Is Post Tubal Ligation Syndrome (PTLS) Real?
Post tubal ligation syndrome (PTLS) is a term used to describe a variety of symptoms that may occur after a tubal ligation. Symptoms that women frequently report include increased menstrual bleeding and cramps, hot flushes, night sweats, irritability, and mood swings. These are thought to be due to changes in hormone levels. One theory about what may cause these symptoms after a tubal ligation has to do with interruption of blood circulation between the ovaries and uterus that affects the production of ovarian hormones.
Doctors differ in their opinions about whether post tubal symptoms constitutes a true syndrome. It has been a subject of controversy n the medical literature for decades. Studies have reported conflicting conclusions about whether these symptoms are more common among women who have had a tubal sterilization than among women who have not had a sterilization procedure.
Women who describe their symptoms are convinced that PTLS is real and they argue that doctors should recognize this as a true medical syndrome. Many of these women have been told by doctors that the symptoms they have developed after their tubal ligation could not be related to the surgery and often report that they feel they aren’t taken seriously. Some doctors recommend treatment with birth control pills, antidepressants, anti-anxiety medications, referral to a psychologist, or even hysterectomy.
During the past several years, increasing numbers of patients have requested tubal lreversal surgery in hopes of finding relief from PTLS symptoms. A recent study of 91 women reporting PTLS used a standardized questionnaire prior to tubal reversal and at 6 month intervals following tubal ligation reversal to gather statistical data regarding the possible effects of tubal reversal on PTLS symptoms. The study found that 90% of reported improvement in their PTLS symptoms, 8% reported no change, and 2% reported an increase in symptoms after tubal ligation reveresal.
Members of the Tubal Reversal Message Board often discuss PTLS and how tubal reversal surgery has helped alleviate symptoms. These women uniformly disagree with the concept that symptoms that they have experienced since their tubal ligation are “just in their heads”. They are certain that their symptoms are not imaginary and are grateful when their symptoms disappear after tubal reversal surgery. The Message Board members offer encouragement and support to women who have similar symptoms and feelings and it helps them to realize that they are not alone. Following are some examples of posts on the subject of PTLS on the message board.
“I want to say thank you… my PTLS is practically gone and gets better ever month. I did not realize how bad I was truly feeling until I felt better and I thank you. I thank you for ‘putting me back together’ and for giving me the opportunity to have another child.”
“My name is Rhonda I had the reversal done because of the Post Tubal Syndrome caused by my tubal ligation. Although I realize that some people think that this Syndrome doesn’t exist, I can tell you that is does. I am so grateful that I found you and your staff. The results I have had since the reversal surgery have been tremendous.”
Conclusion: Counseling before having a tubal ligation rarely includes the possibility of menstrual and other symptoms encompassed by the term “post tubal ligation syndrome”. When women develop problems following female sterilization, they are frequently informed that their symptoms have nothing to do with the tubal ligation procedure. The purpose of this article is to promote awareness of PTLS and the possibility that tubal reparative surgery may remedy the problems.
Gary S. Berger, MD
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Vasectomy Reversal said,
January 17, 2009 @ 2:01 am
May be in some cases it is complicated and lead to the syndrome. That is why I suggest people to go for a vasectomy, if one of the couple should go for sterilization. They can get a vasectomy reversal whenever they need kids and also it is less complicated compared to tubal.
