The Ties that Bind - Post Tubal Ligation Syndrome

Tubal ligation resulting in perimenopause: hot flashes, depression and menstrual cystocele prolapse. Why are tied tubes causing so many problems?

Case #: 476

Concern：

I have had what I think are menstrual pains 10 days before my periods and now have a slight cystocele prolapse with a very heavy feeling in my lower abdomen with incontinence. I have had many tests -- ultra sound and vaginal ultrasound on ovaries and they were ok. Also, three years ago I had a laproscopy and that was all right. No one seems to know what's wrong with me. I have really bad depression, sometimes hot sweats and cold spells when I get in bed at night. I eat all the wrong foods and seem to be giving my body what it wants to eat. I have three children --1 vaginal delivery, 2 cesareans -- and a tubal ligation. Will I need a full hysterectomy? I am sick of feeling depressed, fat and most of the time really ill. Please, could you give me advice? Kind regards.

Discussion：

It seems there are multiple problems at work here, but the number one issue, I believe, is decreased estrogen stemming from your tubal ligation. Unfortunately, while tubal ligation is a safe and secure form of birth control, it can sometimes also result in what is known as perimenopause (some called it Post Tubal Ligation Syndrome).

Perimenopause is the period in which your body begins to prepare for menopause, and many of the symptoms of menopause may be seen during this time, such as hot flashes, depression, painful menstrual cycles, weight gain, weakened pelvic floor muscles, incontinence, and all the other unpleasant side effects of the end of the fertility period.

Some doctors choose not to perform tubal ligations for fear of this syndrome, although it does not affect every woman equally. The worst part is, perimenopause lasts from the point of tubal ligation until the time that your body would normally have gone through menopause.

Main Drain

Tubal ligation causes a disturbance in the production of all sex hormones. Arguably the most important effected hormone is estrogen. During menopause, the production of estrogen essentially ceases, signaling to the body that it’s no longer fertile.

Obviously, infertility is what you’re going for, but decreased estrogen and progesterone levels are wreaking havoc with the rest of your body. Did your doctor tell you that low estrogen levels cause a loss of muscle tone in the pelvic floor, resulting varying degrees of incontinence, and possibly in cystocele prolapse, due to thinned vaginal walls and atrophied muscles? That you might be prone to depression, due to the fact that estrogen promotes seratonin production, which fends of depression?

Did he or she make you aware that you wouldn’t be sleeping well and would be feeling bloated after progesterone production ends? Needless to say, with all these strange, irritating, painful changes occurring, cortisol levels are probably boosted. Raised cortisol levels also contribute to depression, and if that wasn’t enough, they also increase belly fat, insomnia and sugar cravings.

Hormone Harmony

To get back to your old self, the first thing to do is to have your hormone levels tested. Hormone level tests are performed on urine, blood, or saliva, with saliva being generally the most indicative test.

I anticipate that your analyses will show an estrogen deficit. However, this is not the end of the world! There are many, many ways to increase your estrogen levels, and not all are dependent on receiving hormones through an outside source.

A variety of foods simulate estrogen in the body: legumes, such as soy; beans, peas, fruits, and vegetables all contain phytoestrogens. In fact, a healthy diet high in lean meats and fibers, and low in fats, is a great way to create an estrogen friendly environment. I’m not sure what kind of food you’re eating currently, but foods high in simple sugars (like candy, cookies, things with corn syrup, etc.), fats, and carbohydrates, actually decrease estrogen production. I do not think you need a hysterectomy to solve the problems you are experiencing!

Preventative Maintenance

Give your body a boost by practicing some targeted yoga asanas. Yoga has long been touted as a good way to detoxify your body, and asanas are perfect for restoring and toning the tissues of your pelvis, without causing further damage due to strain.

Exercise in general results in seratonin production, and might help you feel better about yourself, and your life. To aid you in your incontinence, your cystocele prolapse, and to boost your estrogen manufacture, I’d recommend this herbal remedy. It is rich with soy compounds to increase estrogen and fatty acids to combat depression.