Before You Say Yes – The Truth About Female Sterilization and Post-tubal ligation syndrome
When I walked into the hospital in 2012 for what was sold as a routine tubal ligation, I never imagined my life would spiral into years of pain, emotional turbulence, and medical gaslighting. But it did. For many women, it starts the same way - not with blind trust, but after doing their research, speaking with doctors, and believing they were making a responsible, informed choice. And it ends in feeling blindsided, dismissed and abandoned.
What followed was a years-long descent into chronic pain, hormonal chaos, emotional instability, and total confusion about what had happened to my body. I saw doctor after doctor, had test after test with no answers at all. I told them this was a result of a bilateral tubal ligation. None of them believed me. They all doubted what I said, telling me they’d never heard of this and sent me on my way with a new prescription for stronger pain medication, antidepressants, nerve pain medication, hormones. I only took the pain meds.
In this post, I dive deeper not just into PTLS, but also into salpingectomy and hysterectomy, procedures increasingly common and often pitched as protective or corrective, yet under‑examined and under‑discussed.
This blog is for the countless women like me, who did the ‘right thing’, trusted their doctors, and were left feeling like strangers in their own bodies. PTLS is real. And the silence around it is costing women their health, sanity, and trust.
This blog is not about cases where women needed a hysterectomy as a truly lifesaving procedure with or without prior sterilization.
What Is Post-Tubal Ligation Syndrome (PTLS)?
PTLS describes a range of symptoms that can emerge after tubal ligation - cutting, sealing, or removing your fallopian tubes (salpingectomy) for permanent birth control.
Symptoms may include:
Heavy, painful, or irregular periods
Hormonal swings: hot flashes, night sweats, anxiety, depression, low libido
Pelvic or back pain, bloating, fatigue
Memory issues or brain fog
Skin, nail and hair changes (dryness, breaking, falling out)
Early menopause
Etc.
For me, and countless women, PTLS felt like a betrayal, a crisis we didn't see coming and couldn’t ignore once it hit.
Why Many Doctors Dismiss It
The medical establishment is trained (directly from the Medical Industrial Complex playbook) to believe that tubal ligation is hormonally neutral. When women report symptoms that don’t fit this narrative, they’re often:
Told it’s stress, aging, or perimenopause
Told they regret their tubal and want more children
Told it’s because they stopped birth control (even though some were never on it)
Offered birth control (Except the whole reason we have sterilization is to NOT be on birth control)
Offered uterine ablation or a hysterectomy (many end up with post ablation symptoms and then get a hysterectomy)
Some OB/GYNs offer to do a ‘uterosacral nerve ablation’ - cut the nerve to reduce pain signals to the brain (this was offered to me personally)
Misdiagnosed with depression or anxiety and offered antidepressants and anxiolytics
Referred to psychiatrists, not gynecologists
Referred to Primary Care, pain management, neurologists, rheumatologists for symptom control
Labeled “emotional” or “overreacting”
It’s systemic gaslighting. And it erases the lived, bodily experiences of countless women. For the most part, doctors truly believe the above and not the woman. In some rare instances, some OB/GYNs will believe it, but they will say it’s very rare and their treatment is always birth control, ablation, hysterectomy, pain medication.
What the Research Actually Shows
Very little high-quality research has been done. Many studies on tubal ligation and salpingectomy are observational, short-term, narrowly focused on surgical safety, or framed to confirm predetermined conclusions.
It’s being sold to ‘prevent ovarian cancer’ because they now believe many ovarian cancers begin in the fallopian tubes. So the rationale is: no tubes – no cancer. But at what cost?
Study Limitations
No long-term tracking of hormonal outcomes, libido, menopause timing.
Little to no data on complications like pelvic pain or ovarian function changes-even though some evidence shows short-term drops in ovarian blood flow after salpingectomy.
Informed consent is often absent: women aren’t told salpingectomy is irreversible or could impact hormones as much as (or more than) ligation.
The Rise of Salpingectomy: A Double-Edged Sword
Salpingectomy - removal of one or both fallopian tubes is now being marketed as the best and latest sterilization and an ovarian cancer prevention strategy.
Pros According to Advocates:
Reduces ovarian cancer risk by 50–65 % compared to doing nothing (ACOG).
Has similar short-term safety to tubal ligation.
Can be performed “opportunistically” during other surgeries like C‑sections or hysterectomies.
