What is the risk of female sterilization?

Female sterilization by tubal ligation is considered one of the most reliable methods of contraception. However, there are more and more reports about the completely devastating consequences of this simple procedure for the psyche and body of women who have consciously made their choice. The tubal ligation syndrome seemed to be a fiction half a century ago, and today doctors and scientists are busy looking for the causes of its development. MedAboutMe looked into how this syndrome is expressed and where it comes from.

Sterilization as a method of contraception

Female sterilization is a procedure during which an artificial obstruction of the fallopian tubes is created. This form of birth control began to gain popularity in the US as early as the 1960s and, according to the US Centers for Disease Control and Prevention (CDC), is now the second most popular form of birth control after oral contraceptives.

In Russia, permission to carry out this procedure is given only when a woman reaches the age of 35 and has two children. Another option is tubal ligation for medical reasons. In many countries of the world there are no such restrictions. Quite often, quite young women who, due to beliefs and other reasons, have decided never to have children, turn to doctors.

Ligation of the fallopian tubes can be carried out by different methods:

• using silicone ligating rings;

• using spring clips;

• electrocoagulation — unipolar and bipolar;

• partial removal of pipes.

The most effective are partial removal of the tubes and unipolar electrocoagulation. Pregnancy risks are higher with clips.

Tubal ligation syndrome

It would seem, what is so difficult? The procedure takes about 10 minutes, and after 2-3 minutes a woman can make love with her partner, without fear of an unwanted pregnancy for the rest of her life. But as it turns out, for some women, this procedure causes extremely unpleasant consequences, called post tubal ligation syndrome (PTLS or PTS).

The list of these consequences includes the following manifestations and conditions:

• Hot flashes, night sweats, chills.

• Attacks of rapid heartbeat.

• Increased irritability, mood swings, sudden tearfulness.

• Sleep disorders.

• Menstrual cycle disorders: lengthening or shortening of the cycle duration, lengthening or shortening of the duration of menstrual bleeding, exacerbation of pain and cramps, increased bleeding, etc.

• Loss of libido.

• Dryness of the vagina.

• Itching in the vagina against the background of the absence of thrush and other infections.

• Discoloration of the vaginal mucosa — a pronounced darkening, from dark red to purple.

• Constant fatigue, deterioration of well-being in general.

• Increased anxiety, feeling of fear.

• Concentration disorders, disorientation, confusion.

• Temporary gaps in memory.

• Urinary incontinence, especially when sneezing, laughing, physical exertion.

• Prolapse of the uterus.

• Skin itching, goosebumps, tingling of the skin of the extremities.

• Pain in joints, muscles and tendons, muscle cramps.

• Increasing the sensitivity of the breast and reducing it in volume.

• Headaches, dizziness, cases of imbalance.

• Disorders of the gastrointestinal tract, flatulence, irritable bowel syndrome, nausea, etc.

• Depression.

• Exacerbation of allergic reactions.

• Overweight set.

• Hair loss and, conversely, the appearance of new hair on the face.

• Change in body odor and breath.

• Problems with the gums, their tendency to bleed.

• Pain in the pelvis.

• Formation of ovarian and / or fallopian tube cysts.

• Adenomyosis is a type of endometriosis.

Usually we are talking about a few symptoms from this list, and not a complete list. It is noteworthy that most of them are suspiciously similar to the symptoms of menopause, that is, they hint at problems with the production of female sex hormones. Others are also characteristic of various endocrine disorders.

Until now, many gynecologists believe that tubal ligation syndrome is nothing more than a patient myth. Research in the 1990s found no change in female hormone levels after ligation surgery. However, since the 1970s, when the procedure began to be done by laparoscopy — through a small puncture in the navel — an increasing number of women seeking tubal ligation, and with it an increasing number of reports of post-sterilization side effects.

The effect of sterilization on a woman’s body

Today, there is a growing movement in the US and other countries to spread awareness about tubal ligation syndrome. Accordingly, the question arises: how does sterilization affect a woman’s body? What happens to him so that the life of some people who have undergone tubal ligation becomes unbearable? There are different opinions on this matter.

So, some doctors believe that tubal ligation syndrome develops against the background of a change in the method of contraception. According to supporters of this theory, regular use of oral contraceptives can halve the amount of menstrual bleeding and even their number. Hormonal pills also relieve symptoms of premenstrual syndrome (PMS), abdominal cramps and prevent irregular periods. Therefore, a complete rejection of oral contraceptives or other hormonal contraceptives taken for years can cause the return of various unpleasant symptoms. Therefore, it is not uncommon for women, even those who have undergone a ligation procedure, to start drinking oral contraceptives again in order to control all these symptoms.

This theory is confirmed by the results of a study in 1976, when scientists compared the specifics of the menstrual cycles in women who took oral contraceptives before tubal ligation, and in women who used barrier methods of contraception — condoms, a diaphragm, etc. Indeed, patients from the second group practically did not complain to increase bleeding, the appearance of painful spasms, etc.

However, it is not possible to explain in this way all cases of tubal ligation syndrome. Often, after the procedure, a woman’s periods disappear altogether, but nevertheless, various negative side effects develop. There is a possibility that an ovary was damaged during the operation, and when both ovaries fail, mood swings, depression, constant bleeding, hot flashes and chronic fatigue can develop — just like during normal menopause, when the ovaries stop working naturally. But the probability of simultaneous damage to both ovaries is small, and then one should speak of one-time cases, and not of a “syndrome”.

According to experts who recognize the existence of this syndrome, as a result of the procedure, the blood supply to the ovaries is damaged. Depending on the damage to the veins and capillaries that supply this paired organ, the volume of blood flowing to it can either slightly decrease or stop completely. In the latter case, isolated ovary syndrome develops, which occurs during hysterectomy operations (removal of the uterus). As a result, the level of estrogen and progesterone in the body drops sharply, which leads to symptoms similar to those of menopause and various endocrine pathologies, which are characterized by hormonal imbalance.

In addition, pain can be caused by damage to the muscles, tissues of the uterus, impaired blood supply to these areas, as well as reverse blood flow to the ligated fallopian tubes.

Finally, there is another theory according to which, during the ligation procedure, target cells, receptors that interact with hormones and are located inside the fallopian tubes, are destroyed or removed. It is from them that signals about what is happening in the reproductive organs of a woman enter the brain. With the destruction of this relay system, the development of both pain sensations and mental disorders is possible.

How to protect the female body?

So, the growing number of requests from women who underwent a tubal ligation procedure and faced unexpected complications suggests that this syndrome is not an invention, but a very real problem. And the more women choose this method of contraception, the more often this syndrome will be diagnosed. But at the moment, its manifestations are often defined by doctors as symptoms of heart and vascular disease, chronic fatigue, clinical depression, irritable bowel syndrome, various types of food allergies and food intolerance, etc.

Does this mean that it is better to refuse this procedure? No. This is an effective long-term and fairly reliable method of protection. But when contacting a doctor for a tubal ligation procedure, you should find out the details as fully as possible. If after the operation there are any negative symptoms and side effects, you should immediately consult a doctor and undergo an examination to determine the level of hormones. If abnormalities are detected, hormone replacement therapy will help to cope with the problem.