In the UK, around 13,000 women each year undergo a female sterilisation procedure. It is said that up to around a third of women may suffer post tubal ligation syndrome (PTLS) after sterilisation.

What is Post Tubal Ligation Syndrome (PTLS)?

Many women opt for the female sterilisation (tubal ligation) procedure, in preference to other long-acting hormonal contraceptives (e.g. coil/ implant), as an effective form of birth control and family planning. Whatever the reason for choosing female sterilisation, there is no denying it that some women do suffer from health issues very soon after having their sterilisation.

In the UK, when a woman has her fallopian tubes tied, clipped, or cut, it is referred to as a female sterilisation. In the US, this exact same procedure is called a Tubal Ligation, and this is where the term Post Tubal Ligation Syndrome derives from: a group of health problems after having a sterilisation.

What are the symptoms of PTLS after sterilisation?

Post-tubal sterilisation syndrome can include:

  • Pain during intercourse (dyspareunia)
  • Changes in libido (sex drive)
  • Aching lower back pain
  • Pelvic pain
  • Hair loss or thinning
  • Premenstrual syndrome (PMS) symptoms
  • Infrequent or absent menstruation (oligo/ amenorrhoea)
  • Abnormal heavy periods and troublesome bleeding
  • Changes in mood and mental health
  • Hot flushes
  • Chronic fatigue

It is thought that PTLS is caused mainly by the disruption and changes in the blood flow in and around the fallopian tubes and ovaries when the tubes are clipped/ tied or cut. Post Tubal Ligation Syndrome is best diagnosed once other causes for the symptoms mentioned above have been ruled out (e.g. endometriosis/ fibroids/ endometrial polyps).

How Is Post Tubal Ligation Syndrome Diagnosed?

The symptoms of this syndrome can sometimes be mild, in which case simple treatments are often sufficient. However, for some women these symptoms do not improve, and can go on to significantly impact their quality of life. In this situation it is important to visit a Gynaecologist, such as Mr Dobson, who has experience in recognising, diagnosing, and treating this syndrome as well as a wide variety of gynecological problems. Mr Dobson will be able to discuss all the treatment options and counsel you, so that you can make an informed decision about the best way forward for you.

When does post ligation syndrome start?

Whilst not always immediately, symptoms can start within only a few days of the sterilisation procedure, making many women connect the procedure to their problems. Rather than improve, these symptoms often then persist or worsen with time. It is important to note that not every woman has symptoms of PTLS after sterilisation.

It is also important to note that for some women, when they are sterilised, they may stop taking a hormonal contraceptive such as the oral contraceptive pill. Stopping hormonal contraceptives can result in changes in periods and bleeding pattern. As such it is important to consider whether new symptoms after sterilisation are related to stopping the hormonal contraceptives rather than the sterilisation.

How To Fix Post Tubal Ligation Syndrome?

Following assessment of their symptoms and consideration of other causes, many women pursue removal of their clips or reversal of their sterilisation. Many women do find that PTLS symptoms significantly improve following a reversal procedure and/ or removal of the clips.



If you are suffering following your sterilisation, it is important that you have an assessment by someone, such as Mr Dobson, qualified and experienced in post tubal ligation syndrome