-Martin
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September 23, 2009 @ 7:35 am
I think it is real, but it is only my opinion
autumn said,
November 6, 2010 @ 4:45 am
yes its real the r a bunch of woman like my self that have it i almost have ever single symptom & my doc didn’t tell me about the after math that would happened after i had my tubes tied i wish i would have known b4 hand i would have never of done it this it has ruined my sex life for me & my parter im aways moody depressed & exhausted after sleeping 8 hrs a day my parter will b talking to me 1 min & i will just zone out & will catch the last part of what he was saying & not know what he just said 2 me & nod like i heard everything & say yes honey ive had knew just recent hot flashes & dizzy spells were i fall over im afraid 2 pick up my gurls & holding them now cause i may get dizzy & lose my balance while holden them i worry over things that i use to not i have terrible head aches ever day i take Excedrin mirgrain i take 4 to 5 tables through out the day every day just to help coupe with my head aches so i can get through my day i never took any of that birth control b4 i had my gurls my daughter is 2 & my other daughter is 9 mos old so dont go & say its do 2 using birth control cause i wasn’t on the pill i had my tubes tied in april of 2010 & there r many more out there like me that suffer with it every day & would beg & peed with woman to not ever get your tubes tied find another way your in consent pain after they tie your tubes & after u heal & your pain only get worse after time goes by docs dont let women know about it cause there males & never had it done them selfs mine didn’t tell me about this i found out about it on my own after i had the surgery ive regretted even since then the periods r unbearable most of the time u itch all the time & it drives u insane & sum times i cant sleep 4 days i worry & stress about stuff that never use to bother me b4 my surgery my partner even has notice my mood swings & he has no clue about ptls because i just found out about it myself 2 night i googled it & found out i wasn’t alone there r more woman out there that suffer with it as i do i have depression that i battle with daily also because of getting my tubes tied as soon as i can afford it im getting it reversed plz woman thinking about getting your tubes tied dont do it try sum thing any time else dont make the same blind sided mistake i did
autumn said,
November 6, 2010 @ 4:49 am
on ya & im not an old lady im 26 gonna be 27 a woman my age should have to go through this at my age or feel this way but i am cause my so called doctor kelped the truth from me thanks doc u sux
autumn said,
November 6, 2010 @ 4:50 am
shouldn’t meant 2 say
Cassidy said,
April 14, 2011 @ 4:11 pm
I had my Tubal-Ligation done Feb 12, 2011 and I’ve been having irregular menstrals, bad cramping ( which I never experienced before) and definite mood swings. I’m getting worried I might actually have this PTLS. My Dr. is awesome, but they want me to wait and track this for 3 months. Anyone have any advice?
miranda said,
May 23, 2011 @ 5:22 am
thank you for this post i have my tubes tied in 2006 and have been having painfull and heavy bleeding sence i hade it done i thought it was normal after but i am totaly wrong i have even noticed the mood swings so going to bring this up to my doctor !!
lisa said,
July 19, 2011 @ 8:07 am
Hi I had my tubes tied after my last son. After the surgery my periods came regular for about 4 months then they stopped after that for about 5months. I went to the doctor no one could give me an answer to why I haven’t gotten it yet. However when it did come back I have had sever cramps, blood clots migraines, heavy bleeding, tingling in my hands and also now my period has gone irregular again. Every Dr I go to says its ok an it has nothing to do with my surgery. But I decided to do my own research and almost all the symptoms that I have seen for PTLS I have. How can I get relief from this problem?
Jackie said,
August 2, 2011 @ 12:16 pm
I had my tubes tied in September of 2010, and this is the first month that I’ve had severe pain and cramping in my right side, which I think is related to ovulation because I am not due for my period yet. I can barely walk because the pain radiates to my right thigh. The mood swings, depression, severe chills are horrible. I asked my doctor at my post-baby checkup if there were any odd symptoms I should be aware of since the tubal, and she told me there was nothing to worry about. I cannot believe all of the posts I am finding about this, and doctors are not acknowledging this as a real condition! I am so angry right now; when are women going to be taken seriously and not cast aside as emotional crazy people??? It’s ridiculous that it’s 2011, and doctors are still not listening to women with these issues post tubal ligation!
Fabienne L Boustead said,
August 18, 2011 @ 8:03 pm
OMGosh…
I’ve just been reading the symptoms of PTLS I have almost all of them especially the mood swings and anxiety and pain and clotting, because of the doom n gloom and mood swings i have been diagnosed with bi-polar disorder. yet i had not had this multitude of combined symptoms before my TL surgery.. also i am scheduled under UK NHS to have more corrective eye surgery as my migraines are debilitating in the last few years and they have put it down to my lazy eye! Not had surgery nor a problem with it in 20 years!
There’s no way i could afford this surgery and in the UK it is one of the few surgeries we don’t get on the NHS, not that they recognize PTLS as anything real nor would they take me seriously. But I’m shocked that i have almost all the symptoms listed and they didn’t come on until after TL surgery and none of my doctors warned me of the possibility nor noticed them and linked it to my TL.
Also over here we’re required to have counseling prior to the surgery and yet i wasn’t offered nor given any and didn’t find out it was required until i required about reversal.
Good luck to those of you who can afford the surgery to reverse TL, it has been the biggest mistake of my life, and if it’s possible it is the cause of all the health issues mental and physical i have had in the last few years and you have any or all yourselves i can only sympathize and wish you all well and a speedy recovery from those bane’s as you have your TL reversal
Aaron said,
September 19, 2011 @ 9:36 pm
Ya, well, thanks for the info, but since reversals aren’t covered by insurance, Medicaid, the VA, or anything else and cost more than my damn car, I guess my wife will just have to suffer. Thanks once again, mainstream medicine, for screwing us over.
