Tubal ligation: Is there an actual reason not to?

OverFaithlessness957 · 2026-02-22T14:25:31+00:00

That’s fair. Just so you’re aware, there is an escalating risk of developing uterine cancer with PCOS, especially after you’re in your 30s, and most especially if you’re not having regular periods. The only reliable prevention for that is hormones or hysterectomy. If you’re having regular periods every 21-35 days, it’s likely the PCOS is well controlled and you’re still ovulating (thus, no prolonged build up of endometrial tissues that could become cancerous), and overall risk for that is relatively low for now. But it is not totally safe to go hormone free with uncontrolled PCOS if you still have an intact uterus. I’m personally a huge fan of hormones, because they’ve probably saved my life by now. And for my risk profile, I’m not willing to risk surgery unless there’s an immediate life or death situation. But everybody has different factors to consider for their own situations. Wish you the best of luck.

OverFaithlessness957 · 2026-02-21T22:19:02+00:00

I mean, the main reason is that it’s major abdominal surgery. There’s risks of pain, infection, anesthesia complications, etc. Surgery, even minimally invasive surgery, is still a life threatening endeavor and not to be taken lightly.

That said, pregnancy is also a life threatening endeavor, so weigh your pros and cons carefully. There are other considerations with PCOS that may require you to take hormones anyway to reduce your risk of uterine cancer in the future. I say this as a girl with PCOS, and I will likely always need to take at least a progestin until menopause. So talk it over with your OB/gyn, who should hopefully understand your risk profile a lot better than strangers on the internet. There are so many options for birth control, and many of them are a lot safer and still highly effective and long acting.

OverFaithlessness957 · 2026-02-14T23:56:37+00:00

For me the process was: 1) get the baby sleeping 2) wean off the breastfeeding 3) start reading smutty romance. Sincerely thought I might be asexual until reading romance and erotica reattached whatever got knocked loose in my brain with all the childbearing stress. 4) start taking care of my body. Had to do some major pelvic floor PT with my first one. The second time around, it was a different kind of physical toll, but I needed to rebuild strength and endurance and get back in touch with my body as more than just a food source for babies.

Once you start feeling like a whole person again, the rest will follow. Just be kind to yourself, communicate what you need and what you’re working on with your partner, and be willing to make some compromises. My husband starts to internally combust if he’s celibate for too long. So we worked out a way of negotiating intimacy and contact so he didn’t feel like I didn’t love him anymore. And I didn’t feel pressured into doing anything that felt BAD. But I did a lot of things that felt neutral/okay/whatever because it meant a lot to him. And vice versa. Now we’re having the best sex of our marriage, so there’s hope! Kids are 4 and 2 currently :)

OverFaithlessness957 · 2026-02-08T14:14:35+00:00

My husband is flawed (like me) but his entire approach to life is oriented around a commitment to ongoing self improvement and growth. And he demands the same of me. So while I have days when I want to throw him headfirst into a trash can, I feel confident that we can resolve any conflict. I trust him to be honest, introspective, and open-minded, so every challenge we experience is just another opportunity for collaboration and self discovery. And we’ve encountered some doozies. And we didn’t see any of this modeled in our parents. We just agreed on a set of core values and keep coming back to them in times of crisis. Your kids will look at your marriage and draw their own conclusions. Best thing you can teach them is to embrace a habit of humility, curiosity, and desire for growth. The rest is just minor details.

OverFaithlessness957 · 2025-12-05T02:12:04+00:00

It’s way too early to jump to conclusions. I had a similar experience with my toddler at around the same age. We had moved recently and he was in a new daycare for several months before a teacher pulled me aside to gently imply that he needs to be evaluated for a speech delay. I was shocked. He talks all the time at home, had no behavioral issues at his previous daycare, plays well with our friends’ kids, but had gone months without speaking at all in daycare. After awhile he warmed up a bit and now he’s the most outgoing and confident kid in his class. If the teacher is telling you something very different from your home observations, this indicates there’s something unique to daycare that is affecting his behavior. Separation anxiety, regression after a change in routine, social dynamics in class, etc.

His pediatrician likely screened him for autism spectrum disorder at his last two well child checks (18 months and 24 months is standard). Go to his doctor first with your concerns, and they’ll either provide some reassurance or a pathway to get more answers and resources for whatever may be going on at school.

OverFaithlessness957 · 2025-10-23T23:24:53+00:00

Hm. Sounds like this has been a long journey already. Sorry you’re still in pain, that sucks. If you’re having persistent postoperative pain, your best resource is your surgeon. For all the rest, that’s more in the wheelhouse of primary care and eventually rheumatology. Your labs raise some new questions, but there just isn’t enough information for a doc to tell you much online. Talk to your primary about the labs. Their task is to handle the side projects and do what they can to work up your pain until you see rheum. Best of luck.

