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Each month, an ovary releases an egg, and then the egg travels through the fallopian tube to the uterus. Tubal ligation removes a segment or the entire ends of the fallopian tubes, preventing sperm from connecting with that egg. Surgery happens in a hospital or outpatient surgical clinic. In most cases, you’ll go home the same day.
Tubal ligation does not stop your menstrual cycle or cause menopause. You will still get your period following surgery. If you had irregular periods before surgery, they’ll likely continue that way following surgery. However, you may notice some changes in your first period following the procedure.
“Blocking or removing the tubes — or highway where egg and sperm usually meet — does not change your period generally,” says Dr. Yolanda Kirkham, University of Toronto assistant professor and OB-GYN at Unity Health Toronto. “Periods are the result of fluctuating hormones from the ovaries that lead to a thickening then shedding of the lining of the uterus. Both the ovaries and uterus are not changed in any way from a tubal surgery.”
Following tubal ligation surgery, it is common to experience changes in the menstrual cycle itself. Some may experience heavier bleeding during their first period after the procedure, while others may experience lighter bleeding. It is important to note that every person’s experience is different and there is no one-size-fits-all answer.
When your period returns after tubal ligation, you may notice heavier bleeding and more discomfort than usual. “Many women have some degree of retrograde menstruation or bleeding out the fallopian tubes backward into the pelvis,” Dr. Kirkham explains. “With the tubes blocked, this may then increase period flow.”
Age can also affect your menstrual flow following tubal ligation. Dr. Kirkham shares, “Many people who chose to have a tubal surgery may also be older. As we age towards perimenopause — mid to late 40s — most women have abnormal uterine bleeding, which means heavier, more frequent bleeding.”
Talk to your healthcare provider if you have an unusual amount of bleeding or concerns about your menstrual period after tubal ligation.
“Some people have reported changes in their periods, [whether] heavier or lighter,’ says Dr. Kirkham. “There are various hypotheses about why.”
The changes are usually mild. Visit your doctor for any severe or unusual symptoms following tubal ligation procedures.
There is no evidence that periods get lighter after tubal ligation. Some people may experience a slight decrease in menstrual flow, while others may not experience any change.
“If someone would like to have less bleeding during their periods, they can request to have a locally-acting progesterone intrauterine device (IUD) inserted in the office or at the same time as their surgery,” suggests Dr. Kirkham. “Many women choose just to have the office procedure instead of a tubal surgery when they learn that the hormonal IUD is just as good as surgery in preventing pregnancies.”
The effectiveness of tubal ligation is comparable to a hormonal IUD, with the risk of pregnancy around 1-2 in 1000. “The hormonal IUD can also prevent uterine and ovarian cancer and agrees with people better than most oral birth control pills,” adds Dr. Kirkham.
Most women who undergo tubal ligation don't have their next period for 4-6 weeks following surgery but delays are possible. Hormonal changes caused by stress and anxiety when undergoing surgery is one possible reason for a delay. Additionally, pain management medications used during or after the procedure can also affect hormone levels. The procedure itself does not affect the hormones produced by the ovaries.
Changes in the menstrual cycle after tubal ligation are not uncommon. A healthcare provider can provide personalized advice based on your needs if you have any concerns.
“[While] not predictably different, all periods vary from time to time re: timing, length, and cramps,” Dr. Kirkham reminds us. It is possible for the first period after tubal ligation to be painful but this doesn’t happen to everyone. The procedure can cause cramps or discomfort, but pain may be the result of factors not related to tubal ligation.
Tubal ligation is a permanent method of contraception for people who are sure they don't want any more children. It also takes a longer recovery time.
“Tubal surgery is a day procedure but may require 2-4 weeks off work,” Dr. Kirkham explains. Talk to your healthcare provider if you're considering tubal ligation. They will help you explore your options based on your medical history, lifestyle and personal preferences.
“We are so lucky to live in Canada where we have many options for long-acting birth control,” says Dr. Kirkham.
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