May 20, 2009

Post Tubal Ligation Syndrome (PTLS)

Post Tubal Ligation Syndrome

Post Tubal Ligation Syndrome (PTLS)

Post Tubal Ligation Syndrome (PTLS)
Symptom List © 1999


Post tubal ligation syndrome (PTLS or PTS) is an an iatrogenesis condition meaning doctor-caused or doctor produced. Many women suffer post tubal ligation syndrome after having a tubal ligation.
Below is a list of symptoms that are associated with post tubal ligation syndrome.

Post tubal ligation syndrome is often the result of a rapid decline of estrogen/progesterone hormone levels caused by the blood supply being damaged to the ovaries during the TL surgery. Depending on the damage to the veins and capillaries, blood volume to the ovaries may slightly decrease or can be eliminated completely which is called isolated ovarian syndrome (common with hysterectomy operations). Many of the symptoms of PTS are associated with menopause, hormone shock, or of having an estrogen/progesterone imbalance.

Other symptoms, such has heavy painful periods may be caused by a hormonal imbalance, could be caused by adenomyosis (bought on by uterus muscle and tissue being damaged, effected by the TL surgery impairing the blood supply to areas of that organ/muscle) or a combination of both. Pain also can be caused by retro bleeding backing into the sealed fallopian tubes.

Other theories of PTLS and the hormonal imbalance that results after a TL is that target or receptor cells that are important in the relay of hormonal messages are damaged, destroyed, and or removed during the TL surgery. These receptor cells act like a telephone, sending messages to the brain. These target/receptor cells are located within the fallopian tube.

With this in mind, it's possible for a woman to have both her ovaries still functioning to some degree (if blood supply was not damaged), have no major problems with her uterus (again if blood supply was not damaged to that organ), and still be experiencing PTS in the from of a hormonal imbalance caused by change in her hormonal message relay system due to receptor cells being removed.

The only way to find out for sure if you have a hormonal imbalance or are menopausal is to be properly hormone tested.

Post Tubal Ligation Syndrome (PTLS) aka PTS is linked with:

Castrative Menopause
Severe Hormone Imbalance
Ovarian Isolation (Post Hysterectomy, Post Tubal Ligation)
Atrophic Ovaries
Hormone Shock
Increased Risk of Heart Disease
Bone Loss and Osteoporosis
Dysfunctional Uterine Bleeding (DUB)
Severe Pelvic Adhesions
Misplacement of Female Organs
Decreased Lactating Ability

1. Eptopic pregnancy or pregnancy (well known risk of tubals)

2. Hot flashes, flushes, night sweats and/or cold flashes,
clammy feeling, chills

3. Bouts of rapid heart beat

4. Irritability

5. Mood swings, sudden tears

6. Trouble sleeping through the night (with or without night sweats)

7. Irregular periods; shorter, lighter periods; heavier periods, flooding;
phantom periods, shorter cycles, longer cycles