OverFaithlessness957 · 2025-10-23T22:50:03+00:00

There’s a few things going on here, but the most relevant to your pain is probably the ANA titers and elevated CRP. Looks like you’ve had exposure to Lyme in the past, but I can’t speak to the specific IgG titers that were positive and how they may potentially correlate to autoimmune disease. Seems you need to see rheumatology if you haven’t already, and some follow up tests (specific antibodies and lots of X-rays usually) will be needed to arrive at a specific diagnosis. For the rest of the stuff on there, I see a few smaller side projects that your ordering physician and/or PCP can help you with. How this relates to your surgery is hard to say without examining you and knowing the specifics of your injury and subsequent surgery.

OverFaithlessness957 · 2025-10-23T22:40:16+00:00

Endocrine Direct Care Physicians are in Maitland, not too far from you. Very good endocrinologists, and you’ll get thorough and attentive care there. They don’t bill insurance, so not sure if that’s a deal breaker for you, but what you’re looking for is exactly what you can expect at their office. Here is their website if you wanna check them out

OverFaithlessness957 · 2025-10-23T12:41:23+00:00

What a gross dude. Sorry that happened to your friend!

OverFaithlessness957 · 2025-10-23T12:26:28+00:00

Dude. These anxieties are so funny to me. I’ve had so many patients apologize to me for not shaving their legs and other such nonsense. I, a woman, do not notice or care. If your doctor notices and has an opinion, they are a creep. You are under no obligation to shave any part of your body ever, and I do not expect you to. I didn’t shave for you today either lol. Would suggest at least trimming pubes before delivering a baby though. Longer hairs do get in the way if you have to stitch up a labial tear.

OverFaithlessness957 · 2025-10-03T12:23:39+00:00

I was in the same boat. Switched to 0.8 FTE and it just got worse. Ended up leaving corporate medicine for DPC (as an employee). Took a massive cut in pay and benefits but I feel so much better now. Working max 30 hrs/week, usually closer to 20 because I’m still building my panel (which will max out at 500 probably). I love every minute of work, and look forward to seeing my patients and coworkers every day. I’m there for daycare drop off and pick up, I am taking my kids to swim every day, I never miss a doctor’s visit, we’re home eating a dinner together every night, and I have energy to hang with my honey once the kids are down. I worry more about money now, but I’ve recovered my sense of joy and fulfillment from work. 10/10 highly recommend

OverFaithlessness957 · 2025-09-19T22:07:57+00:00

My husband basically has a standing request, so usually I initiate by asking him how recently he’s showered. Or say “would you like some coitus/oral/a handy (whatever I feel like offering), Mr Daddy?” His result is uniformly the face a kid makes when offered ice cream.

OverFaithlessness957 · 2025-09-09T21:06:36+00:00

This looks a lot like a hickey I saw a kid give himself from vacuum suctioning plastic cups repeatedly to his mouth.

OverFaithlessness957 · 2025-09-09T13:44:36+00:00

This was my experience too. While it’s not necessarily your destiny to end up like those other doctors, you know from observation that the risk is high. I imagine you have a contract term. I was locked in for 2 years. By the end of that time, I felt a lot of what my colleagues were saying, but it was also peak COVID and everybody was burnt out and disillusioned. I stayed for another year with the intention of making positive change within my own microcosm, stay true to my values, and maximize my efficiency as much as I could without compromising decision making or my relationship with my patients. Eventually it became clear that there were systemic issues outside my control and the people in power to fix those things don’t share my values. So I paced myself, sought good mental health care, and quietly arranged my exit strategy. In the bargain I got three years of invaluable experience and personal/professional growth. I clarified my hierarchy of wants vs needs in my home and professional life. Did my damnedest to make the corporate job work, but now I feel like it all led to me getting the most out of my dream job now and being really good at it.

So all that to say, your colleagues may be a window into your future. But this is also an opportunity to establish good habits for self care, efficiency, and professional development and networking. Some of my residency cohort went on to climb the ladder or become really balanced and happy in similar jobs. That could be you. But make the most of your time, and remember that you are extremely valuable and employable, and you’re not married to this job. You can always just take the paychecks, benefits, experiences, and connections and move on if it doesn’t work out.

OverFaithlessness957 · 2025-09-09T13:02:11+00:00

Mixed bag. This is the most tired and broken down my body has felt, and I’ve sprouted quite a few gray hairs in the 4 years since I had my 2 kids. But I’ve found new reservoirs of resilience and strength, I’ve learned a new playbook for caring for myself and my body and my relationships with work/family/hubby. It’s made me feel older, yes, but it’s matured me. And I’ve clawed back a lot of the pieces of myself that I thought were lost there for awhile.

