Tubal Reversal Blog ‘tubal ligation’

At the age of 32, Rebecca underwent a tubal ligation in 1995. Within one year, she began to notice worsening menstrual symptoms which were attributed to Post Tubal Ligation Syndrome (PTLS). She dealt with these symptoms for 12 years before deciding to undergo tubal ligation reversal surgery.

Her story prior to tubal ligation reversal can be read in the article entitled Meet Rebecca. Rebecca reported her symptoms after tubal ligation as:

Loss of libido
Losing more that the normal amount of hair daily
Unexplained Weight gain
Loss of sexual arousal
Loss of natural lubrication
Painful intercourse
Depression
Isolation
Spotting
Heavier cycles
Unexplained Joint pain
Migraine headaches
Severe Mood Swings
Severe Temperature fluctuations

Rebecca’s Tubal Reversal Surgery

Rebecca underwent an outpatient tubal ligation reversal in July 2008. Drs Berger and Monteith performed her surgery. Rebecca’s fallopian tubes were found to be in good condition and she had a successful bilateral, microsurgical tubotubal anastamosis. Her surgery lasted 88 minutes. She was subsequently released to the local Sheraton hotel, was seen the next day by a Chapel Hill Tubal Reversal Center staff member, and was then discharged to home. She has recovered from reversal surgery without any complications.

Rebecca After Surgery

Rebecca’s report on her symptoms since having reversal surgery:

As far as my symptoms at this point:
I believe it is too early to really notice any changes but here are the few that I am aware of this month.
I am thinking about intimacy once again and I feel that my libido is coming back.
Intercourse was not painful.
My headache this month lasted only one day.
My moods are still erratic and my hair continues to fall out.
I plan to keep track of my feelings, including the desire for intimacy, and sexual arousal signs; in addition to other symptoms.
I believe hormone testing is important before and after a tubal reversal. Perhaps every 3 to 6 months along with keeping a journal of menstrual symptoms.

CHTRC Series of Worsening Menstrual Problems After Tubal Ligation

This is the twelfth article in our fourteen part series on PTLS and associated medical conditions. Our first article, Pain After Tubes Tied: Symptom of Post Tubal Ligation Syndrome?, reviews symptoms associated with PTLS.

Our next several articles will continue to present patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures ( women who had their tubes tied).

Readers can also view other patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Praybelieving
Meet Katherine

We invite readers to join our Tubal Reversal Message Board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.

Rebecca’s experience with Post Tubal Ligation Syndrome in her own words…

My name is Rebecca and I am 45 years old. My husband’s name is Dana and he is 47.

I have a BA in Elementary Education. After teaching, I chose to stay at home the past twelve years with my daughter. I have home schooled her for the past 7 years. At the present time, I design and sew costumes for ballets and other performances.

My husband has a BS in Industrial Engineering. He works for a non-profit organization. He works as a liaison between the government and manufacturers that hire individuals with disabilities, in particular those who are blind.

We have been married for 26 years. We have four children. Two sons, ages 25 and 22 and two daughters ages 23 and 12. We have a grandson (4) and granddaughter (2) by our daughter, who is married to a wonderful man.

I had the tubal ligation in 1995 after the birth of my daughter. Just prior to this pregnancy I had a miscarriage. This put a scare into my husband. It was a pretty nasty miscarriage and although the next pregnancy was fine, he was concerned for my health and future pregnancy’s in addition to the age factor. I had my daughter at the age of 32. I did regret the tubal ligation. I felt I had interfered with God’s plan for my life. However, this I had come to terms with.

I found Chapel Hill Tubal Reversal Center in 1999. However, I did not read the message boards because I thought it was selfish of me to even think of spending that kind of money (for reversal surgery). The thought of a tubal ligation reversal went to bottom of the priority list. Life went on for the next 12 years. I finally began reading the boards and realized how many other women had suffered what I had and that there was hope by having a reversal.

I was approximately 33 when the symptoms of Post Tubal Ligation Syndrome (PTLS) began to show up. It is only after researching PTLS and reading my journals I realized my symptoms were very similar and often times identical to many other women out there. When the symptoms did show up I did not realize what the “condition was”. I thought what I was going through was part of the aging process.

The first thing to go was the desire for intimacy. This included a diversion to intercourse. I was unable to produce any signs of arousal, including cervical mucus. Intercourse became painful and had never been so before.