But Here’s What’s Not Being Said:
It can’t be reversed - no going back if complications arise.
The evidence mainly comes from observational studies, with no randomized control trials or decades-long follow-up.
There are potential impacts on ovarian blood flow and follicle count
Not enough studies track sexual function, hormone levels, onset of menopause.
Informed consent is often lacking - a major ethical concern.
Hysterectomy: The Fallout of Failed Solutions
A staggering 600,000 hysterectomies occur in the U.S. each year, making it the second most common surgery for women after C‑sections. By age 60, nearly one-third of women will have had one.
The Connection to PTLS and Salpingectomy:
Many women with PTLS or those who get salpingectomy end up getting a hysterectomy as a ‘treatment’ for post sterilization symptoms
Hysterectomy brings more risk: surgical menopause if ovaries are removed, loss of fertility, emotional grief.
Many are told hysterectomy is their only option when it may not be (tubal ligation is reversible)
Yet half a million women a year go under the knife, with approximately 20 million women in the U.S. having had one by 2023 (Premier Health).
Together, these procedures form a cascade: one procedure leads to symptoms disregarded by medicine, which leads to the next, more invasive solution-in a vicious loop.
The Emotional & Identity Impact
Choosing or ending up with any of these procedures can unleash grief, hormonal chaos, loss of identity, and relationship trauma. Navigating them without acknowledgment or support is isolating and unfair.
The grief around losing reproductive capacity, being dismissed, and presented with narrow options is real, raw, and often ignored.
What You Can Do
Track your story: Keep detailed logs of symptoms and changes after surgery.
Seek informed practitioners: Find gynecologists, functional medicine doctors, or naturopaths who recognize PTLS and the limitations of standard research.
Question “standard” narratives: Challenge blanket statements like “it doesn’t affect your hormones.”
Explore alternatives: Tubal reversal, somatic therapies - approaches that validate your experience.
Connect with community: There are PTLS and salpingectomy survivor groups on Facebook and other social media.
Demand better research and consent: Ask your provider about studies on long-term hormonal outcomes. Ask for written consent explaining full risks and uncertainties.
Ask your OB/GYN how many women in their practice end up with a hysterectomy 1, 2 and 5 years post sterilization.
Understanding the Industry Incentives
Follow the Money: Total Industry Revenue Estimate
It would be hard to talk about all this without looking at how much money the medical system makes from the above procedures, many of which are completely necessary and purely ‘elective’.
Tubal ligation: ~$2.3 billion/year in the U.S.
Salpingectomy: likely $1–2 billion/year, based on sterilization market share.
Hysterectomy: ~$18 billion/year in direct procedure charges, plus ~$576 million equipment revenue.
Combined U.S. estimate
A conservative total of over $21 billion per year generated by these three procedures-making this a major revenue stream in women’s healthcare.
The Tubal Reversal Market: Paying to Undo What Was Promised as Permanent
While sterilization is often sold as permanent, many women later regret the decision if they experience Post-Tubal Ligation Syndrome. This has created a large, under-discussed market for tubal reversal surgery.
An estimated 40,000 women undergo tubal reversal each year in the U.S. (not just for PTLS, but also for return of fertility)
The average out-of-pocket cost is around $6,000 to $8,500, since insurance rarely covers it
This generates $250–350 million annually in direct revenue
These numbers reflect more than just dollars—they represent women paying again to repair what they were never fully warned about in the first place.
Why These Numbers Matter
Incentive: With tens of billions at stake, medical systems have financial motivations to promote sterilization and surgical solutions.
Data gaps: Business interests may overshadow the need for thorough, long-term research on side effects, informed consent, and alternative care.
Patient impact: The financial scale of these procedures reinforces the importance of advocating for transparency, support, and better post-operative outcomes-for women’s health and autonomy.
If you're questioning what these surgeries may have done to you-physically, emotionally, hormonally-trust yourself. You are not alone. Your story matters. And your health deserves to be seen in its full complexity.
We Deserve Better
Women deserve full transparency, genuine listening, and care rooted in evidence and empathy, not dismissal, rushed procedures, or profit-driven narratives.
We deserve:
Research that tracks full-spectrum outcomes: hormonal, emotional, physical for decades.
Consent that reflects uncertainty, not overconfidence, and lists all possible outcomes - including the risk of PTLS.
A medical system that values women’s lived experience.
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