WHAT ARE THE POSSIBLE PROBLEMS AFTER A TRUBAL LIGATION?

1. Menstrual and gynaecological problems
Since 1951, there have been reports in the literature that women have a higher risk of heavy menstrual bleeding, irregular bleeding and hysterectomy after tubal ligation. The incidence of pelvic pain, period pains, longer periods and pain during sexual intercourse may also be higher. Endometriosis may also be more likely after surgical sterilization. These problems often get worse with increasing time after the tubal ligation. Another irony of tubal ligation is that it may increase your chances of needing a hysterectomy in the future, although many women believe that it will provide an end to their contraceptive and gynaecological problems.
A study in the U.S. in 1951, followed up 200 women after tubal ligation. At least 16.5% of these women developed abnormal bleeding requiring a hysterectomy within ten years of sterilization which was three times more than the hysterectomy rate in non-sterilized women. A Scottish study found that the hysterectomy rate after tubal ligation was 9.3% compared to 2.5% in non-sterilized women.
Many surgeons minimise these complications refusing to admit that they have any relationship with tubal ligation and ascribe them to the fact that the patient is getting older, has come off the oral contraceptive pill since
sterilization, and would have developed these problems anyway. Therefore, it is difficult to gauge the true incidence of subsequent gynaecological problems linked to tubal ligation.
If tubal ligation fails and pregnancy occurs, then there is a greater possibility of this being a tubal or ectopic pregnancy.

2. Hormonal problems
Some researchers believe that hormonal deficiencies and imbalances may affect up to 90% of women after tubal ligation and this area urgently needs more scientific scrutiny. Some women do escape any significant hormonal problems after tubal ligation, while others experience symptoms due to oestrogen deficiency or imbalances of oestrogen and progesterone.
The chances of hormonal problems depend upon damage to the ovarian blood supply and is higher if burning or tying/cutting techniques were used in the tubal ligation. The production of oestrogen from the ovary is more likely to be affected than is the production of progesterone, as oestrogen needs more oxygen for the many steps necessary in its synthesis by the ovary. If the ovarian blood supply is reduced by tubal ligation, the supply of oxygen to the ovary is diminished, resulting in inadequate oestrogen synthesis.
Women with inadequate amounts of oestrogen in their body will typically complain of loss of libido, fatigue, loss of feminine physique, difficulty in losing weight, vaginal dryness, bladder problems, reduced orgasms, poor memory and musculoskeletal aches and pains. Because oestrogen is necessary for the maintenance of collagen, women with low oestrogen levels after tubal ligation often complain of more rapid ageing of the skin and aches and pains as collagen is lost from the skin and bones.
The long-term effects of inadequate oestrogen production from the ovary, especially in younger women undergoing tubal ligation, are very harmful and increase the risk of cardiovascular disease and osteoporosis.
Women lacking both oestrogen and progesterone usually complain of mood disorders, fatigue, pre-menstrual syndrome and menstrual disturbances. Understandably, women with these hormonal problems are at greater risk of marital and family discord.
The development of such hormonal problems can be gradual and insidious, especially if not recognised for what they are, and may take several years after tubal ligation to fully develop. I have seen many women with such problems who were searching for an answer.
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