Doctors told me I had endometriosis, when in fact I did not.They also told me it was because of my tipped uterus. Not so. A tipped uterus has nothing to do with arousal. I told myself it was age, and the fact that I had born four children.

My moods became very erratic. I would blow up at the least little thing. Then moments later I would be fine. I would get depressed and have no desire to be around people.

This was not me; I love interaction and being around people. The saddest part about the erratic mood swings was the very real possibility that my husband may get fed up with me and all we had would be lost. It felt as if I had no control over my emotional state of mind, as if my world was crumbling and the only way to fix it was to take anti-depressants. This was not an option for me.

I began to get migraine headaches prior to my menstrual flow.

Severe headaches. They would last up to four to five days. I had never had headaches. My hair began to fall out. That began happening almost immediately. Again I thought that was normal.

Although I was very active, I began to put on weight around the age of 35. I began to get night sweats. One moment I would be cold then sweating profusely. My joints began to ache. I got unexplained joint pain. I was even diagnosed with tendinitis at the age of 35 (I do not play tennis). My doctor could not figure this out.

My menstrual cycle stayed at 28-day cycles, lasting about 7 days. Typically 3 days heavy 4 days light. However, they also began to be much heavier for longer than 3 days, and I began to experience spot bleeding. I would believe my cycle was over and then I would begin to bleed again about 3 days past my cycle. I didn’t say anything to the doctor; I was too concerned he would say I needed a “hysterectomy“. Or they would tell me that I was preparing to go into menopause. My friends even had me convinced that I was in the early stages of menopause.

I had been told for so long that everything that was happening to me was because of early menopause; I have a tendency to question if PTLS is real. That is why when I read the stories on CHTRC’s message boards about PTLS; I came to realize it is real…

Rebecca’s after surgery story can be viewed on the following blog article entitled Rebecca After Tubal Ligation Reversal.

CHTRC Series of Worsening Menstrual Problems After Tubal Ligation

This is the eleventh article in our fourteen part series on PTLS and associated medical conditions. Our first article, Pain After Tubes Tied: Symptom of Post Tubal Ligation Syndrome?, reviews symptoms associated with PTLS.

Our next several articles will continue to present patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures ( women who had their tubes tied).

We invite readers to join our Tubal Reversal Message Board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.

Andrea describes her recovery and improvement of symptoms after tubal ligation reversal surgery. Her story prior to ligation reversal is Meet Andrea.

Andrea after tubal reversal surgery in her own words…

I had my tubal ligation reversal surgery on 7/30/08. I was on my second day of my period that day. After surgery, I bled for only four more days!

This past month was the first month I had NO migraine or cluster headaches, no odd bleeding or cramping, and I have now started my period. I started right on time, and had tolerable cramps with NORMAL moderate blood flow. This isn’t the blood flow that has caused me to leave in the middle of church-weak, nauseated and pale. I am so very happy that I can live without the exhaustion of anemia during my period, and not live in fear that one time will just be too heavy to be OK. I don’t have to live with the pain, constant moisture, showering 2-3 times a day and clotting.

Most importantly, I’ve given God control over my body. I don’t have to cry and grieve over the loss of a possible future child, nor do I have to cry over the pain and turmoil my physical body is in.

Andrea has exciting news…

Andrea has become pregnant almost two months after her tubal ligation reversal! Her baby is in her uterus and things seem to be progressing well.

The staff of CHTRC wishes Andrea and her family good luck with their first tubal reversal baby. Undoubtedly, there is nothing like a pregnancy to cure bad menstrual periods!

This is the tenth article in our fourteen part series on PTLS and associated medical conditions. Our first article, Pain After Tubes Tied: Symptom of Post Tubal Ligation Syndrome?, reviews symptoms associated with PTLS.

Our next several articles will present patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures ( women who had their tubes tied).

Readers can also view other patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Rebecca
Meet Praybelieving
Meet Katherine

We invite readers to join our Tubal Reversal Message Board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.

My name is Andrea, and I’m a 31 year-old home schooling mother to four children.

I’m married to my partner in Christ, Jeff, who is 36. Jeff has his own CPA practice here near our home. We live in beautiful Coeur d’ Alene Idaho, where we are a very close knit Christian family.

