Post Tubal Ligation Syndrome – Evidence?

There are numerous symptoms linked to “post-tubal ligation syndrome” –some of which are listed below:-

Hot flushes, night sweats

clammy feeling, chills

Irritability, mood swings, sudden tears

Irregular periods; shorter, lighter periods; heavier periods, flooding;

phantom periods, shorter cycles, longer cycles

Loss of libido

Chronic Fatigue

Breast tenderness

Difficulty concentrating, disorientation, mental confusion

Prolapse of uterus do to rapid decrease in oestrogen levels

Depression

Weight gain

Pelvic Pain

Hair loss or thinning, head, pubic, or whole body; increase in facial hair

Changes in fingernails: softer, crack or break easier

These symptoms could be linked to a hormone imbalance due to the target or receptor cells, which are located within the fallopian tubes and are vital in the relay of hormonal messages, being destroyed, damaged, and or removed during the surgery. This theory is partly supported by the fact that this “syndrome” seems to be more common after tubal cauterisation which is likely to cause more damage.

Although many authors doubt that the syndrome exists; a review article1 of 200 English Language articles on the subject suggests that there may be an effect in patients undergoing sterilisation between the ages of 20 and 29 but not above this age.

RESULT(S):

Many authors have investigated the sequelae of female sterilization. Increased premenstrual distress, heavier and more prolonged menstrual bleeding, and increased dysmenorrhea have been reported. However, failure to control for age, parity, obesity, previous contraceptive use, interval since sterilization, or type of sterilization may have affected study results. Most studies that have controlled for these important variables have not reported significant changes, except in women who undergo sterilization between 20 and 29 years of age.

CONCLUSION(S):

Tubal sterilization is not associated with an increased risk of menstrual dysfunction, dysmenorrhea, or increased premenstrual distress in women who undergo the procedure after age 30 years. There may be some increased risk for younger women, although they do not appear to undergo significant hormonal changes.”

It is important therefore to assess individuals who believe that they may have this syndrome and to individualise their care before considering what treatments might help.

Treatment Options:

  • Anti-stress medications
  • Antidepressants and psychological counselling
  • Birth control pills
  • Hysterectomy.
  • Tubal reversal repair (which may be a better alternative to a hysterectomy).

Recently, Mr Pickles was asked for his opinion about this condition in an article by the Daily Mail:

http://www.dailymail.co.uk/femail/article-2571619/Every-year-thousands-choose-contraception-But-crippled-inexplicable-pain-growing-numbers-asking-did-sterilised-RUIN-lives.html

 

Reference:

1: Fertil Steril. 1998 Feb;69(2):179-86.

Is there any evidence for a post-tubal sterilization syndrome?

Gentile GP, Kaufman SC, Helbig DW.