Stacey said,
September 26, 2011 @ 5:24 pm
I’m printing out all the information i cant find about PTLS I had my tubal ligation 3 years ago and have had problems starting the first period i had after my ligation, i have an appointment with my OB-GYN weds to discuss this syndrome with him and discuss a tubal reversal I’am 26 years old and on the depo shot to keep my periods from coming because they are so horribly painful, the doctor i see weds have heard about this syndrome within there practice and i hope he will consider me for a reversal i have 27 of the 34 symptoms listed i highly suggest women research into this syndrome before having a tubal ligation if i would have known about it before my ligation I never would have got it done….
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Scrappydoo1109 said,
November 6, 2011 @ 1:09 am
I have been thinking for a while all my pain was due to my tubes being tied so now that I’m reading this. Is thre a way to get them untied that is reasonable….. I really can’t handle the pain anymore n my dr has subjected a hystcromy but I’m 31 years old n really would like to try n have another baby some day
ana said,
November 9, 2011 @ 4:22 pm
Hi guys had my tubes tied about 3 years ago. Kept having pregnancy symptoms or what I thought was, I had tests that were neg put it down to my body thinking It was phantom pregnancy or something. On top of that I have had the most extreme mood swings and my mental health has become much harder to maintain. 2 weeks of extreme pmt. It seems to be getting worse I have one week a month when i can be myself if I’m lucky. As time has gone by since my op.
I have ended up with more and more uncomfortable and painful symptoms. have not gone to my doctor as yet. After finding there is such a thing as Ptls I’m relieved that i am not going crazy. So glad that I know whats going on now Just wanting to know if anyone can give me any suggestions of self management to help minimize the symptoms.
ana said,
November 9, 2011 @ 11:03 pm
And the doctor tells me my symptoms will be due to damage of the nerves orders bloods to be taken and prescribes me the pill.
Sabrina said,
November 13, 2011 @ 9:03 pm
Well, I’m not 100% convinced that post-tubal stress is a real disease, and if it is I don’t think it is as widespread or universal as some advocates try to make it sound. Maybe those ’symptoms’ are from something else…or maybe more a matter of a woman feeling guilt from doing the surgery that may be causing psychosomatic symptoms? I know that over the years people made judgmental comments to me about getting and implied that somehow I wasn’t a “real woman” for getting one which of course is utter BS. The ability to conceive isn’t what makes a woman a woman. That’s like saying that going through menopause means you’re no longer a woman. How would I know? Well, I had a tubal ligation done in 1984 at age 23. The tubal failed and I became pregnant anyway. I had it redone in 1986 after giving birth because I was bound and determined not to get pregnant again. I did despite the criticism I was receiving from peers and family. Anyway, I’m now 50 and over the past 25 years, I’ve not experienced any of the so-call post-tubal stress problems as described. Hence the reason I question it.
Dawn said,
December 5, 2011 @ 11:34 pm
Sabrina I can honestly say that you were one of the lucky ones who wasn’t affected. I am 38, 4 healthy pregnancies and children. I was concerned about hormonal change after my TL, oh you will be fine the dr. tells me. I had my TL 4yrs ago, I experienced what I thought were possible pregnancy symptoms, and actually went and bought tests two different time for them to come back negative…thankfully, but still didn’t understand why I was feeling what I was feeling! At this point I have night sweats, to the point of having to change clothing because I am soaked head to toe. I have extremely painful ovulations, not every month, but every couple. I used to have an extremely regular cycle, I have now experienced a period for 14 days! Now I am getting random bleeding. My sex drive is non existant, I feel like I am all over the place with my moods and emotions. I realize I am getting to the beginning of the early phases of the change, however I do think what I am experiencing is a direct cause from my TL. I believe the TL has made my body think its time to start the change rather than in maybe five more years. I know I will not be able to do a reversal for too many reason to list, but I do think this is a very real syndrome, and doctors need to start learning more about this and get educated so women don’t have to suffer like this, because honestly it is a hell, and its very difficult when no one will listen and when no one understands!
SPREAD THE WORD ….PTLS is real, we need to educate and find other ways to treat it besides reversal or anti-depressants!