In 2005, against the advice of my doctor and with my husband cautioning against it, I had a Filshie clip tubal ligation at the planned c-section birth of my daughter. My doctor used clips because of my age at the time of tubal ligation, as well as the fact that he believed I would want more kids based on my nature.

Soon after the birth of my daughter, I began experiencing symptoms that independently wouldn’t have been alarming, but when gathered together, had me very worried and feeling terrible. Early after the birth, I felt very sad about not having more children. At times I thought the symptoms were just because I was sad about ending my fertility. Now I know they are separate, as well as the desire to continue to have more children, even if you already have “more than normal”, is a God given desire, and NOT something BAD.As my symptoms began to mount, I began a journal of NEW symptoms for me. While one or two of these may not be abnormal, each one of these was new for me, and together made a host of symptoms.

· Period returned 3 weeks after post-partum bleeding, despite breastfeeding full time.    The earliest I had a period while breastfeeding before was 8 months!

· Cyclical migraines or cluster headaches. Typically, one in the week before my period, one upon my period leaving, and one mid-cycle. Each took up to 4 days to clear completely, and each required prescription medication. Nausea and vomiting would accompany without treatment.

· First time I couldn’t lose my baby weight through breastfeeding, diet and exercise.

· Highly emotional, and easily brought to tears or sadness.

· Extremely dry skin.

· Mid-cycle cramping and breast tenderness.

· Terrible cramping for 1-2 days of menstruation, with moderate cramping before bleeding starts, with light cramping entire period. I’m a very active woman with high pain tolerance. This cramping was enough to nearly bring me to tears.

· Bleeding so severely, I would soak a pad in an hour. My doctor suspected menstrual anemia.

· Bleeding sometimes mid-cycle. Spotting would begin on CD 23-24 and continue through 28 when heavy period would start. Bleeding would last 7 full days, with spotting another 2-3 at the end.

· Persistent yeast infections, presumably from being “damp” due to having to wear pads much of the month to catch unexpected flow.

When looking at this journal, I sought the advice of my OB/Gyn and family physician. Both doctors acknowledged tubal ligation can and often does cause painful and heavy periods. However, my family physician went a step further. She conveyed that she had heard numerous cases of women having severe problems following tubal ligation, and was fully on board in my seeking a reversal. She did hormone screening and other blood work, and my OB/Gyn performed a pelvic ultrasound to rule out endometriosis, infections, fibroids, cancers and cysts. Both doctors gave me a clean bill of health, with no other cause for my new problems. Both doctors wrote to my insurance company, requesting payment for a tubal reversal on the sole basis of Post Tubal Ligation Syndrome (PTLS).

The insurance company, a national and well-known provider, wrote back these words:

“Although a tubal ligation reversal is medically necessary for the health of the insured, tubal reversals are not covered as the code falls under fertility treatment which is excluded. *Named insurance company* will authorize payment for treatments of hormone therapy, ablation, D&C and hysterectomy.”

Obviously, at 29 years old and also seriously mourning the loss of my fertility, these were not acceptable treatments for the physical manifestations of my tubal ligation.

We began the process of searching out the best doctor to perform a tubal ligation reversal, and saving the funds to do so. Some local physician’s, including my own, perform tubal ligation reversal. However, I was unable to feel satisfied about the outcome since none maintained accurate PTLS relief and pregnancy statistics based on their own work. Doctor’s in the Seattle area also do tubal ligation reversal, as well as many other cities in the nation. The local doctor’s were going to cost us about $12,000. Even with travel from Northern Idaho, Chapel Hill Tubal Reversal Center was a more affordable, and a more highly skilled facility.

Post Tubal Ligation Syndrome Series

This is the ninth article in our fourteen part series on PTLS and associated medical conditions. The first article, Pain After Tubes Tied: A Symptom of Post Tubal Ligation Syndrome?, introduces the most common symptoms some women attribute to their tubal ligation.

Readers can also read Andrea’s after surgery follow-up story: Andrea After Tubal Ligation Reversal Surgery. In addition to telling us how she has done after her tubal ligation reversal, she also has some exciting news to share!

Our next several articles will present personal stories of some of our patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures ( women who had their tubes tied).

We invite readers to join our Tubal Reversal Message board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.

