Tubal Ligation (Tubes Tied)



Tubal Ligation (TL) is a surgical operation performed to make a woman sexually sterile. There are two common methods of tubal ligation; minilaparotomy and laparoscopy.

Post Tubal Ligation Syndrome

Post-tubal problems are so frequent they are now called "post tubal ligation syndrome." A review of the literature on post-tubal ligation problems by Drs. Joel Hargrove and Guy Abraham revealed an incidence of long-term complications in as many as 22 to 37% of sterilized women.9

In a study of over 8,000 women five years after their tubal ligations, 49% suffered heavy periods and 35% reported an increase of severe menstrual cramping.14 The risk of cervical cancer among a study of 489 post-tubal women was 3.5 times the normal rate.15

"Recently, it has been recognized that Premenstrual Syndrome often increases in intensity following tubal ligation...After women had the simple operation to block their fallopian tubes, they subsequently produced less progesterone from their ovaries ."22 A study entitled “Changes in Ovarian Function After Tubal Sterilization”, (published in “Advances in Contraception” Medical Journal (Vol.10, No. 1) found that progesterone levels significantly decreased and anovulation (when the ovary does not release a ripened egg) was observed in 30.2% of 43 cases.

Causes

Post tubal ligation syndrome is often the result of a rapid decline of estrogen/progesterone hormone levels caused by the blood supply being damaged to the ovaries during the TL surgery. Depending on the damage to the veins and capillaries, blood volume to the ovaries may slightly decrease or can be eliminated completely which is called isolated ovarian syndrome(common with hysterectomy operations). Many of the symptoms of PTS are associated with menopause, hormone shock, or of having an estrogen/progesterone imbalance. Elevated levels of estrogen and inadequate progesterone may explain the heavier bleeding and cramping that often follow female sterilization.24
Other theories of PTLS and the hormonal imbalance that results after a TL, is that target or receptor cells (located in the fallopian tube) that are important in the relay of hormonal messages are damaged, destroyed, and or removed during the TL surgery. With this in mind, it's possible for a woman to have both her ovaries still functioning to some degree (if blood supply was not damaged), have no major problems with her uterus (again if blood supply was not damaged to that organ), and still be experiencing PTS in the from of a hormonal imbalance caused by change in her hormonal message relay system due to receptor cells being removed.

Symptoms

Post Tubal Ligation Syndrome (PTLS) aka PTS is linked with:

  • Castrative Menopause
  • Severe Hormone Imbalance
  • Ovarian Isolation (Post Hysterectomy, Post Tubal Ligation)
  • Atrophic Ovaries (deteriorating ovaries)
  • Hormone Shock (Hormone Imbalance)
  • Increased Risk of Heart Disease
  • Bone Loss and Osteoporosis
  • Dysfunctional Uterine Bleeding (DUB)
  • Adenomyosis
  • Severe Pelvic Adhesions
  • Misplacement of Female Organs
  • Decreased Lactating Ability

Symptoms of Post Tubal Ligation Syndrome

  1. Eptopic pregnancy or pregnancy (well known risk of TL)
  2. Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling, chills
  3. Bouts of rapid heart beat
  4. Irritability
  5. Mood swings, sudden tears
  6. Trouble sleeping through the night (with or without night sweats)
  7. Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles
  8. Loss of libido (see note)
  9. Dry vagina (see note)
  10. Itchy vagina-at time raw like, can radiated from whole area, with absence of yeast infections. (see note)
  11. Color change in vaginal area. (color gets darker -darker red to purple)
  12. Chronic Fatigue
  13. Anxiety, feeling ill at ease
  14. Feelings of dread, apprehension, doom (see note)
  15. Difficulty concentrating, disorientation, mental confusion
  16. Disturbing memory lapses
  17. Incontinence, especially upon sneezing, laughing; urge incontinence (see note)
  18. Prolapse of uterus do to rapid decrease in estrogen levels.
  19. Itchy, crawly skin (see note)
  20. Aching, sore joints, muscles and tendons (see note)
  21. Increased tension in muscles
  22. Breast tenderness
  23. Decrease in breast mass
  24. Headache change: increase or decrease
  25. Gastrointestinal distress, indigestion, flatulence, gas pain, nausea, Irritable bowel syndrome (IBS)
  26. Sudden bouts of bloat
  27. Depression (see note)
  28. Exacerbation of existing conditions
  29. Allergies developing or increasing - (Chronic sinusitis).
  30. Nasal infections-necessitating antibiotics
  31. Weight gain (see note)
  32. Hair loss or thinning, head, pubic, or whole body; increase in facial hair
  33. Dizziness, light-headedness, episodes of loss of balance
  34. Changes in body odor
  35. Electric shock or stabbing sensation under the skin. (see note)
  36. Tingling in the extremities, (see note)
  37. Gum problems, increased bleeding
  38. Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor (see notes)
  39. Osteoporosis (after several years )
  40. Changes in fingernails: softer, crack or break easier
  41. Stabbing pains in pelvic area at time of ovulation
  42. Pelvic Pain
  43. Development of Adenomyosis
  44. Development of Ovarian/Tubal Cysts
  45. Decreased Lactation Ability

