If you have had a tubal ligation and are observing changes in your body or mental state then you have probably asked yourself or your doctor, “Does tubal ligation cause problems?”
As a physician who specializes in tubal surgery, I am convinced some women have tubal ligation problems or side effects from their tubal ligation procedures.
In the early part of my training, I did not believe tubal ligation could cause problems other than a tubal ligation failure, which could lead to an unplanned pregnancy or ectopic pregnancy.
After years of specializing exclusively in tubal reversal, I have come to understand some women can have problems from their tubal ligation procedures.
Can tubal ligation cause problems? I have come to understand the answer to this question as a definite “Yes”.
- Tubal ligation can cause problems IN SOME WOMEN and for many different reasons.
- The majority of my patients (>85%) request tubal reversal ONLY to have another baby.
- Some want reversal (approximately 10%) to restore fertility BUT ALSO to evaluate tubal ligation side effects.
- A few of my patients (approximately 5%) want reversal ONLY to treat symptoms they began experiencing after getting their tubes tied. These patients will tell me they have no desire to get pregnant and will definitely use another form of birth control after tubal reversal. Many of these women will also ask me to perform vasectomy for their partners.
Some women do have tubal ligation and experience problems. Most do not have problems at all from their tubal ligation procedures.
Does tubal ligation cause problems?
Does tubal ligation cause problems, symptoms, or troubling side effects? This is an easy question to ask but a complicated question to answer.
Charles W. Monteith M.D.
Medical Director A Personal Choice
Before specializing in tubal surgery, I practiced general obstetrics and gynecology at a high volume, high-risk hospital in Raleigh, North Carolina.
I performed tubal ligations every week for eleven years. One day a week our service had a dedicated operating room to perform tubal ligation procedures. We would do up to eight tubal ligation procedures on some days.
I thought tubal ligation did not cause problems only because I never received any complaints from patients about abnormal symptoms or tubal ligation side effects.
No one ever told me they had a problem from their tubal ligation, but I will readily admit I did not see many of our patients for long term follow up.
I am simply saying I did not hear about problems because I would lose touch with most of our patients. I did many tubal ligations but I would usually never see these patients again.
I performed many hysterectomies for a variety of conditions, including pelvic pain, and I was never convinced tubal ligation was the cause for any of their hysterectomies.
Since exclusively specializing in tubal reversal, I now have come to understand tubal ligation is directly responsible for some abnormal symptoms in some women who have their tubes tied.
Essure: A tubal closure technique that can cause problems
Essure trans-cervical hysteroscopic tubal occlusion has been associated with abnormal symptoms in some patients. This association has been documented in data submitted to the FDA in the Phase 1 and Pivotal trials submitted for Essure approval.
Green arrow demonstrates uterine perforation
In these Essure acceptability studies, some patients reported back pain, abdominal pain, pain with sex, severe menstrual cramps, severe pelvic pain, and uncharacterized pain which persisted for 12 months after insertion. The percentage of women reporting these symptoms ranged from 1% to 9%.
Although it is debatable if the Essure caused these symptoms directly or was simply associated with these symptoms, there was a clear association between Esure tubal occlusion and the development of abnormal symptoms which persisted for up to one year after Essure was inserted.
For more information: Can Essure cause problems?
Since the release of Essure the medical community will now more readily admit that Essure tubal ligation can cause problems for some women. The company that made Essure, Bayer, voluntarily stopped selling and distributing Essure in the U.S. on December 31, 2018.
The company reportedly removed the device from the market due to a decline in sales. Interestingly enough they made a big effort to get unused devices returned to the company so these remaining devices could not be implanted.
Most people believe it was removed from the market due to the large number of women complaining of Essure related problems and pending class action litigation.
Can tubal ligation cause symptoms?
We see a significant number of patients who report tubal ligation side effects.
Many times we see women who are reporting tubal ligation problems because they want to justify their reasons for getting tubal reversal surgery. Some patients will claim they are having side effects because they hope it will force health insurance to pay for the procedure or they want a reluctant spouse, partner, or family member to be accepting of the procedure and any possible future children.
We commonly see patients who are hoping health insurance or state funding will pay for reversal if they demonstrate complications were experienced as a result of their sterilization procedure.
We also see some couples who are discordant in their desire for more children and are seeking restoration of natural fertility under the pretense of medical necessity.
We have also experienced patients who are attempting to defend their desire to have more children against those in their family or social circles who believe these women should not have more children. For these women their defense is easier to conduct when the surgical treatment is for tubal ligation side effects rather than for restoration of fertility.
Unfortunately when women claim symptoms from tubal ligation as a convenient excuse to have more children it hurts the cause of those women who are legitimately having problems after getting their tubes tied.
Can tubal ligation cause endometriosis?
Endometriosis of ovary and tube after tubal ligation
I have also been impressed on how often I have observed endometriosis at the tubal ligation sites in a significant number of my patients.
It is very uncommon to see endometriosis on the fallopian tubes. Most endometriosis is seen deep in the pelvis…either deep in front of the uterus or deep behind the uterus.
I commonly see endometriosis on the fallopian tubes and at the site of the tubal ligation procedure. Usually these patients did not have a diagnosis of endometriosis before the tubal ligation. Not only do these patients not have a history of endometriosis, their doctors did not see endometriosis on the tubes or in the pelvis at the time of the tubal ligation procedure.
For more information: Can tubal ligation cause endometriosis?
As a generalist, I rarely saw endometriosis involving the fallopian tube during diagnostic laparoscopy or hysterectomy, but as a reversal specialist I see tubal endometriosis very frequently (both symptomatic and asymptomatic) in a significant number of my patients. I see endometriosis on the fallopian tubes of my patients at least once a week.
What symptoms does tubal ligation cause?
It is important to emphasize that the vast majority of patients do not have symptoms after getting their tubes tied. If patients do report abnormal symptoms they most complain of abnormal periods and pelvic pain.
Abnormal periods. Most women who have symptoms after tubal ligation often complain of their periods being heavier. Some report bleeding in between their periods. A few women will report skipping periods but the majority complain of heavier periods.
Painful periods. The second most common complaint from women with tubal ligation side effects is that their periods will become more painful. Often we will find fallopian tube endometriosis in these patients. Some patients have entirely normal tubes. Amazingly most of these patients report improvement after tubal reversal surgery.
Want to better understand the tubal reversal process?
Watch the following video to better understand the process of having reversal surgery with Dr. Monteith.
If you would like more information about reversal surgery with Dr Monteith then read: Most frequently asked questions about tubal reversal
If you would like know if you are a candidate for reversal surgery then you should send your tubal ligation operative note for a free review. For more information on how to send your records to A Personal Choice for a free review then visit: Sending records for a free review
You can also call Dr. Monteith’s office at (919) 977-5050 to speak with a helpful staff person if you have questions about reversal surgery.