Momzilla is actually Tracy.  She is a 43 year-old married, mother of three and is employed as a Senior Human Resource Manager. Tracy is married to Glenn who is a Transactional Real Estate and Business Attorney. In the previous article, Meet Momzilla, Tracy described her symptoms of Post Tubal Ligation Syndrome (PTLS).

Tracy is currently four months out from her tubal ligation reversal surgery and both she and her husband describe her recovery.

In their own words….

Tracy

“Just weeks after my reversal the first thing I noticed was that I had lost the overwhelming sense of dread that had been shadowing me. As I was still healing from the surgery I was less fatigued and more energetic. My mood and outlook were “lighter”. My emotional healing began quickly and the physical healing soon followed. As the weeks passed I noticed improvement in my hair, skin and nails. I was sleeping again and my fogginess and inability to concentrate improved. I have not had a PMS headache, dizziness or tingling in my extremities. Each menstrual cycle since the reversal has gotten progressively better and more “normal”. My exaggerated and prolonged PMS symptoms have diminished. At about 6 weeks post reversal I got my libido back and, for that, my husband is eternally grateful (LOL!). I was no longer feeling like a stranger in my own body. Aside, of course, from getting my health back, the best part of my recovery has been re-connecting with my family. I feel like I have gone from the evil “Momzilla”, tired, moody and short-tempered all the time to just plain “Mommy” again. I feel at ease again in my own skin and with life. I no longer wake up dreading what symptom might take control of me. Shortly after the surgery, Glenn said to me “Welcome back, I missed you…”. In good times and in bad, he and I have always “loved” each other, but, for the duration of time that PTLS held me hostage, we “lost” our connection to each other. After the reversal, along with my obvious physical healing came the healing of my marriage and my family. It still amazes me that, after 3 years of suffering, I could see relief from my symptoms so quickly. I hope, through this series of blogs, that more women and their families as well as their physicians can be educated about PTLS and know that a reversal can bring them new hope for restoring their health and their lives.”

Glenn

Aside from the symptoms, the tragedy of PTLS is that we could have ended up divorced if Tracy didn’t have an inquisitive mind and, after almost three years, discovered PTLS online. From my viewpoint, PTLS transformed my best friend and wife into a detached unaffectionate roommate. Since the medical community did not recognize the possible effect of the tubal ligation procedure, we did marriage counseling which, of course, was unhelpful at best and could not succeed since the cause of the problem was biological. With no other explanation available from medical “experts”, we went through a series of episodes of “blame” with pop-psychology reasons to explain disinterest, depression and other symptoms that we didn’t know were symptoms. I received some truly bad advice from well-meaning sources. Symptoms like memory loss also put a strain on day-to-day living. In the end, we made it through because we started with love, a strong relationship and mutual respect. I have to wonder how many marriages have ended without ever knowing the reason?

I hope that the data compiled by the Chapel Hill Tubal Reversal Center can be used to provide proof to the medical community of this syndrome because it could help so many families if doctors provided pre-tubal ligation counseling and recognized this a possible cause of common symptoms experienced by women.

This is the eighth article in our fourteen part series on PTLS and associated medical conditions. The first article of this series, Pain After Tubes Tied: A Symptom of Post Tubal Ligation Syndrome?, discusses the most common symptoms associated with PTLS.

Our next several articles will present stories of our patients who have sufferred from worsening menstrual, physical, and emmotional symptoms after surgical sterilization procedures ( women who had their tubes tied).
Readers can also view other patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

We invite readers to join our Tubal Reversal Message board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.

Momzilla came to us at Chapel Hill Tubal Reversal Center seeking relief of problems that occurred after her tubal ligation. Momzilla is her sign-on name for the tubal reversal message board. She is 43 years old, happily married, and has three children. She is employed as a human resource manager and her husband is an attorney.

Momzilla had her tubal ligation three years ago and she describes the gradual onset of Post Tubal Ligation Symptoms (PTLS) after her tubal ligation. We asked her if we could use her as the subject of a blog featuring several of our patients. She agreed and provided us a comprehensive list of her physical problems.

