Tubal Ligation Problems
A Helpful Explanation

Tubal ligation problems are perceived by many women who have a tubal ligation procedure.

For many women, tubal ligation may be associated with side effects but may not be the direct cause of side effects. Tubal ligation will often unfairly be blamed for symptoms after tubal ligation. Tubal ligation is often guilty by association only.

Tubal ligation problems: Guilty by association!

Tubal ligation was unfairly blamed for some problems in older medical studies because these studies did not adequately examine other factors that could have also been contributing. These studies suffer from confounding bias. Confounding bias is when you don’t adequately consider all other factors.

Wikipedia offers a great example of confounding bias. Researchers may observe that drowning deaths increase with increased ice cream sales. A careless scientist would assume that ice cream causes people to drown. Obviously this is ridiculous.

The neglected observation is that drowning deaths and ice cream sales are directly associated with increased temperature. Increased temperature happens in the summer time. More people swim in the summer and when more people swim… more people are at risk for drowning.

Many past studies on symptoms experienced after tubal ligation suffer from confounding bias.

Unfortunately women who have legitimate problems from their tubal ligation are victims of previous poor research, confounding bias, and the tangential discussion of Post Tubal Ligation Syndrome.

Tubal ligation: Life before and life after

During most of a woman’s reproductive life she is either preventing pregnancy, pregnant, recently pregnant, or breast feeding. All of these conditions can provide relief from problems associated with the menstrual cycle. During this time in a woman’s life, her abnormal menstrual symptoms may not be severe and/or may not be as noticeable.

Prevention of pregnancy

Most women will use hormonal birth control as the primary means of preventing pregnancy before tubal ligation.

The birth control pill is the most popular contraceptive. Injectable hormones, hormonal patches, and hormonal IUDs are also popular. All hormonal medications will regulate the menstrual cycle, reduce bleeding during menstrual cycles, decrease menstrual cramps, and minimize the systemic problems (bloating, breast tenderness, headaches, etc) some women experience with hormonal changes during their menstrual cycle.

Pregnancy, postpartum, and breastfeeding

Pregnancy can provide up to 12 months of freedom from all of the problems associated with the menstrual cycle. Breast feeding creates and maintains a hormonal state that inhibits ovulation and suppresses the menstrual cycle and any problems associated with the menstrual cycle.

Understandably when one considers the total duration of time a women has been on hormonal birth control, been pregnant, or has been breast-feeding then this amount of time can be considerable.

Age and weight gain

As all of the above is occurring, all women will experience an increase in age and some women may gain weight. Becoming older and gaining weight can have adverse effects on the menstrual cycle.

As some women become older, they can develop other medical and gynecologic conditions that can cause painful and irregular periods. Weight gain changes the hormonal balance experienced by women and the effects of this hormonal imbalance may be more noticeable in some.

Often these symptoms are not noticed as much when on hormonal medication, pregnant, or breast feeding. After a woman has a tubal ligation she usually will not take hormonal birth control and not be pregnant. Often conditions which could have been developing over the years will then begin to manifest more symptoms and often become more noticeable.

Tubal ligation: The prime suspect for tubal ligation problems

Often tubal ligation is the prime suspect because a patient consciously makes the decision to undergo a procedure intended to provide permanent birth control. If a person begins to have symptoms after a medical intervention, they will often, understandably, focus on the last major intervention and attribute the cause of the problem to the intervention. This results in observation bias and this has also contributed to the poor quality research on tubal ligation problems.

The reality for some may be the tubal ligation was not the cause but rather hormonal changes from weight gain, the gradual development of other medical or gynecological conditions, and a seemingly increase in symptoms experienced because she is not taking hormonal medication which previously could have made the symptoms seem less intense.

Some patients unfairly blame tubal ligation because of observation bias. Often the tubal ligation is held accountable for the cause of problems… often wrongly but sometimes rightly.

Tubal ligation problems: Reality check

If you were on hormonal medications before your tubal ligation or pregnant or breast feeding for significant amounts of time or if you gained a significant amount of weight before your tubal ligation then the tubal ligation may not be responsible for your symptoms. If your problems started years after your tubal ligation then the tubal ligation is likely not the cause.

If you were not on hormonal medication for significant amounts of time before your tubal ligation, or if you were not recently pregnant and breast feeding and your symptoms started soon after your tubal ligation (weeks to months), then you may be experiencing tubal ligation problems.

In our practice we do treat women whose symptoms are a direct result of their tubal ligation.

For more detailed information about tubal ligation problems for medical professionals visit: For Physicians