 [ Symptoms ] how can you tell a child has strep [ Disease ] tubal ligation is considered a permanent form of birth control it is highly doubtful you could get pregnant 13 years after having your tubes tied a more likely culprit in your lack of a period would be the onset of menopause before jumping to that conclusion however you would be wise to take a home pregnancy test just to be safe and then you would be well advised to take a trip to the gynecologist to find out what is going on for sure if you are in fact in the beginning stage of menopause called  perimenopause  your gynecologist can advise you about what to expect over the next few years wishing you all the best