Her symptoms in her own words…

“Longer clotty periods with a day or so of flooding blood followed by nothing and then bleeding again. (My menstrual periods from the dawn of time prior to that had been regular and predictable to almost the day), horrible insomnia, light-headedness/dizziness (almost passing out on a few occasions), exaggerated PMS and mood swings, absence of libido and an aversion to sex, fatigue, a sense of dread or doom (not depression), withdrawal from my family (almost needing isolation from people), inability to concentrate, fogginess and an awful memory, tingling in extremities, very dry skin no matter how much I drink or how much lotion I used, more frequent headaches, bloating and GI issues, inability to lose my baby weight (I lost my waist), breaking hair that is more oily, breaking nails, changes in perspiration and body odor (sweating and smelling more easily), bad taste in my mouth, more sinusitis and allergies…I think that about covers it..”

She also had told us she had tingling in her legs, which required her to see a neurologist and have a brain MRI. She also had increased sugar cravings and gained 15 lbs.

Momzilla told us her story of having a tubal ligation and then noticing the onset of these symptoms. She has seen several doctors and had a variety of inconclusive tests. She found information about PTLS on the Internet and discovered Chapel Hill Tubal Reversal Center as well. She was very clear she was not getting a ligation reversal so she could have more kids. She was trying to get her body to be like it was prior to the ligation. She desired a return to her normal state.

I am happy to report Momzilla had a successful tubal ligation reversal on June 2, 2008. Her surgery went well and was performed by Drs. Berger and Monteith. She had good tubal lengths and did well in the recovery room. She was released to the local Sheraton hotel for an overnight stay and was discharged home the next morning. She has recovered without any complications.

Readers can read about Momzilla’s after surgery report: Momzilla Reveals Her True Identity.

We will also publish reports on patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures (women who had their tubes tied).

We invite readers to join our Tubal reversal message board and discuss and share personal experiences with tubal ligation. We also have a dedicated PTLS forum for readers to share experiences of worsening symptoms after tubal ligation procedures.

Some women will develop problems after a tubal ligation procedure. Many will attribute these symptoms to Post Tubal Ligation Syndrome (PTLS) and will consider sterilization reversal. Some of these women will not have PTLS but, instead will have other underlying  medical conditions.

We started this series of articles for women suffering from adverse symptoms developed after a tubal ligation. We discussed the symptoms of Post Tubal Ligation Syndrome (PTLS), current medical studies about PTLS, and common medical conditions that can closely mimic PTLS. Like a long bus ride, we have expected most passengers to have exited this bus trip at each of their respective and appropriate stops after a thorough evaluation of the possible causes of their symptoms. If passengers are still riding, then the only stop left is PTLS.

In the past, the existence of PTLS has been widely debated but not agreed upon in various medical studies. The largest study to date, the CREST study, found no significant difference in the percentage of women with menstrual problems after a tubal ligation with a “control” group of women who did not have a tubal ligation. The authors of the CREST study concluded that adverse symptoms do not ocurr as a  result of tubal ligation. This study, however, was not designed to study the multitude of symptoms that women report after surgical sterilization.

The end of the journey

Our experience at Chapel Hill Tubal Reversal Center suggests PTLS does exist for a select group of women for whom no contributing medical, psychological, or other causes have been identified. Among this group of women, the vast majority have reported dramatic improvement in their symptoms after a reversal of their tubal ligation.

We will report the stories of several of our patients (both before and after tubal ligation reversal) who have had worsening physical and psychological conditions after sterilization and who have come to us seeking tubal ligation reversal. They will share with us their symptoms and how they have fared after tubal ligation reversal (had their tubes untied).

This is the sixth article in our fourteen part series on PTLS and associated medical conditions. Our next several articles will present patients who have suffered from worsening menstrual, physical, and emotional symptoms after surgical sterilization procedures (women who had their tubes tied).

Readers can also view patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

Visitors may join the PTLS Forum on the Tubal Reversal Message Board to share their experiences of symptoms after tubal ligation procedures and what happened to them after a tubal reversal.

The ligation reversal specialists at Chapel Hill Tubal Reversal Center are experts in tubal ligation reversal. We evaluate and treat a large number of women who request sterilization reversal. While most women seek ligation reversal to have more children,  some seek relief from worsening physical and psychological symptoms experienced after they had their sterilization procedures. Many of these women report symptoms of Post Tubal Ligation Syndrome (PTLS). Previously, we described medical conditions that can mimic PTLS. This article describes common psychological conditions that can have symptoms similar to PTLS. These conditions can exist independently of a sterilization procedure or could be associated with the profound guilt and regret some women experience after sterilization.