8. Loss of libido (see note)

9. Dry vagina (see note)

10. Itchy vagina-at time raw like, can radiated from whole area, with
absence of yeast infections. (see note)

11. Color change in vaginal area. (color gets darker -darker red to purple)

12. Crashing fatigue - Chronic Fatigue

13. Anxiety, feeling ill at ease

14. Feelings of dread, apprehension, doom (see note)

15. Difficulty concentrating, disorientation, mental confusion

16. Disturbing memory lapses

17. Incontinence, especially upon sneezing, laughing; urge incontinence
(see note)

18. Prolapse of uterus do to rapid decrease in estrogen levels.

19. Itchy, crawly skin (see note)

20. Aching, sore joints, muscles and tendons (see note)

21. Increased tension in muscles

22. Breast tenderness

23. Decrease in breast mass

24. Headache change: increase or decrease

25. Gastrointestinal distress, indigestion, flatulence, gas pain, nausea
Irritable bowel syndrome (IBS)

26. Sudden bouts of bloat

27. Depression (see note)

28. Exacerbation of existing conditions

29. Allergies developing or increasing - (Chronic sinusitis).

30 Nasal infections-necessitating antibiotics

31. Weight gain (see note)

32. Hair loss or thinning, head, pubic, or whole body; increase in facial hair

33. Dizziness, light-headedness, episodes of loss of balance

34. Changes in body odor

35. Electric shock or stabbing sensation under the skin. (see note)

36. Tingling in the extremities, (see note)

37. Gum problems, increased bleeding

38. Burning tongue, burning roof of mouth, bad taste in mouth, change in
breath odor (see notes)

39. Osteoporosis (after several years )

40. Changes in fingernails: softer, crack or break easier

41. Stabbing pains in pelvic area at time of ovulation

42. Pelvic Pain

43. Development of Adenomyosis

44. Development of Ovarian/Tubal Cysts

45. Decreased Lactation Ability

Zentralbl Gynakol 1989;111(16):1124-7 [Article in German]

The effect of postpartum tubal sterilization
on milk production

Vytiska-Binstorfer E.
I. Universitats-Frauenklinik, Wien.

We investigated 64 women after the so called "post partum sterilization" and recorded also retrospectively the milk production within the first seven days. It was performed by at semilunar subumbilical incision and a bipolar coagulation of the fallopian tubes. The total daily milk production, which was compared with the quantity of milk after the previous pregnancy, was on day six and seven significantly lower after tubal ligation than in the normal puerperal phase before.

PMID: 2816156 [PubMed - indexed for MEDLINE


The effects of blood supply being affected to the ovaries:

The onset onset of PTS is not always obvious to the post tubal woman. She may know that she is sick and that she has suffered a health change but she may not always be properly diagnosed.
The symptoms of the hormonal imbalances that are often seen in post tubal women are often mis-diagnosed by the medical community as being heart conditions, chronic fatigue, common depression, IBS, common allegeries, and so on.

The medical community avoids hormone testing post tubal women under the age of 40. These women are told that they are too young to be post menopausal when in fact more often then not they are suffering from a hormonal imbalance or are post menopausal.

Severe and prolonged hormonal imbalances of this nature can cause bone loss, heart disease, and can cause psychological symptoms that mimic mental illnesses and Alzheimer's.


Symptom 2 - (flashes) Hot flashes are due to the hypothalamic response to declining ovarian estrogen production. The declining estrogen state induces hypophysiotropic neurons in the arcuate nucleas of the hypothalamus to release gonadotropin-releasing hormone (GnRH) in a pulsatile fashion, which in turn stimulates release of luteinizing hormone (LH). Extremely high pulses of LH occur during the period of declining estrogen production. The LH has vasodilatory effects, which leads to flushing.

Symptom 8 - (loss of libido) For some women the loss is so great that they actually find sex repulsive, in much the same way as they felt before puberty. What hormones give, loss of hormones can take away.

Symptom 9 - (dry vagina) results in painful intercourse.

Symptom 10 - (Itchy and or raw vaginal area) A normal vaginal pH level is around 4.5. A vaginal pH of 6.0 to 7.5 -- in the absence of a vaginal infection (yeast infection)-- indicates low blood estrogen levels and signals that the woman is menopausal. "The vagina (and whole area) becomes more acidic."

Symptom 14 - (doom thoughts) includes thoughts of death, picturing one's own death. Feelings of complete despair.

Symptom 17 - (incontinence) reflects a general loss of smooth muscle tone.

Symptom 19 - (itchy, crawly skin) feeling of ants crawling under the skin, not just dry itchy skin.

Symptom 20 - (aching sore joints) may include such problems as carpal tunnel syndrome.

Symptom 27 - (depression) different from other depression, the inability to cope is overwhelming. There is a feeling of loss of self. Hormone therapy ameliorates the depression dramatically.

Symptom 31 - (weight gain) often around the waist and thighs, resulting in 'the disappearing waistline'

Symptom 35 - (shock sensation) This is often discribed as the feeling of a rubber band snapping in the layer of tissue between skin and muscle. It may be a precursor to a hot flash.

Symptom 36 - (tingling in extremities) can also be a symptom of B-12 deficiency, diabetes, alterations in the flexibility of blood vessels, or a depletion of potassium or calcium.

