Post Tubal Ligation Syndrome

Following tubal ligation, some women experience abnormal gynecologic problems that may include abnormal menstrual cycles, pain with intercourse, a decreased libido, hot flashes, premenstrual syndrome, and menopause. These collective symptoms are often referred to as Post Tubal Ligation Syndrome (PTLS).



The causes of PTLS include an alteration in the circulation of blood in the fallopian tubes and ovaries; nerve pressure; the formation of scar tissue; and an imbalance in the hormones estrogen and progesterone. It is estimated that 2 – 5% of women who have a tubal ligation develop PTLS.

Symptoms of PTLS

Hot flashes or Irregular menstrual cycles

Breast tenderness or Decreased libido

Vaginal itching or Dry vagina

Fatigue or Irritability 

Bloating & Weight gain

Anxiety & Depression

Hair Loss or Itchy skin

Mood swings or Memory lapses

Difficulty concentrating or Sleeping

Gum problems or Fingernail changes

There appears to be two prominent risk factors for developing PTLS:

Women who have their tubal ligation through cauterization have a higher incidence of PTLS when compared to women who had a tubal ligation with Hulka Clips or Falope Rings. 

Women who have a tubal ligation before the age of thirty have a higher incidence of PTLS than women having a tubal ligation after the age of thirty.

The diagnosis of PTLS is based on symptomatology following a tubal ligation and is considered controversial in the medical literature. However, anecdotal and personal experience notes that the symptoms of PTLS significantly improve with a tubal reversal.