Tubal Ligation - Side Effects, Alternative and Prevention

What Are Fallopian Tubes?

A pair of tubes that connect the ovaries to the uterus and carry fertilized eggs released from the ovaries into the uterus. The fallopian tubes are an essential part of the female reproductive system.

What Is Tubal Ligation?

Tubal ligation is a surgical procedure performed in women, which involves getting the fallopian tubes blocked or cut. This procedure is also known as ‘female sterilization’ and prevents pregnancy.

For Whom Is Tubal Ligation Advised?

Tubal ligation is generally performed for women who:

• Have had multiple pregnancies and do not desire any children.

• Do not want children; in order to avoid pregnancy and to engage frequently in sexual activity.

• Are in a stable relationship where both partners do not want children.

• Have a genetic disorder and fear their children might be diagnosed with the same. This also applies, if the male partner has a genetic disorder.

• Cannot risk getting pregnant as it may affect their health negatively.

How Is Tubal Ligation Performed?

Tubal ligation is a surgical procedure performed under either general or local anesthesia. It is carried out in a hospital or surgical clinic. Patients are usually discharged the same day.

Procedure:

The abdomen is inflated with either carbon dioxide or nitrous oxide gas through a needle insertion or an incision made through the belly button. Next, a laparoscope is inserted into the abdomen, and other special instruments are inserted through the abdominal wall to either destroy some parts of the fallopian tubes or clip them. The gas is then removed, and the patient may go home a few hours after the procedure. Patients may experience abdominal bloating and pain, tiredness, and occasional dizziness or fainting spells as immediate side effects of the procedure that will soon wear away.

When Can Tubal Ligation Be Performed?

• Postpartum: Immediately after delivering a baby (cesarean section or vaginal delivery).

• Postabortion: Immediately after abortion (whether spontaneous or induced).

• Interval: A scheduled procedure specifically for a tubal ligation unrelated to pregnancy.

Does Tubal Ligation Prevent Periods and a Normal Sex Life?

Women will still menstruate after getting their tubes tied and can enjoy a normal sex life without the added hassle of worrying about pregnancy.

Does Tubal Ligation Prevent Sexually Transmitted Infections?

Tubal ligation only prevents pregnancy by preventing the fertilized egg from traveling to the uterus from the ovaries and preventing sperm from traveling to the egg through the fallopian tubes. It does not offer any form of protection against sexually transmitted infections. Therefore, using adequate protection like condoms or other STI prevention devices is a must even after tubal ligation; unless one is in a committed, monogamous relationship and both partners have tested negative for any STI.

Can the Tubal Ligation Procedure Be Reversed?

Tubal ligation is an effective permanent birth control option. Nevertheless, depending on the original ligation type and procedure, it may be possible to reverse a tubal ligation. However, it is complicated and does not guarantee a pregnancy. Reports on women getting pregnant after reattachment of tubes have ranged from 50 % - 80 % success rates. This means that the chances of getting pregnant after a tubal ligation are slim.

What Are the Side Effects of Tubal Ligation?

Side effects may include:

• Symptoms arising after the procedure (that will wear off in time) such as abdominal pain, cramps, bloating, tiredness or fatigue, shoulder pain.

• Risks or complications from the procedure include:

  • Improper wound healing.

  • Bleeding from the site.

  • Bowel and bladder damage.

  • Pelvic pain and raised temperature of about 100.4 F, among others.

  • Improper closure that might increase the chances of pregnancy.

  • Ectopic pregnancy (implantation of fertilized egg outside the uterus)

What Is Post Tubal Ligation Syndrome?

Some women may experience a series of characteristic symptoms following tubal ligation, referred to as post tubal ligation syndrome. On average, around 37 % of women face the possibility of developing the syndrome, of which younger women form the more significant part.

The symptoms associated with post tubal ligation syndrome include:

• Pain during intercourse.

• Menstruation troubles.

• Absence of menstruation.

• Premenstrual Syndrome: Signs and symptoms displayed by women in the week leading up to their periods. This includes breast tenderness, mood swings, irritability, and a general sense of fatigue.

• Weight gain.

• Depression and anxiety.

• Hemorrhage of the Uterus: Abnormal bleeding from the uterus that lasts a long time.

• Pelvic pain.

• Increased frequency of headaches.

• An ache in the lower back.

Can Pregnancy Occur Even After Tubal Ligation?

While tubal ligation is a highly effective procedure, there is a 1 in 200 possibility of getting pregnant, especially in younger women. Women below the age of 28 show the most significant risk of getting pregnant even after tubal ligation, while women over 35 may be at a lower risk of getting pregnant. However, this comes with a complication of an ectopic pregnancy (the fertilized egg is implanted outside the uterus - usually in a fallopian tube). This type of pregnancy is dangerous and requires medical attention. It is also not possible or advisable to attempt carrying such a pregnancy to full-term.

What To Do if Pregnancy Is Desired After Tubal Ligation?

Pregnancy after tubal ligation may be facilitated in the following ways:

• Tubal Reversal Surgery: A tubal ligation reversal procedure can be performed after tubal ligation if the woman changes her mind and wishes to get pregnant. However, this depends on how the tubal ligation procedure was performed. It is also a complicated procedure and may not be effective.

• In Vitro Fertilization (IVF): The woman is stimulated with medications for the growth of multiple eggs, which are then taken from her ovaries, fertilized with sperm from the male partner outside in a laboratory, and then transferred back to her uterus. This may result in the implantation of one embryo in the uterus and subsequently bring about pregnancy.

Is Tubal Ligation Expensive?

• Tubal ligation is an expensive procedure in most countries.

• When compared to tubal implants, tubal ligation surgery is undoubtedly more expensive.

• Tubal ligation is also a costlier option than vasectomy (male birth control surgery that blocks the sperm from reaching the semen ejaculated by the penis).

What Are Some Alternatives to Tubal Ligation?

• Use of Condoms: This is the simplest, most economical, and most feasible solution. Additionally, condoms have a dual role. They can prevent pregnancy and protect against sexually transmitted infections.

• Vasectomy: Male sterilization procedure that is more affordable, has fewer side effects, and cannot result in ectopic pregnancy for the female partner. Even if the procedure does fail and pregnancy occurs in the woman, the chances of ectopic pregnancy are negotiable, unlike tubal ligation.

• Birth Control Implant: This device is implanted in the arm, and it releases hormones such as progestin to prevent pregnancy.

• Oral Contraceptive Pills.

• Intrauterine Devices (IUDs): A long-term, reversible option for birth control, where a coil-like device is inserted into the uterus to prevent pregnancy.

Conclusion:

Tubal ligation is an intelligent choice for those who are sure that they do not want any children or those who cannot undergo pregnancy for medical and other reasons. It can be challenging work trying to make a decision, but with enough information and support from physicians and partners, it is possible to make informed decisions and choose what suits one’s physical and personal needs best.