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
Difficulty concentrating, disorientation, mental confusion
Prolapse of uterus do to rapid decrease in oestrogen levels
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.
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.
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.
- Anti-stress medications
- Antidepressants and psychological counselling
- Birth control pills
- 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:
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.