Saturday, February 11, 2012

Hormonal Decisions (Guest Blogger)

A friend of mine named Sarah, who blogs at I Love Nail Polish (you should check her out!), told me a while back about unexpected complications she'd had from having her tubes tied after her second child.  I had never heard of these complications before, so I thought it would be interesting to have her write a guest blog about her experience.  Like I said in yesterday, everybody and every body is different, what works well for some might not work well for others, and vice versa.  The key is to make informed decisions for yourself.  So with that, let's welcome Sarah!....

It’s a Girl!

With that announcement I knew Adam and I would need to discuss permanent birth control. Prior to my pregnancy with Bryce I was on “the pill” for about 7 years. Afterward, I had the Mirena IUD for 3. At my 20 week ultrasound, we learned our second child would be a girl, thus (for us) completing our little family. At my next OB/GYN appointment, Adam and I talked briefly with the doc that this baby would be our last. The OB/GYN practice I was using had several practitioners; each patient was required to have an appointment with each doctor. At every appointment we explained to each doctor that this would be our last baby. One doctor suggested the Essure procedure. Essure is a permanent birth control procedure that works with your body to create a natural barrier to prevent pregnancy. To find out more about Essure, ask your OB/GYN and visit www.essure.com.

For me the cons of Essure were:

  • It would mean an additional OB/GYN visit.
  • Additional cost, as it was not approved by my insurance.
  • I’d never heard of it before and it looked strange. (I wasn’t exactly excited to have inserted into my vagina what looked a whole lot like mattress springs, just on a smaller scale.)


The other choice in permanent birth control was a tubal ligation (AKA having my tubes tied). So, that was that. I honestly didn’t ask a whole lot of questions, with only two options tubal ligation seemed to me to be the “only” choice.
Courtesy of theprickcushion.com

What I understood about having my tubes tied was

  • It’s 99% effective.
  • It could be done immediately after giving birth to Maggie.
  • It is covered 100% by insurance.
  • It is “permanent,” unless one decided to have a reversal.
  • It is the most common form of birth control among married women.


What I didn’t know, but found out later

  • Post tubal ligation syndrome is more prevalent than the medical community will admit.
  • Afterward, most women need some kind of hormonal support, in the way of hormone replacement therapy or birth control pills.
  • Many women experience emotional changes so severe their mood can only be improved with anti depressant treatment.


My personal experience is not one of regret because I am no longer able to have children; the regret stems from not educating myself or exploring other options. It turns out that tubal ligation is more costly and has more complications than a vasectomy. Looking back, continuing use of the Mirena may have been a good solution until we thoroughly researched all of our options. Since having the tubal ligation in May of 2009 my body has gone into what my doc is calling “early menopause.” At the age of 32 it was the last thing I thought I’d be experiencing. My OB/GYN recommended hormone replacement or I could try taking birth control pills to see if they helped. I wasn’t going to take birth control pills; why should I pay for more birth control and put anymore hormones into my system? Instead, I suffer terrible night sweats and hot flashes so severe they send my coworkers searching for sweaters to escape the frigid temps in my office. Post Tubal Ligation Syndrome (PTS) is not something I ever heard or read about prior to my own experience. PTS results from a rapid decline in estrogen levels due from the blood supply being damaged to the ovaries during the TL surgery.

Symptoms of PTS are:

1. Eptopic pregnancy or pregnancy-I was unaware of the number of women who experience these following a TL.

1a.Hot flashes, flushes, night sweats and/or cold flashes, clammy feeling, chills

2. Bouts of rapid heart beat

3. Irritability

4. Mood swings, sudden tears (I’ve been on Zoloft since my pregnancy, without it, I am mush)

5. Trouble sleeping through the night (with or without night sweats)

6. Irregular periods; shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles

7. Loss of libido (not having this)

8. Dry vagina (or this)

8a.Itchy vagina-at time raw like, can radiated from whole area, with absence of yeast infections. (or this)

8b. Color change in vaginal area. (color gets darker - purple/black) (or this)

9. Crashing fatigue (sometimes)

10.Anxiety, feeling ill at ease (for real)

11.Feelings of dread, apprehension, doom (again without the Zoloft I’m a wreck)

12.Difficulty concentrating, disorientation, mental confusion (seriously!)

13.Disturbing memory lapses (yeppers)

14.Incontinence, especially upon sneezing, laughing; urge incontinence (hmmm, this is particularly bothersome)

14a.Prolapse of uterus do to rapid decress in estrogen levels.

15.Itchy, crawly skin (not experiencing this)

16.Aching, sore joints, muscles and tendons

17.Increased tension in muscles

18.Breast tenderness (not this one either)

18a. Decrease in breast mass (definitely no trouble here)

19.Headache change: increase or decrease

20.Gastrointestinal distress, indigestion, flatulence, gas pain, nausea (yep, had to have my first colonscopy due to blood in my stool and vomiting blood)

21.Sudden bouts of bloat --sucks

22.Depression (Zoloft, 200 mg PO QD)

23.Exacerbation of existing conditions --??

24.Increase in allergies --yes

25.Weight gain (everything “except Weight Watchers” makes me gain weight..primarily food is the culprit though)

26.Hair loss or thinning, head, pubic, or whole body; increase in facial hair (…ewe glad I’m not experiencing this)

27.Dizziness, light-headedness, episodes of loss of balance –yep this is scary

28.Changes in body odor –I don’t think so

29.Electric "shock" or "stabbing" sensation under the skin. --nah

30.Tingling in the extremities, --nah

31.Gum problems, increased bleeding --nah

32.Burning tongue, burning roof of mouth, bad taste in mouth, change in breath odor --nah

33.Osteoporosis (after several years)

34.Changes in fingernails: softer, crack or break easier –nah

If those life changing symptoms aren’t enough to scare a person out of having a tubal ligation I’m not sure what would be. However, the beauty of living in the U.S. is that women are able to make these decisions for ourselves. And we do have options. It’s too late for my hormonal mess, but do yourself (and your spouse) a favor and do a lot of research, ask other women, talk to your doctor(s) and explore every option available.

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