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Post-Tubal Ligation Syndrome

Medically Reviewed by Brunilda Nazario, MD on April 13, 2021

If you’re a woman who doesn’t want to have kids (or doesn’t want more kids), you can choose to have a tubal ligation. Informally, you might call this “getting your tubes tied.” During this procedure, a gynecologic surgeon cuts or blocks your fallopian tubes. This prevents eggs in your ovaries from traveling through the tubes to your uterus. That means sperm can’t reach your eggs and you can’t get pregnant.

The procedure is safe, and few women have complications. Still, there is a risk that you could have a cluster of painful symptoms afterward. Some doctors call this post-tubal ligation syndrome (PTLS). But not all experts are convinced that PTLS is real.

PTLS Symptoms

Signs of PTLS can vary greatly from one woman to the next. Some of the symptoms attributed to this condition include:

Pain. Any of the following types of pain could be a part of PTLS:

Period changes. Your periods might be different from how they were before the tubal ligation. Some changes might include:

You may also have some symptoms that typically seem like PMS symptoms, such as:

You could have the mood changes that usually go along with PMS, too. You might have:

Menopause-like symptoms. Some women develop problems they didn’t expect see till menopause, such as:

Some women with PTLS have constipation or diarrhea, too.

PTLS Causes

There’s a lot about PTLS that doctors don’t know. Because it affects women differently -- and your symptoms could arise years after the procedure -- experts haven’t figured out a clear reason behind this condition.

Tubal ligation could damage the blood supply to your ovaries and nerves and disrupt your hormone levels. Those changes could explain quite a few of the symptoms. But some doctors think the symptoms come from stopping birth control before getting your tubes tied. That often causes changes to your hormones and affects your period.

Getting a PTLS Diagnosis

No single test can confirm you have PTLS. Your doctor will first try to rule out other reasons for your symptoms, like endometriosis, uterine polyps (small growths inside your uterus), or cancer. They’ll ask you questions and do a physical exam. An imaging test like an ultrasound could also help find an explanation for your pain.

Treatment for PTLS

If your symptoms are mild, your doctor’s focus will be on trying to manage them and reduce your pain.

In severe cases, you could look into surgery to reverse your tubal ligation. Even though getting your tubes tied is a permanent form of birth control, different techniques can undo it.

Alternatives to Tubal Ligation

If you want to get tubal ligation but are worried about PTLS, talk to your doctor. They can explain some other long-lasting, reversible birth control options. An IUD (intrauterine device), for example, is a tiny device that goes in your uterus. A birth control implant, about the size of a matchstick, goes into your arm. These methods can last for up to 10 years. They may prevent pregnancy up to 20 times better than birth control pills.

Get the Help You Need

Just because doctors don’t completely understand PTLS doesn’t mean that any symptoms you have aren’t real. If you feel your doctor isn’t listening to your concerns, ask to see a specialist or get a second opinion from another doctor you trust.

WebMD Medical Reference

Sources

SOURCES:

Ryoikibetsu Shokogun Shirizu: “Post-tubal ligation syndrome.”

Mayo Clinic: “Tubal ligation,” “Premenstrual Syndrome,” “Endometriosis: Diagnosis.”

Planned Parenthood: “How Safe is Tubal Ligation?” “Birth Control Implant,” “Long-Acting Reversible Birth Control.”

Johns Hopkins Medicine: “Tubal ligation.”

New England Journal of Medicine: “The risk of menstrual abnormalities after tubal sterilization.”

StatPearls: “Tubal ligation.”

United Nations University: “Health Consequences of Sterilization.”

British Journal of Cancer: “Tubal ligation in relation to menopausal symptoms and breast cancer risk.”

Fertility and Sterility: “Complications of female sterilization: immediate and delayed.”

Contemporary OB/GYN/OBGyn.net conference coverage: “Post-Tubal Ligation Pain.”

Cleveland Clinic: “Tubal Reversal: 5 Facts About Your Fertility.”

Society to Improve Diagnosis in Medicine: “Feeling Dismissed and Ignored by Your Doctor? Do This.”

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