Symptom 38 - (Burning mouth syndrome)


Please note: Some of the symptoms above are also symptoms related to hypothyroidism, diabetes, iron deficiency, and other conditions. If you believe that you may be experiencing a hormonal imbalance or hormone shock, please contact your health care provider to consult and have proper serum testing done. Proper testing will check for ALL conditions. The findings of hypothyroidism, diabetes, or anemia does not rule out that a hormone imbalance is not also occurring. The findings of normal thyroid, insulin, and iron levels does not rule out that a hormone imbalance is not occurring.

Note: Diagnosis of health/medical conditions are not made at this web site, by, by the CPTwomen, or by any of it's associates. This site is an informational and educational site only. No treatment is provided.


  1. It's interesting that doctors do not really mention post tubal ligation syndrome when talking to you about having one done.

    I had a tubal ligation a couple of years ago. I did suffer a few side effects for about 6 months, but they fortunately went away.

    Something else they don't tell you is that there is a failure rate with tubal ligations. Even though it's a small percentage, you can get pregnant after a tubal ligation. 5 women in 1,000 get pregnant after one year. This increases to 18 women in 1,000 who get pregnant 10 years after a tubal ligation.

  2. I had a tubal ligation done about two years ago, and have had almost everyone of the symptoms listed plus some other fun extras. All of the doctors I have spoken to haven't paid much heed to what I've found, but were pretty quick to order 8,000 dollars worth of diagnostic tests to rule out everything else it could be. My OB even suggested that if birth control pills didn't help me, maybe we could suppress my hormones like an artificial menopause. When I suggested a reversal instead he said not to waste my money. Putting my body back the way it's supposed to be makes more sense to me than artificially messing with it. I'm having a reversal done in about a week. If it helps me I will write back.

  3. Going through the same thing, and would love to know more information about your experience and where you had your TR done. Thanks for sharing! What a blessing knowing I'm not alone!!

  4. Countrymama,
    I think I posted my surgery story on here if you search. I know I have posted an update or 2.

    I had my surgery in Rio Bravo, MEXICO with Dr Perez (under $3300 w/trip)

    It was the best experience! I am now 5 mo post-op and feeling awesome!

    if you can not find the link to my surgery let me know. I will try to dig it up. Anymore questions just drop me a line. There are lots of TR DRs in your area! Surgery IS possible for most women!!!

    God bless and thanks for reading my blog

  5. First of all I am going to share PTLS and this wonderful website with every woman I speak with. It's a shame that Doctors knowingly put women through such anguish, I beleive it's all money driven. I asked my Doctor if would change my hormones when I was making the decision to have TL done in 2003, he just shook his head with his eye's closed as if it were a silly question, he then convinced me I would be better off. Reading the symptoms now, I had almost everyone including bone and joint aches that had me walking like I was in my nineties. I was having three periods a month and even had cramping in my lower back even when I wasn't on my period. I went to a highly regarded OBGYN, the female Doctor there just looked puzzled, she said that TL does not change your hormones and then ordered oodles of test, biopsies,one consisted of going through the center of my cervix to scrape tissue from my uterus which gave me tremendous pain for months, and probing with hi-tech machines that my insurance barely covered any of the cost. She then suggested a hysterectomy, I refused,(60,000 unnecessary hysterectomy's performed every year) she was disappointed (possible $17,000 surgery)w/ prolapse lift, bladder etc. My TL was done through Kaiser, the method they used consisted of removing and inch of fallopian tube between the cut and a titanium clip at each end, they said it was irreversible so I found bioindentical Testosterone and Progesterone, It is managing my symptoms :) It was important for me to stay away from synthetic especially after being on BCPs for 15 years. I am using vienue, in case any of you girls want to check it out. Also when it comes to testing hormones saliva testing is most accurate, I use ZRT. God Bless all of you and your health.

    1. I also have this TL procedure done, can you tell me where I can buy the venue testosterone and estrogen? Will this also help me with the concentration, cause after the procedure feel like my brain is fried.

