Is this common procedure causing uncommon problems?
May 1, 2000 (Portland, Ore.) -- When Susan Belcher of Lockport, Ill., had
her tubes tied at age 34, she thought the procedure would be simple. She signed
a consent form before the surgery and was told by her doctor that she should
expect to have few -- if any -- side effects. However, following the surgery,
she stopped having her periods. In fact, at the age of 36, she was diagnosed as
postmenopausal. Belcher's doctor says she'll need to be on hormone replacement
therapy for the rest of her life. "If someone had told me that the surgery
could create a hormone imbalance, I never would have done it," she
In the United States, about 10 million women have had their tubes tied -- a
procedure called tubal ligation -- as a permanent form of birth control since
the 1960s, according to the Centers for Disease Control and Prevention (CDC)
National Center for Health Statistics. This makes it the second most popular
method after oral contraceptives, according to the CDC.
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The exact number of women who, like Belcher, claim to have post-tubal
ligation syndrome -- a range of symptoms including hot flashes, heavier
periods, mood swings, depression, anxiety, insomnia, vaginal dryness, mental
confusion, and fatigue -- has not been studied, though the syndrome has been a
popular topic in Internet chat rooms and support groups. On the other hand,
many women report no such symptoms after the surgery.
No Clear Answers
Belcher says her struggle to find an answer has been difficult because many
medical experts say that post-tubal ligation syndrome does not exist. "It
is a medical myth," says Stephen L. Corson, MD, professor at the department
of obstetrics and gynecology at Thomas Jefferson University and Women's
Institute in Philadelphia. Corson led a study that compared hormone levels in
women who had had tubal ligation versus those of women who had not had the
surgery. His study showed no significant difference in the hormone levels of
the two groups, indicating that the ovaries were not damaged by the surgery.
Numerous other studies, including one conducted by the American Society for
Reproductive Medicine with results published in the February 1998 issue of the
Journal of Fertility and Sterility, also show no evidence to support the
However, allegations that the surgery could lead to post-tubal ligation
syndrome first surfaced in the 1950s. With the introduction in the 1970s of
laparoscopy (the so-called "belly button surgery"), which was less
invasive than previous surgeries, more women than ever before chose tubal
ligation, and reports of postoperative symptoms increased, says Corson.
A Surprising Possibility
What could be causing the symptoms? According to Corson and other doctors
looking into post-tubal ligation "syndrome," it may actually be a
combination of discontinuing the use of birth control pills and age-related