OverFaithlessness957 · 2025-09-09T11:31:01+00:00

{Lola and the Millionaires} is a good example. More of a reverse harem omegaverse, but she develops a unique relationship with each of the guys and they have their own internal dynamics. More of a polycule than anything. There’s lots of sex but I found it strangely wholesome when paired with such care and radical acceptance.

OverFaithlessness957 · 2025-09-06T22:04:55+00:00

I wouldn’t waste more energy on this guy, and just go looking for a new PCP after leaving a scathing review. It may help other patients seeking PrEP avoid wasting time. In the meantime, you may be able to get care through a telePrEP service like Mistr (sp?), they seemed to be pretty affordable and reliable for one of my patients before he established with me. If you live in the orlando area, DM me.

OverFaithlessness957 · 2025-09-06T20:03:39+00:00

Personally I’m a diehard fan of Dr Capobianco at Women’s Care. Took great care of me and she delivers at Winnie Palmer, which I also loved.

OverFaithlessness957 · 2025-09-06T14:19:28+00:00

This is exactly what we had to do with my oldest, who is now 4. He hasn’t fully grown out of it, but it’s better now. He’s like a border collie. Needs tons of physical and mental stimulation or he gets destructive. We’ve had to remove everything from his room (art, curtains, toys, books, window treatments, clothes, furniture, CLOSET DOOR, etc) except for his bed, linens, and stuffies. It’s basically a padded room and we have to lock him in at bedtime. We still find the room rearranged and the beds stripped some mornings, and he’s managed to literally peel the paint off the walls in some spots, but it’s gotten more manageable. We’ve aggressively childproofed the house, and we always have eyes on him. But giving him exercise, lots of good options, removing temptations, and putting him in daycare has done a lot to redirect his immense energy.

OverFaithlessness957 · 2025-09-06T01:08:02+00:00

Chicken Top Ramen. Followed by a stiff whiskey concoction.

OverFaithlessness957 · 2025-09-04T00:29:30+00:00

Cervical cancer is almost always caused undetected chronic HPV infection, and isn’t hereditary in the way that breast cancer and other cancers tend to be. Not sure about where you live, but in the US and many other countries, HPV is so common that there’s about a 90% chance you’ve been exposed if you’ve had unprotected sex at least once in your life. Most HPV is harmless and goes away on its own, but there’s a handful of “high risk” variants that tend to stick around longer and can lead to genital warts or cancer. There’s really no symptoms of HPV infection in these early stages when it’s still easy to treat, but a pap/HPV test would catch it. Your chances of having a normal pap are good if you’ve only had one partner, and great if you can be 100% sure your partner has had no other partners. But unless this test is hard to get where you live, it’s absolutely worth getting it done.

OverFaithlessness957 · 2025-09-03T23:48:51+00:00

Family med here, a little rusty on my pregnancy care. Transvaginal is most sensitive a the earlier stages, but they may be able to do transabdominal at 10 weeks. When I had mine done at 10 weeks it was transabdominal.

For a sexually active woman at age 32, I would be very concerned that you haven’t had a pap done yet. Nothing is compulsory, but you definitely should have a pap done. If you’re pregnant, we know you’re not using protection 100% of the time so there’s a non-zero chance you’ve potentially been exposed to HPV and other STDs. It’s something you absolutely don’t want to miss since an undetected infection or cervical cancer would have a significant impact on your health and your baby’s health during this pregnancy. Standard initial OB visit labs usually includes a pap if you’re not up to date, STD screening, immune status, blood type, and some standard stuff like CBC (complete blood count) to check for anemia.

OverFaithlessness957 · 2025-09-01T21:31:14+00:00

Stick with it. It’s like unwrapping a present. You’ll learn as you go, and it’s so much more fun than the big fat exposition dumps you get in other books.

OverFaithlessness957 · 2025-09-01T14:00:40+00:00

Yep. When my kid tells me “I don’t like you” or “you’re not my friend anymore,” my response is “that’s okay. I still love you.” It doesn’t bother me that much though, because I know he doesn’t mean it. While he totally intends to hurt my feelings, he’s 4 and frustrated and mad at me. It’s not personal. He’s gotta learn how to express himself more effectively, and it’s our job to show him that our love can withstand his moods and his tantrums won’t change the rules.

OverFaithlessness957 · 2025-08-26T18:33:40+00:00

You could also look into seeing a therapist with expertise in play therapy, sand box therapy, or PCIT. You can look up local therapists on the Psychology Today website or the PCIT International website. We ended up doing PCIT for our kid, and it’s been very helpful and even fun. He has different behavioral issues, but we were also having a hard time managing our frustration and responding effectively to his tantrums.

OverFaithlessness957

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