Depression

Depression is a common condition affecting many people. Depression can be categorized into several types; however, for simplicity we will focus on major depression.

Major Depression

Symptoms of major depression last for a minimum of six months and may include:

• Loss of interest in normal daily activities
• Feeling sad or down
• Feeling hopeless
• Crying spells for no apparent reason
• Problems sleeping
• Trouble focusing or concentrating
• Difficulty making decisions
• Unintentional weight gain or loss
• Irritability
• Restlessness
• Being easily annoyed
• Feeling fatigued or weak
• Feeling worthless
• Loss of interest in sex
• Thoughts of suicide or suicidal behavior
• Unexplained physical problems, such as headaches

There are many overlapping symptoms between major depression and Post Tubal Ligation Syndrome. Identifying the symptoms of depression can be easy, but identifying the cause of depression can be difficult.

Anxiety

Generalized anxiety disorder can be a common condition. Anxiety is characterized by excessive or exaggerated worry about life events. People with symptoms of generalized anxiety disorder tend to expect disaster and can’t stop worrying about health, money, family, work or school. The degree of worry is often unrealistic or out of proportion for the situation. Daily life becomes a constant state of worry, fear and dread. Eventually, the anxiety so dominates thinking that it begins to interfere with daily functioning, including work, school, social activities and relationships.

Generalized Anxiety Disorder

The symptoms of generalized anxiety disorder may include:

• Excessive, constant worry and tension
• An unrealistic view of problems
• Restlessness or a feeling of being “edgy”
• Irritability
• Muscle tension
• Headaches
• Sweating
• Difficulty concentrating
• Nausea
• The need to go to the bathroom frequently
• Tiredness
• Trouble falling or staying asleep
• Trembling
• Being easily startled

People with anxiety disorders have an extreme sense of nervousness, panic, and inability to concentrate or focus. They may have depression as well. Anxiety can be generalized (happens during most of the day without any apparent cause) or can be situational (triggered by a specific event).

Post Traumatic Stress Disorder

Post traumatic stress disorder (PTSD) can develop after a person has experienced a traumatic or terrifying event in which serious physical harm occurred or was threatened. PTSD is a lasting consequence of traumatic ordeals that cause intense fear, helplessness, or horror, such as a sexual or physical assault, the unexpected death of a loved one, an accident, or a natural disaster. Most people who experience a traumatic event will have reactions that may include shock, anger, nervousness, fear or guilt. For a person with PTSD, however, these feelings continue and even increase, becoming so strong that they prevent the person from living a normal life. Symptoms of PTSD often are grouped into three main categories:

• Reliving – This involves reliving the event through thoughts, memories, and dreams of the trauma. These may include flash backs, hallucinations, and nightmares. People with this form of PTSD may also feel great distress when events occur that remind them of the trauma they suffered.
• Avoiding – This involves avoiding people, places, thoughts or situations that are reminders of the trauma. This may lead to detachment from family, friends, and loss in interest in things that were once enjoyed.
• Increased arousal – This includes excessive emotions and problems relating to others, including difficulty feeling or showing emotion, difficulty sleeping, irritability, outbursts of anger, and difficulty concentrating. Physical symptoms may also occur.

Self Evaluation

Women seeking tubal ligation reversal may be at higher risk for the above conditions for various reasons, such as sterilization performed while in an abusive relationship, sterilizations done under pressure, or death of a child or spouse after a tubal ligation. It is helpful to discuss with yourself and your partner whether you may be experiencing symptoms of depression, anxiety, or Post Traumatic Stress Syndrome. The insights of a trusted friend or loved one help in this self evaluation. In some cases the advice and intervention of an experienced mental health provider may be helpful.

If you have had a tubal ligation and are experiencing any of the problems associated with Post Tubal Ligation Syndrome (PTLS), consider having an evaluation by your doctor for undiagnosed medical conditions. If  depression, anxiety or other symptoms interfere with your daily life, work, or relationships, then you may benefit by consultation with an experienced mental health provider.

PTLS Article Series

This is the fifth article in our fourteen part series on PTLS and associated medical conditions. Our next article, Post Tubal Ligation Syndrome|A Long Journey, will address our experience with Post Tubal Ligation Syndrome.

Readers can also view patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

We invite readers to join the Tubal Reversal Message Board and participate in the PTLS Forum to share personal experiences with physical or psychological symptoms following a tubal ligation.

