I'm 42. I had my tubes tied 23 years ago at the age of 19 and after the birth of my 2nd child. Approximately 10 years later I had an ovary and tube removed due to female problems that I'd been experiencing. My periods have always been regular, occuring every month either a bit early or right on time. My periods usually lasted 4 to 7 days, usually moderate to heavy flow the first few days then gradually decreasing thereafter. I Have never been late or missed a cycle. I've typically had moderate to severe symptoms of PMS beginning a few days prior to my period and ending toward the end of my cycle. I have been sexually active since my tubal ligation all but 7 years of the 23 years. I started dating someone new about 2 and a half months ago. We began dating about 7 months after I had ended a 4 year relationship, in which we were living together. My last period started on April 20th. I met the new man for our first overnight date on May 3rd. We split a bottle of wine at dinner, I have little memory of anything past that. I woke the following morning realizing that he and I had, in fact, had sex late May 3rd or early May 4th. Totally distraught by the whole ordeal, I awoke the following morning, gathered my belongings and left. Upon returning home from my date, my ex was waiting on my doorstep with a ring and a proposal, which was the reason our relationship had ended because of his lack of interest in commiting and moving forward with our relationship. The distance, time apart and me moving on with my life and dating someone new had apparently cured his commitment phobias. I ended my new relationship and accepted his proposal. I then had sex a few days later with my new fiancé. Having had my tubes tied with no complications, or pregnancy scares in 23 years I didn't worry about or even think about the consequences of the situation. Since my divorce 11 years ago, I've only had sexual relations with 3 people. I was very busy planning our engagement party and announcements and hadn't given the incident much thought. When I went to mail out the invitations I noticed it was June 1st. I subsequently realized, I hadn't had a period in May. I then began my calculations and realized that my last period had been April 20th. I also realized I should have been ovulating on or around May 4th. I remembered that when I had sex with my fiancé the first time after getting back together I had bled profusely and believed I'd started my period, but I hadn't. I'd just bled during sex that initial time. I haven't experienced any bleeding during sex, or any other time, since then. I've been experiencing head aches several times a week. I experienced some sharp throbbing pains in the lower right side of my abdomen on a few occasions. I've experienced some cramping that was similar to the cramping I've gotten prior to my periods in the past, but have failed to start my period. I've experienced leg cramps a couple times. When I'm up on my feet a lot I get severe cramps in my lower stomach and back. My appetite is insatiable. Because of the tubal I'd had years ago and never suspecting the possibility of pregnancy, I hadn't altered my usual activities. My fiancé entertains clients frequently. I've consumed alcohol on a couple occasions in May. After both occasions of consuming alcohol I was violently ill the majority of the following day. Other than those two incidents I haven't experienced any nausea. Although I've experienced some discomfort after eating on several occasions. I do feel more bloated than normal. At times I urinate more frequently than I normally have in the past. I've woken up with heartburn a couple times as well. I have also experienced a thicker, odorless, clear discharge earlier as well. I've not noticed any common symptoms of a UTI. I've not had any discomfort urinating, no burning or itching or vaginal irritation. I began worrying about what medical reasons could cause a woman to be late or miss their period. I believed there may be something seriously wrong with me, because of female problems in the past. Immediately upon discovery of missing my period, in June, I started researching reasons that a person could be late or miss a period, which is when I discovered that a person could actually get pregnant after a tubal ligation. I later discovered that a study confirmed that the likelihood of tubal ligation failure actually quadrupled 10 years after the procedure was done. The study stated that there was a less than 1% failure rate among women that had the procedure done. But after 10 years the percentage increased to 5%. And of those cases, it mostly occurred in women that opted to have the procedure in their early 20's and postpartum. The study stated that women that elected to have the procedure early in their reproductive years were at highest risk to experience failure later in life. Which is still good odds, given that only 18.5 out of a 1000 women will become pregnant; unless of course, you happen to be one of the 18.5 women that finds themselves pregnant again at 40+ yo. As unlikely as the odds are, 5% versus less that 1% is still not great. I can't really think of anyone that wants to solely rely on a birth control method that is only 95% effective. What I also have trouble understanding is why these findings aren't explained to patients. Because I'm sure most people are like me and would feel secure in believing if they'd remained sterile for 23 years, pregnancy would not be something to worry about. My question is, with all the information I've given you, what is the most likely cause of missing a period? Could there be a more likely medical explanation? I'm not working, I don't have medical insurance. Rushing out to the doctor is not as easy for me as it is for some people. Given all the circumstances, it's certainly not a subject I want to bring up if it doesn't have to be brought up. I've read on here where women with similar issues, it has been suggested it could be perimenopause. Would peri menopausal symptoms come on suddenly by missing a period altogether? Or would you experience lesser symptoms, such as length and/or frequency of periods, hot flashes or other common symptoms first and over a period of time?