, and the fertility issues and medical conditions of both the woman and her partner. The general success rate for a tubal reversal procedure may be as high as 90%, depending on these factors.

During a tubal reversal procedure, Dr. Morice will remove the blockage of the fallopian tube (scar tissue). Dr. Morice will then surgically put back together the two different ends of the fallopian tubes.

Before a tubal reversal procedure, the patient should provide Dr. Morice with her operative reports, pathology reports (if any), partner’s semen analysis, and any present medical condition for a more complete evaluation of her chance of a successful tubal reversal.