    2. I haven't heard of venue testosterone. I ended up going to an RE and getting on prometrium to help my hormones.

  6. thanks for this nice and informative
    blog here is a blog about women health
    pregnancy and tubal reversal
    tubal reversal

  7. i think this what i have trying to find a doctor to fix me back. when i went to my doctor she said that it was i am looking if anybody know a good doctor please post it.thank you so muck

  8. I had a tubal ligation with filshie clips in April 2009. In Sept. 2010 I had the clips removed due to pain. At that time the surgeon did a bipolar triple cautery. I was not aware he did this until 2 weeks post op. I would NOT have consented to this. In the last 5 months my health had deteriorated. I have severe pelvic pain, pain and bleeding with intercourse, bladder problems, GI upset, my body aches all the time, I'm physically and emotionally exhausted, losing hair by the handful, have a rash that won't go away on my chest, sinus headaches at least once a week (never had them before), get severe gas pains with no change in my diet, my periods last less than 48 hrs but they are excruciating, the list goes on and on....before the surgery I ran 4 miles a day, now I can barely get off the couch to take care of my 3 children. I've had 3 ultrasounds which came back normal, CT scan was also normal. Hormone tests were in normal ranges. Today my gyno (not the one who performed the surgery) referred me to a urologist suggesting I have interstitial cystitis.....I also have an appt with a reversal doc for the 24th of Feb. I don't understand this. How can I feel SO awful and doctors tell me everything is fine? I hope a reversal will help. I'm tired of living in this nightmare. I'm 30 yrs old and feel as if I've aged 10 yrs in the last 5 months. When I told my doc today that I can't help but feel like this is related to that surgery she said, "It is absolutely a coincidence." Is it? Really? She also suggested a hysterectomy and oophorectomy. NO THANKS....... someone please tell me if a reversal helped!!!!

  9. I am sorry you are going through this too :(

    I can tell you most women who have reversals DO get nearly complete PTLS relief. I got 100% relief with in weeks of surgery :)

    What reversal DR are you seeing if I may ask?

  10. I live in Kansas City. I am going for a consult with Dr. Dan Gehlbach. I'm hoping he can give me a miracle. Who did you see? Did your surgeon believe in PTLS?

  11. I am in TX and I wen to Mexico to see Dr Perez. YES! He does believe in PTLS! TR and VR are his ministry so he keeps his price lower than American doctors.

    My PTLS story is on here as well as my surgery story. Feb 23 will mark 2 yrs of being whole for me :)

  12. yes you are saying very well..
    we always trust on God that he is Almighty.
    i want to share here that those women have done tubal ligation and wishing to give birth again then they must no need to worry...
    visit and feel relaxed.

  13. I love your blog. I found it many months ago when I was suffering with PTLS. It was your site which encouraged me to seek out a reversal. It will be six weeks this friday and I feel great. I have prayed so much about my mistake of having a tubal, and I prayed even harder for help in finding the right location for the reversal. Now I feel like I am being guided to warn other women about the side effects of this surgery. If you are ever interested, my blog is Thank you for the beautiful blog, and God Bless.

  14. Dose any of you can recommend doctor in SLC that can help me with the PTLS. Please help, I'm 35 and feel like 70.

  15. Every weekend i used to pay a visit this website, for the reason
    that i wish for enjoyment, since this this web site conations truly pleasant funny material
    my site > Ovarian Cyst Miracle

  16. I had my tubes burned on aug 12, 2013. Couple days after the ligation, I experiences severe chills and hot flashes, anxiety, rapid heart beats, insomnia, pressure in my head and ears, pain in the abdominal area, shooting pains to my legs, tiredness, moody, irritable and more can't remember them now. My first f/u with my gyn she said it was a transition from birth control and to give it time or see a therapist. She told me to continue taking anxiety pills (that i got from the er doctor i went see after when i got these symptoms. my husband was worried so he too me to the er). I asked about getting a reversal and she said it wouldn't do anything. A week later I saw her again, I told her its not in my head and I've never been like this in my life. I told her it all started right after the ligation. She did more blood work and I mentioned about tubal reversal again and this time she listened and will refer me to a fertility specialist to recommend me to a doctor for tubal reverse. I came home hopeful now.
    I wanted to know how fast did you realize after the reversal that it helped you and the ptls. I don't want to be like in this position any longer and don't want to suffer for a long time like most women I read their post that came across on the web. This is a real problem and I wish this tubal ligation ever existed and I am so dumb that I didn't do my research before getting it done. Aug 27, I went to see a clinic b/c my ears and head was so congested. She was concerned I might have thyroid. Another problem after the ligation. What's next? I want my life back.


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