Nicole said,
December 18, 2011 @ 2:07 am
I am amazed by what I am reading. I had my tubes tied after having not 1 but 2 pregnancies that threatened my or my child’s life. The first one was placenta previa and my son was 6 weeks premature. I was told it was a 1 in a million chance of having another pregnancy the same way, well 2 years later my daughter was conceived and the same issues took place. Considering the first pregnancy the dr decided to take my daughter via c-section 3 weeks early to avoid any complications durring delivery. At that point I was determined to never have another child, I had my tubes tied durring the c-section. For 10 years now I have had extreme pain, trips to the ER and given Meds and sent home, they think this or they think that. Prior to my TL my periods were fine, I never once had one that was unbearable. On top of the clotting and cramps I’ve been to the hospital with migraines that made me walk sideways and slurr my speech, they actually thought I had a stroke. I was 29 at the time. Recently I am having blockages in my intestines and pain that the drs think is my gallbladder, yet no stones or anything that they can actually diagnose. The GI said he was classifying me in a group of millions of women my age that they don’t know why we feel this way. My periods keep getting worse and worse over the years and I have unexplained pain in between. Thank you for this thread, I now feel like I have something I can take to my dr, before having the TL I never had ANY of these issues.
Teresa said,
December 23, 2011 @ 6:02 pm
I had tubal ligation around 15 years ago. But the thing is, I had all of the horrible symptoms both before and since tubal ligation. What I wonder about is this. Have women who have had tubal ligation been properly studied? I wonder how many of the women who now have symptoms were on hormonal birth control before their tubal ligation? Did the hormones in the birth control suppress symptoms that they would have otherwise had then? And no, after the tubal ligation, when they no longer use hormonal birth control, the symptoms appear because they are no longer suppressed. I am someone who never used any form of hormonal birth control in my life, even if that may seem a rarity.
Remember that the hormones in the birth control will cause your periods to be lighter. It will suppress ovulation, so you will never feel any pain in your side (ovary) mid-month when an egg is released. You may be less likely to have all of the other effects such as fluid retention, tenderness especially in breasts, probably suffer less menstrual cramping and so on. Irritability etc also.
In other words, all this time, hormonal birth control has suppressed the effects of your own natural hormones. Now, you go and have a tubal ligation, and what is the first thing you do. Why of course, you stop taking the hormonal birth control, and hey presto, your body’s own hormones are given free rein again, and you suffer many symptoms that have been suppressed.
Not to say it is not possible that damage to blood vessels supplying the ovaries or uterus could not happen to some people, and cause problems. But I think that is a lot rarer than you might think.
It is a fair hypothesis, and needs to be tested by a large study to say that many of the symptoms were symptoms previously masked by the use of hormonal birth control. People undergoing tubal ligation who used hormonal birth control would be compared with a group who had not used hormonal birth control - and matched in other aspects.
amy said,
January 2, 2012 @ 3:08 pm
I had a tubal in fall of 2009 after my 4th c-section. My “Dr.” said it was free of any side effects, that i would be 100% fine, I was never given, offered any counseling about having this done, in fact he said i had enough children and shouldn’t have any more anyway! Gotta love that military medicine! So c-section number 4 came with this symptom free tubal, In the past 2 years i have declined so much in health that my new “Dr” are testing me for everything under the sun, i have had CT MRI’s screenings, pills, creams…..consults to therapy In short everything and no one has any clue, I have long felt that the last thing done prior to feeling this way is/was to blame. So i have been hunting down all the information i can find. I am 100% convinced that PTLS is real, that I have it, and that the “Dr.” is to blame for what is wrong with me.
I can only hope that after i have this reversed that i can get back to something that resembles normal.
I have spoken to a lot of woman about this, and the one thing i have yet to hear is how great this surgery was, EVERY ONE i have spoken to regrets having had it done. Not one woman says wow im so happy i had a tubal done. They should put that on this consent form that i wasnt even aware i signed cause it was in a stack of papers 2 inches thick.
erin conner-park said,
January 7, 2012 @ 7:41 pm
I am so relieved to read that I am not the only one going through this. I have gone through two ultrasounds and a painful uterine sampling taken to see what has been causing my midcycle spotting. Everytime I mention this to my obgyn ( I have been through two since c-section/ligation five years ago) they look and act as if I am suggesting the insane. I have also had my hormone levels checked to see if I was going through periomenopause. Levels did not reflect that yet. Prior to tubal ligation 5 years ago all was the norm. Since then, relatively regular cycles but with bloating, pain and breakthrough pink bleeding midcycle and consistently around day 20, it feels like I am possessed by a rabid badger ( my family will confirm this). I have had an episode where I almost passed out during heart palpitations and the heart palpitations are a regular visitor every month now. I have had that checked out as well. Nothing notable. I remember mentioning this issue to the receptionist at my prior gyno and she agreed it may be due to my ligation. However, now my current obgyn says, “You have me stumped.” and wants me to go through a 3rd ultraound. When will I start to glow?