Is it PTLS or another medical or gynecologic problem?

The symptoms of Post Tubal Ligation Syndrome (PTLS) can be widespread and pervasive. Women who have problems after a tubal ligation, however, may not have PTLS. Another medical or gynecological condition may be at the root of the symptoms. The prior article in this series on PTLS reviewed medical and gynecologic disorders that may cause menstrual problems after a tubal ligation.

Over 7,000 tubal ligation reversals have been performed at Chapel Hill Tubal Reversal Center. We have had the opportunity to see the impact on these women whose tubes have been tied and who, having regretted that decision, have had their tubes untied.

Under what circumstances were the tubes tied?

Often, the decision to have a one’s tubes tied is made under stressful circumstances. Sometimes the decision to have the tubes untied is made under similar circumstances. The staff of Chapel Hill Tubal Reversal Center has compiled a list of stressful reasons women have had tubal ligations or have come to us seeking ligation reversal. Stressful circumstances under which patients sometimes have a sterilization procedure or a sterilization reversal include:

• Forced by parent or spouse
• Pressured by doctor
• Frightened by medical conditions or illness
• Mid-life crises
• Empty nest syndrome
• Infidelity
• Divorce
• Death of spouse
• Fear of birth control risks
• Decision while in poverty
• Decision during period of substance abuse
• Illness/death of close family member
• Sterilization while in an abusive relationship
• Death of a child
• Religious conversion

Regret and guilt can be powerful forces on any individual. Given the appropriate stressful circumstances these feelings can be amplified and can spread into other aspects of ones life. When decisions are made under stressful conditions, as listed above, one can easily see how this may leave a lasting sense of remorse upon any individual. The sense of remorse can be even more dramatic when the thought is suppressed and eventually emerges in the future during a stressful life event. Then consider the sense of regret and how these feeling could be increased as a person grows older and wiser when a person finds their ‘life’s match’ or if their pastor tells them they ‘violated the will of God’ by having their ‘tubes tied’.

How common is regret after tubal sterilization?

Most women do not regret their decision to have a tubal ligation. However, 1 out of 4 women will regret their decision about having their tubes tied. This was shown in the CREST Study mentioned in a previous article.

Offering Hope at Chapel Hill Tubal Reversal Center

The tubal ligation reversal experts at Chapel Hill Tubal Reversal Center help women in reversing these ‘permanent’ decisions when they are no longer the right decisions for individuals and couples. We have helped many patients come by restoring the hope of new life and the chance for some to relieve their burdens of guilt and regret.

This is the fourth article of a fourteen part series on PTLS and associated medical conditions. The fifth article, Psychological Conditions or Post Tubal Ligation Syndrome?, will address common psychological conditions that could be masquerading as Post Tubal Ligation Syndrome.

Readers can also view patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

We invite readers to join the Tubal Reversal Message Board to discuss and share personal experiences with tubal ligation. We also invite women with post tubal ligation symptoms to join the PTLS Forum and share personal experiences with worsening physical or mental symptoms noticed after tubal ligation.

Has your body gone ‘haywire’ after having your ‘tubes tied’? Many women report a variety of changes occurring after a tubal ligation. There are various gynecologic conditions that may be the cause and deserve proper evaluation by your doctor.

Problems that can occur after a tubal ligation

Previously, we introduced the topic of Post Tubal Ligation Syndrome (PTLS) as a suspected cause of problems that can occur after a tubal ligation. Women who experience problems after a tubal ligation may not have PTLS. If women have problems after a tubal ligation they commonly have two complaints: changes in their periods (menstrual pattern) and/or more painful periods. If you have had a tubal ligation and are experiencing these complaints, you could be suffering from an undiagnosed medical condition.

To determine if you have an underlying medical condition causing the above symptoms, it is helpful to be aware of the medical terminology for menstrual disorders.

Medical terminology

The medical terminology for changes in the frequency or amount of bleeding with your periods are:

• Oligomenorrhea
• Hypomenorrhea
• Hypermenorrhea (menorraghia)

Menstrual periods that are infrequent or irregular is termed oligmenorrhea. Periods that are scanty in amount of bleeding is called hypmenorrhea. Periods that are heavier in the amount of bleeding is termed hypermenorrhea or menorraghia (both terms refer to heavier periods).