Zentralbl Gynakol 1989;111(16):1124-7 [Article in German]

Treatment

Finding an alternate method of birth control and avoiding TL is recommended. For those women who have had the procedure, treatment options are varied, depending on your symptoms.

A TL Reversal

This procedure reconnects the tubes and re-establishes the blood flow. This may help relieve the symptoms of the syndrome. The success of this procedure depends upon several factors including the original surgery and the number of years since the surgery was performed.

Natural Progesterone Cream

A bio-identical progesterone cream, either with or without plant estrogen, relieves many of the symptoms of TL. By restoring the hormone balance, which is critical in maintaining optimum health and well-being, as well as in preventing many conditions and disorders from occuring, natural progesterone cream helps the body regain proper amounts of estrogen and progesterone. Please visit the Conditions section to the left to learn more about symptoms you may be experiencing.

*Note:

Symptom 2 - (flashes) Hot flashes are due to the hypothalamic response to declining ovarian estrogen production. The declining estrogen state induces hypophysiotropic neurons in the arcuate nucleas of the hypothalamus to release gonadotropin-releasing hormone (GnRH) in a pulsatile fashion, which in turn stimulates release of luteinizing hormone (LH). Extremely high pulses of LH occur during the period of declining estrogen production. The LH has vasodilatory effects, which leads to flushing.
Symptom 8 - (loss of libido) For some women the loss is so great that they actually find sex repulsive, in much the same way as they felt before puberty. What hormones give, loss of hormones can take away.
Symptom 9 - (dry vagina) results in painful intercourse.
Symptom 10 - (Itchy and or raw vaginal area) A normal vaginal pH level is around 4.5. A vaginal pH of 6.0 to 7.5 -- in the absence of a vaginal infection (yeast infection)-- indicates low blood estrogen levels and signals that the woman is menopausal. "The vagina (and whole area) becomes more acidic."
Symptom 14 - (doom thoughts) includes thoughts of death, picturing one's own death. Feelings of complete despair.
Symptom 17 - (incontinence) reflects a general loss of smooth muscle tone.
Symptom 19 - (itchy, crawly skin) feeling of ants crawling under the skin, not just dry itchy skin.
Symptom 20 - (aching sore joints) may include such problems as carpal tunnel syndrome.
Symptom 27 - (depression) different from other depression, the inability to cope is overwhelming. There is a feeling of loss of self. Hormone therapy ameliorates the depression dramatically.
Symptom 31 - (weight gain) often around the waist and thighs, resulting in 'the disappearing waistline'
Symptom 35 - (shock sensation) This is often discribed as the feeling of a rubber band snapping in the layer of tissue between skin and muscle. It may be a precursor to a hot flash.
Symptom 36 - (tingling in extremities) can also be a symptom of B-12 deficiency, diabetes, alterations in the flexibility of blood vessels, or a depletion of potassium or calcium.
Symptom 38 - (Burning mouth syndrome)
Please note: Some of the symptoms above are also symptoms related to hypothyroidism, diabetes, iron deficiency, and other conditions. If you believe that you may be experiencing a hormonal imbalance or hormone shock, please contact your health care provider to consult and have proper serum testing done. Proper testing will check for ALL conditions. The findings of hypothyroidism, diabetes, or anemia does not rule out that a hormone imbalance is not also occurring. The findings of normal thyroid, insulin, and iron levels does not rule out that a hormone imbalance is not occurring.
Cited Coalition for Post Tubal Women, Tubal.org
9. J. Hargrove and G. Abraham, "Endocrine profile of patients with post-tubal ligation syndrome," Journal of Reproductive Medicine, 26-7 (July 1981) 359-362.
14. L. W. Wilcox et al "Menstrual function after tubal sterilization," American Journal of Epidemiology, 135:1368-1381. 15. Ibid.
22. K. Dalton, Once a Month (Claremont, CA: Hunter House, 1990) 33.

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