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Date of last update: 10/14/2017.

Forum Name: Gynecology

Question: Post Tubal Ligation Syndrome

 Pooh12599 - Fri Aug 20, 2004 11:14 pm

Post Menopausal @ 35 yrs. of age :!:

I had a tubal ligation @ age 22. At no time in my life had I had cramps prior to menstration. Almost immediately following my surgery I was plagued by horrendous cramps and excessive bleeding. I was told that this was normal and that my body just had to adjust, from the surgery. :(
Within a year I had moved across the country, and could not bring my medical records with me. I was without insurance for the first time in my life, so I endured the constant pain and soon became anemic. :cry: Pap smears were done regularly, never showing any abnormalities, or so I was told by my new Dr's. :? Slowly my body did "adjust". I started having fewer periods and with less intensity until age 30 when all menstrations halted. :o At the same time, I had started gradually gaining weight, while no changes were made in my diet. I even tried aerobics and walking to get the weight off, to no avail. My new Dr's then informed me that I was obviously on too much thyroid medication (4 gr thyroid /day since 1969), and so started the long process of decreasing my dosage, as well as changing it to synthroid. Much to their dismay, my menstrations did not resume. And I felt miserable all the time :cry: I was diagnosed as Post-menopausal at age 35. My Dr. put me on Premarin and progesterone to ward off Osteoporosis and heart disease.....and my menstrations came back with a vengence :evil: My Grandmother had died from Breast cancer which made me anxious about the hormone replacements, not to mention that I did not want to return to an awful 2 week period every month followed by fatigue due to anemia, after having been menstration-free for at least 5 yrs :x My Dr's suggestion to this dilemna was a hysterectomy. I vetoed this suggestion, due to my normal Pap smears. Why remove something that was supposedly not doing any harm, although it had been useless for many years :? Which brings me to my present questions :?: Is it possible that I had PCOS after my Tubal ligation :?: And if so, why would my Dr. not suggest this as the cause for all of my suffering, or the reason he suggested the hysterectomy :?: I have been gaining an average of 5 lbs per year since age 30. I was never a skinny person, but 190 lbs. for a 5' frame does not sit well with anyone :!: I ache in all my joints. I have had severe tendonitis on more occasions than I can count. I seriously fear for my life :cry: So far the only advise I have gotten is to watch what I eat and walk:!: Weight-watchers doesn't even help :? I have been doing some research on PCOS, and it seems to fit my prior problems. Could it also be the reason for my TSH levels being lowered making me appear to be on too much medication) :?: Please help me understand, or at least give me suggestions as to how to approach my Dr's with my suspicions :idea:
 Dr. Tamer Fouad - Sat Aug 21, 2004 2:59 am

User avatar Hello,
Why do you suspect PCOS? Because of the weight gain and irregular periods? The irregular periods that happened after tubal ligation are self explanatory. As for weight gain it is a very general manifestation, meaning it can be the result of almost anything including the hormonal imbalances you have gone through. Did you experience any androgenic manifestations such as increased hair growth etc.

Please have a look at our PCOS page for more info on the symptoms and hormonal changes that occur in this disease.
 Pooh12599 - Sat Aug 21, 2004 12:13 pm

Dr. Fouad,

I have read extensively on the subjects of Hypothroidism, menopause, PTLS, and PCOS. Including reading of your PCOS page.

Menstrual periods that are infrequent, irregular or absent (had or have)
Difficulty getting pregnant (Had a Tubal Ligation, Cauderized type)
Obesity (in 40 percent to 50 percent of women with this condition)( I am)
Acne (Had)
Hair growth in the beard area, upper lip, sideburns, chest, the area around nipples or the lower abdomen along the midline(beard)
Appearance of darkened, thickened skin, sometimes appearing velvetlike, in the armpits.
High blood pressure, high blood sugar or a cholesterol problem(have # 3)
Insulin resistance (now thought to be a cause rather than a symptom, more on this later). When insulin resistance is found along with high blood pressure, high triclyceride levels, decreased HDL (good cholesterol) and obesity, it is sometimes termed "Syndrome X".
Higher risk of developing coronary heart disease