The medical terminology for painful periods is dysmenorrhea.

Dysmenorrhea is divided into two categories:

• Primary (since puberty)
• Secondary (developed as you became older)

More painful periods developing after a tubal ligation would be categorized as secondary dysmenorrhea.

Medical causes of menstrual disorders

There can be many medical causes for oligomenorrhea, hypomenorrhea, or hypermenorrhea:

Uterine fibroids
Endometrial polyps
Adenomyosis
Uterine infections
Thyroid abnormalities
Endometrial hyperplasia
Endometrial cancer
Blood abnormalities (platelet disorders)
Ovulation disorders?
Polycystic Ovarian Syndrome?
Pregnancy*
Anorexia nervosa*
Congenital adrenal hyperplasia*
Perimenopause?
Pituitary abnormalities?

* Marked items are mostly associated with oligomenorrhea
? Marked items can be associated with both oligo and hypermenorrhea

Most women who develop abnormalities in their menstrual cycle after a tubal ligation will not have a serious medical condition. Most will have hormonal abnormalities, uterine fibroids, or anovualtion as the cause for changes in their menstrual cycle. These are common conditions that occur as a person either ages or experiences significant changes in weight.

Dysmenorrhea

There can be many medical causes for dysmenorrhea. These are the major causes of secondary dysmenorrhea:

Gynecologic disorders
Endometriosis
Adenomyosis
Ovarian cysts
Pelvic adhesions
Pelvic inflammatory disease
Uterine polyps
Congenital obstructive Müllerian malformations
Cervical stenosis
Nongynecologic disorders
Inflammatory bowel disease
Irritable bowel syndrome
Uteropelvic junction obstruction
Psychogenic disorders

Secondary dysmenorrhea can be experienced by many women. The most common causes are endometriosis, adenomyosis, and ovarian cysts. Causes of secondary dysmenorrhea can sometimes be difficult to identify. Sometimes, women may need to be referred to other medical specialists to diagnose the cause of secondary dysmenorrhea.

Changes in one’s menstrual cycle are common and can also occur after a tubal ligation procedure. When a woman has a tubal ligation and then develops any of the symptoms discussed above, it is tempting to attribute them to Post Tubal ligation Syndrome; however, there may be other underlying medical or gynecological conditions responsible for these changes.

The tubal ligation reversal experts at Chapel Hill Tubal Reversal Center recommend you see your medical provider if you develop any of the above symptoms after a tubal ligation. The purpose of your visit will be to diagnose any medical conditions which could the cause of your symptoms. If your doctor is unable to determine any medical explanation or if your symptoms are more extensive than those listed above, the doctor might attribute your symptoms to depression, anxiety, post traumatic stress disorder, or regret over your prior decision to have a surgical sterilization.

PTLS Articles on the Tubal Reversal Blog

This is the third article of a fourteen part series about Post Tubal Ligation Syndrome. Our next article is Guilt or Regret About Tubes Tied.

Readers can also view patient submitted stories about their menstrual symptoms, reasons for reversing tubal ligation, and outcomes after reversal reversal surgery. Each patient’s story is listed below:

Meet Momzilla
Meet Andrea
Meet Rebecca
Meet Praybelieving
Meet Katherine

We invite readers to join the Tubal Reversal Message Board and discuss and share personal experiences with tubal ligation. We also would like patients to join our PTLS Forum and share their personal experiences with worsening physical or mental symptoms noticed after tubal ligation.

Comment by Dr. Berger

The terms introduced in this article – such as oligomenorrhea, hypomenorrhea, hypermenorrhea, and dysmenorrhea – are descriptive medical terms for common menstrual disorders. When they occur, they deserve a thorough medical evaluation. As Dr. Monteith has described, there are many underlying causes or diagnoses for these conditions.

The question that seems to be at issue regarding Post Tubal Ligation Syndrome is this: when symptoms develop after a tubal ligation, are they attributable to the tubal ligation itself or to some other underlying condition? If no other underlying causes are found, then is PTLS the diagnosis remaining by exclusion? If a doctor does not believe in the existence of PTLS and no underlying medical or gynecologic diagnosis is evident, is attributing the symptoms to depression, anxiety, post traumatic stress disorder, or sterilization regret reasonable, accurate, or sufficient?

Articles About Post Tubal Ligation Syndrome