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Post Tubal Ligation Syndrome (PTLS)

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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)
  • PMS
  • Endometriosis
  • Adenomyosis
  • 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 www.tubal.org,  by the CPTwomen, or by any of it's associates.   This site is an informational and educational  site only.   No treatment is provided.

With proper laws in place doctors will be required to
inform women of Post Tubal Syndrome.

While we were not informed, working
together we can break this cycle of abuse.

This is a call for help.

To get the "Informed Consent for Tubal Ligation Bill" passed
we desperately need your donations.

Please donate if you have found this site and information
provided helpful or educational, if it made you pause and
contemplate, or if you would like to see a tubal ligation
informed consent law put in place.


Coalition for Post Tubal Women
Copyright 1999- 2004




Contains information regarding tubal ligation, bilateral tubal ligation, tubal pregnancy, tubal reversal, PTS, post tubal syndrome, permanent sterilization, hormone replacement therapy, FSH, follicle stimulating hormone, PMS, post menstrual syndrome, progesterone, estrogen, testosterone, sex binding hormone, SHBG, early menopause, ovarian failure, POF, peri menopause, peri, libido, sex drive, chronic fatigue, chronic fatigue syndrome, CFS, fibromyalgia, irritable bowel syndrome, IBS, bone loss, bone health, osteoporosis, osteopenia, heart disease, menopause, hormone testing, saliva hormone testing, menopause test, menopause treatment, menopause home test, menopause test kit, HRT, natural HRT, menopause HRT, menopause and HRT, fertility and conception, fertility calculator, fertility cycle, fertility treatment, fertility test, fertility specialist, female hormone, female hormone replacement, female hormone imbalance, hormone level, female sex hormone, natural female hormone, tubal ligation reversal, tubal syndrome