Fortunately, I have not yet developed some of the more serious symptoms :o Although I am considered morbidly obese, I do not have HBP for instance. But I feel that I have enough of the symptoms to warrant further investigation :idea: I do not want to place blame on anyone. I just want my life to be the way it should be :) I want my health back. I want my energy back :!: I am not very old (45 this coming b'day), but I sure feel old :( And I want to be here when my Grandbabies graduate from high school :!:
 Dr. Tamer Fouad - Sat Aug 21, 2004 4:15 pm

User avatar Hello Grandma!
Let me add to your statements above:

Menstrual periods that are infrequent, irregular or absent (a common condition)
Difficulty getting pregnant (Why did you get a tubal ligation?)
Obesity (a very common condition almost 20% of Americans are cosidered obese) Acne (Even more common)
Hair growth in the beard area, upper lip, sideburns, chest, the area around nipples or the lower abdomen along the midline (That is an important symptom only if you have significant increase in hair)
Appearance of darkened, thickened skin, sometimes appearing velvetlike, in the armpits.
High blood pressure, high blood sugar or a cholesterol problem(have # 3)
Insulin resistance (now thought to be a cause rather than a symptom, more on this later). When insulin resistance is found along with high blood pressure, high triclyceride levels, decreased HDL (good cholesterol) and obesity, it is sometimes termed "Syndrome X".
Higher risk of developing coronary heart disease

Most cases of PCOS are diagnosed by ultrasonography where the ovaries show multiple cysts. However, some cases are diagnosed based on the blood hormone results and symptoms alone.

If you do have significant hair growth (thats up to a physician to decide) then this may warrant further investigation of your hormone balance.

Another quick question: What was the cause of your hyperthyroidism? Hashimoto's?

Best regards,
 Pooh12599 - Sun Aug 22, 2004 12:31 pm

Well Dr.,

I am not sure that I have ever been tested for Hashimoto's :? I was diagnosed with Hypothyroidism after my mother's urging that I be tested for it in 1970. At the time, I was the 13th person on her side of the family in 3 generations to be diagnosed with the disorder (only one male in the family had it). My younger sister was later diagnosed with Hashimoto's around 1976. I had a Tubal ligation in 1982, because the Dr's told me that I had a platapoid pelvis and the next baby could kill me. I already had two normal deliveries(24hrs and 29 hrs. labor) with two beautiful children that needed their mother, so I went through with the surgery.

The reason that I was tested for thyroid disfunction was because of my rapid increase in weight since the age of 8. I weighed 110 lbs. at 10 yrs old, and was only about 4' tall. I was extremely lethargic, and had severe problems with concentration, when I was previously an honor student. The Dr.s did extensive testing at Syracuse, NY. for everything they could think of, including dwarfism and goiter. At the time, the only thing that I tested positive for was the hypothyroidism.

I was immediately started on Armour thyroid, gradually increased to 4 gr. per day. By the time that I was 13 yrs. old, I was on a maintenance dose of 4 gr. of thyroid per day. I have been tested at regular 6 months intervals since that time. It wasn't until I started to have cessation of menses at age 30 (1989), that the Dr's here thought me to be on too much medication. Throughout my life I had been tested for TSH, T3, and T4 levels. When I moved here, the Dr's only watched my TSH levels.

At the present time I am taking 2 gr. of Thyroid per day, and my TSH levels are showing me to still be on too much medication. I am afraid to go any lower with my dosage. :cry: How can a thyroid gland said to have been dead for 20+ yrs., be working on it's own again :? As TSH is given off by the pituitary gland, not the thyroid gland, should'nt I be tested for pituitary gland efficiency :?:

Since my decrease in dosage, along with cessation of menses, I have gained 5 lbs. per year. I have severe headaches that start at the base of the left side of my head, climb over the top, and sit there for days. When I have them, even the sound of my own voice hurts, but they do not effect my eyes. I have developed GI disorders, tendonitis in numerous places, and have developed chronic bronchitis for which I use a combivent inhaler and Advair Diskus. I have also become very quick to develope bladder infections, and am incontinent when sneezing or coughing. My Dr. has confirmed that I have bladder drop.

