Post Tubal Ligation Syndrome occurs in women who have undergone tubal ligation and endometrial ablation (a minor surgical procedure for abnormal bleeding where the uterine lining is destroyed rather than undergoing a complete surgical removal of the uterus).  Approximately 6 months to 1 year following their ablation procedure or tubal ligation women may experience cyclic pelvic pain.  The pain can be on one or both sides and can be severe.

The symptoms of PTLS (Post Tubal Ligation Syndrome) are the following:

• Hot flashes
• Night sweats
• Flushing
• Chills
• Headache
• Racing pulse
• Dizziness
• Difficulty concentrating
• Irritability
• Anxiety
• Depression
• Mood swings
• Nausea
• Bloating
• Weight gain
• Change in hair growth pattern and thinning fingernails
• Fatigue
• Difficulty sleeping
• Decreased libido
• Breast tenderness
• Decrease in breast size
• Painful intercourse
• Irregular heavy or light bleeding
• Osteoporosis
• Uterine prolapsed, where the uterus becomes misplaced through the vagina

Although it is not entirely clear what causes PTLS, it is correlated with a previous history of tubal ligation.  Some studies have indicated that women who undergo tubal ligation may be at risk factor for hot flashes, chills, night sweats, and other menopause-like symptoms.  These changes are thought to be related to changes in estrogen and other hormone production in the ovaries.  These changes can lead to loss of normal monthly ovulatory cycles as a result of the change in ovarian hormone production that is thought to occur as a result of tubal sterilization and endometrial ablation.

Depending on a patient’s particular situation, tubal ligation reversal surgery has been considered as a method to reduce the pelvic pain symptoms many women experience after a tubal ligation.  For some women, the desire to return to a more normal pattern of menstrual cycles may be reason to consider a tubal reversal.  The ligation reversal gives the woman back not only the option to consider pregnancy in the future but also can help relieve the symptoms associated with Post Tubal Ligation Syndrome.

Possible Risks of a Tubal Ligation

The possibility of tubal ligation failure has the greatest risk for ectopic pregnancy. It is debatable and questionable that Post Tubal Ligation Syndrome consists of only a few medical symptoms or that it is possibly a direct side effect and/or another risk of tubal ligation. In most studies, those who do have symptoms after having a tubal ligation consider these symptoms Post Tubal Ligation Syndrome.

What is considered the major cause of these symptoms?

Several of the symptoms of PTLS (Post Tubal Ligation Syndrome) are linked with having estrogen or progesterone imbalance. There are many research and case studies leading to controversies about these hormone imbalances. It is assumed that imbalance may be the direct result of capillary damage and decreased blood supply to the ovaries during the surgery. The damage to the veins and capillaries is quite varied and slight damage may possibly result in a slight estrogen progesterone imbalance.

For a woman who has both of her ovaries still functioning, if blood supply was not damaged to the uterus and ovaries, then she may experience PTLS due to estrogen/progesterone imbalance by some change in her hormonal message relay system.

Hormonal message relay system destruction is questionable

The assumption behind this is destruction of “target” or “receptor” cells that are significant in the relay of hormonal messages for the female reproductive system. It is unspecified that these cells might be injured, damaged, and or detached during the tubal ligation surgery. Having assumed that these target or receptor cells are positioned within the fallopian tube, many people consider a tubal ligation to be the cause of the destruction of some of these cells. For patients who believe this hypothesis, a tubal reversal would not be an option to reverse symptoms of PTLS. Tubal reversal should only be performed for patients who therefore have a strong belief that the symptoms are related to blockage of their fallopian tubes.