Hillary said,
January 12, 2012 @ 11:32 am
I am glad I am reading all this info now. I to had a TL done 2 1/2 years ago and my health has rapidly declined with most of the symptoms of ptls . I did not know it existed til now. I to have gone to so many doctor appts for this an that and nothing helps. Just the migraines themselves are so horrible and no meds help. I am heading to the OB/GYN soon and need advice on how to advise them of this condition and refer a TR. Other question is how do the doctors disgnois it to a person as having ptls? If is medically necessary to have it reveresed then why aren’t ins. co helping with the pay? What does a TR normally cost?
Lindsey said,
February 7, 2012 @ 3:07 am
Hello Everyone….
My name is Lindsey and I have been suffering from PTLS FOR 6 YEARS NOW!! I am finally undergoing a tubal reversal surgery at the end of this month and have to spend my whole income tax on it. I have had headaches, dizzy spells, itchiness, dry skin, dry hair, crazy mood swings, anxiety, depression, don’t want to leave my house around my period along with not even pick up the damn phone!!! The reason I am choosing to undergo the reversal procedure is because It has affected my marriage( don’t ever want to have sex), relationship with my children, my finances (I don’t want to go to work), I feel like I have aged 10 years in 6 years and SICK OF IT. Dr’s think i’m nut’s and I know I’m not lol… So anyway’s, the main reason for me choosong the surgery is because I want to feel better, the 2nd is so that my new husband and I can try and have a baby because I have children but he does not yet. I am hoping that this adventure helps me because I know it will. I will update soon, I go in for surgery at the end of this month. Have a wonderful day and GOD BLESS
Lindsey said,
February 7, 2012 @ 3:13 am
OH, and my tubal reversal is $5,400 total with out trip and airfare, food and transportation. I am going in Beverlyhills, LA with DR. ERILAN MOR I believe his web is center4tubalreversal.com They are book’s about a month out because this time of year people are getting them done with their taxes so he’s doing two a day from what im told by his staff… (866)99-Tubal Hope this helps
Rosema said,
March 4, 2012 @ 2:46 pm
Hi, Lindsey did you have your tubal reversal? Did it help with you ptls symptoms? Did you choose Dr Erilan? sorry for so many questions but I also suffer from ptls symptoms (severe) and I want to have a reversal.
Rosema said,
March 4, 2012 @ 2:47 pm
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Meridien said,
May 15, 2013 @ 2:19 am
I was curious about PTLS after I ran across it looking up something else. I am adding a comment about my TL experience. It was very different. I was unaware of PTLS, and I wish all the women here who have been suffering since their surgery relief a right outworking of each situation. After mine, a little soreness at the incisions (laparoscopy) but not much else. Then, my first period…It was extremely heavy and long, with killer cramps, completely unlike my regular periods. I was in the agony of “what the hell did I just do to myself?!?” Is this going to be my fate from now on? I hung in there, the period ended, and the next month, my period was back to normal, with nothing out of the ordinary, and I breathed a big sigh of relief. They’ve been nothing special since. I’ve always had clockwork periods, and that didn’t change.
The other symptom I had later on that year, 1988, was I descended into a depression that lasted a month. I just kept on getting dressed and brushing my teeth, and somehow got through it. I would have benefited from professional help, but that wasn’t an option for me at the time. Upon meditation I discovered that my body went into mourning for my lost fertility, even though I wanted TL and knew all my life I didn’t want kids. I never had baby hunger ever in my life! Maybe there was a motherhood gene in me that never expressed. (I have since been diagnosed with bipolar disorder, and since counseling and medication has worked wonders in helping me control the crazy-manic episodes I was having, too). I’ve been stable and in control for 12+ years now. It’s a horrible life-destroyer that I wouldn’t wish on my worst enemy.
My sexual desire kicked up to a higher level, mostly because the fear of having an accidental pregnancy used to scare me to death. I just didn’t want Nature to take the decision out of my hands, because if I got pregnant, I would have had a child. My husband and I began experiencing a new intimacy and sexual closeness, and I never experienced hot flashes or dryness. At least, not until I entered menopause. And even then, I can’t believe now I sailed through that. I can count the hot flashes on one hand. I can’t say this had anything to do with it, but I’ve been a lifelong vegetarian and runner. I eat a LOT of soy, but who can say??
Maybe it’s just me and a streak of good luck for my anatomy. I think I’m just like anybody else. Absolutely, it was the best decision I ever made, with zero regrets. I’m 60 now and somehow I must have “dodged the bullet.” My most sincere best wishes for all the women here is to heal and rid yourselves from a burden of pain that has taken over your lives! Please don’t call me a braggart or names like that because I believe your symptoms are real and reading your stories have made me feel for you deeply. Be well. Thanks for reading.