As I said before, I am in fear for my life :( I have on several occasions worked very hard to lose the excess weight, with no positive results :!: I am certain that I am not healthy because of my thyroid dosage being dropped so drastically. But the Dr. still wants to drop it further. I am seriously scared to drop it any further, since I have been told in the past that I would die without this medication :shock: This does not make sense to me at all :? I have a very good internal Dr. that I have been seeing since 1995, but he doesn't take the time to explain all of this to me. Please give me your proffessional opinion and/or guidence :)
 Dr. Tamer Fouad - Sun Aug 22, 2004 3:44 pm

User avatar Hello again,

The TSH has what is called a negative feedback relation with thyroxin. When thyroxine is too much (due to medication or thyroid gland production) then the TSH starts falling. It appears in your case that its falling cause you are taking too much. Read more on our thyroid functions page.

If that is the case then I agree with your doctor that you may need to reduce your dose.
 Pooh12599 - Sun Aug 22, 2004 5:35 pm


I read the thyroid function page. Most of which I was already aware of. Am I to assume than , that your opinion is that I should follow my Dr's advise more closely, and continue to reduce my dosage? What outcome can I expect from this change? :?

As I have said previously, I am frightened that doing this will cause more total body fatigue and loss of concentration and memory abilities :( My parents are both taking synthroid at their ages (67 and 69), and so does my sister and brother (41 and 40). But they have only been diagnosed with hypothyroidism over the last couple of years. It has not been a life-long battle for them, as it has been for me :!: .

I have also read the PCOS page which states that thyroid function tests can have normal readings if you have this disease. Or did I read it improperly :?:
 doylefran05 - Thu Dec 02, 2004 2:58 pm

:( Hello,
i am 23 years old and in 2003 i got a tubal ligation after my 2nd child. i had asked my doctor if their would be any side effects after the operation and he said all should be well. ALL IS NOT WELL :x I have been having side effects for a long time now. including that of heart palpatations, loss of memory, sever migranes, joint pain and spasms, loss of sex drive, weight gain, body odor, hot flashes, and severe pelvic pain during menses and at surgical site without any type of cause. :!: i have been to my doctor month after month since may of this year and have gained 40lbs during that time. I have never had a issue with my weight i was a steady 125 after both of my children then boom :cry: weight gain i had a change in diet to veggies and fish that is suppose to be healthier and have been walking and doing excersize videos but nothing. I think I'm a little to young to be going through all of this what is your thoughts.
 benwalsh - Thu May 19, 2005 7:32 pm

The debate on 'tubal syndrome' will continue for some time, meanwhile if i was you i would get a reversal. The terribly high number of tubal ligations, is causing much regret amongst women, and while most reversals are done to restore fertility, it is also valid to have one just because you want to, to obtain a feeling of... um there is a myriad of them flooding in, but as they settle it is relief and also satisfaction that i have done it, taken control and restored my body, because i was not in control when the tubal ligation was first done to me.

if you are looking for more info on this, there is a great community at

 anajelina - Wed Nov 16, 2005 5:05 pm

I had a TL done Nov. of 2002. About 10 months later, I noticed my periods weren't normal. Very heavy and HORRIBLE pain on my right side. So I just dealt with it, kind of figuring it had something to do with the TL. So in march of 2005 is when something bad started to happen. I got my period and I was bleeding so heavily that I passed out. Went to the ER, and they found several little cysts on my right side and sent me home saying that they had burst, which caused so much pain. Then I noticed a month later I didn't get my period and I had a small lump sticking out the right side of my stomach. I went to the dr. and he did a pelvic exam and said he felt a lump the size of a plum, or small orange. I had cat scans and ultra sounds done, and nothing showed. Then I was sent to a Gastroenerologist because my ob thought it was backed up feces. I had the colonoscophy done and nothing was wrong there. I went back to the ob and he had the audacity to call me a "wierdo". So he said I should go to a urologist. I said "forget it". I went back to my family dr, and she put me on birth control to "regulate my periods and ease my right-sided pain." She did another exam and didn't feel that lump anymore. But I am still having that pain there, even though I am on TWO DIFFERENT birth control. And I've been bleeding almost everyday since I've been on the BC. I am so frustrated, because I don't want to have to "LIVE" with this pain for the rest of my life. I pretty much regret having the TL done. And even though I asked all the drs. I've seen if it would have anything to do with the TL, they deny,deny,deny!!!!

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