Tubal Ligation for PCOS Patients: What to Know

Getting Your Tubes Tied with PCOS

For women with polycystic ovary syndrome (PCOS), permanent contraception like getting your tubes tied may be an appealing option. However, there are important considerations for those with PCOS considering tubal ligation.

Understanding PCOS and Fertility

PCOS involves a hormonal imbalance causing ovarian cysts, irregular periods, and often infertility issues. Yet some with PCOS can still ovulate and get pregnant unexpectedly. This makes contraception complicated with tubal ligation offering a permanent solution.

However, even after getting tubes tied, those with PCOS may struggle with ongoing symptoms like:

Excess male hormones
Facial/body hair growth
Scalp hair loss
Obesity
Insulin resistance
Skin tags

Without ovaries removed, ties tubes alone won’t resolve PCOS itself. Hormone levels may remain high post-surgery.

Advantages of Tubal Ligation with PCOS

Permanent sterilization offers women with PCOS several potential benefits including:

No pregnancy worries - Unexpected conception unlikely
No contraceptive side effects - Avoid mood, weight and blood pressure issues on birth control
Reduced cancer risk - Lower odds of reproductive organ tumors later on
Cost savings - No ongoing costs for prescription birth control

For those finished growing their families or not wanting kids at all, tubal ligation brings significant lifestyle advantages.

Considering Ovary Removal Also?

Some women opt to have their ovaries removed during the same surgery as tubal ligation. This eliminates virtually all remaining risk of pregnancy. It also reduces male hormone production to ease PCOS symptoms like excess hair.

Yet ovary removal impacts long term health by:

Initiating menopause if done before natural age
Raising earlier cardiovascular and bone disease odds
Potentially decreasing longevity

Have an in-depth talk with your gynecologist about the risks and benefits of concurrent oophorectomy.

Ectopic Pregnancy Risks After Tubal Ligation

While uncommon, pregnancy can still happen after getting tubes tied. This raises the possibility of a dangerous ectopic or tubal pregnancy.

Risk rates for post-sterilization pregnancy are lower with cauterization methods than ligation by cutting/tying tubes. But ectopics remain possible, especially within the first years after any tubal procedure.

Is Ectopic Risk Higher with PCOS?

Some research indicates women with PCOS may face higher ectopic pregnancy chances both before and after tubal ligation. Doctors aren’t exactly sure why those with ovarian disorder appear at increased risk.

Theories include:

Altered Fallopian tube structure/function
Faster embryo transport through tubes
Hormone imbalances impacting implantation
Greater risk of cell abnormalities in embryo itself

More studies on the links between PCOS and ectopics are still needed. But it highlights the importance of prompt care for post-sterilization conception.

Signs of Ectopic Pregnancy

After tubal ligation, be aware of potential ectopic red flags like:

Missed/abnormal periods
Lower tummy pain
Unusual spotting/bleeding
Dizziness or fainting
Shoulder pain

Catching ectopics early is crucial to preserve the Fallopian tube and avoid life threatening internal bleeding.

Surgical Considerations for Tubal Ligation with PCOS

Several factors around the tubal ligation procedure itself must be weighed for those with PCOS.

Anesthesia Concerns

General anesthesia is typically used for tubal ligations. But those with PCOS have increased risks for breathing issues or blood clots under sedation.

Be sure your surgery team understands your PCOS status before scheduling. Additional monitoring or medications may be warranted.

Incision Options

Tubes can be tied/blocked via:

Minilaparotomy - small open abdominal incision
Laparoscopy - several tiny cuts, camera guided

Obese PCOS patients may not be candidates for less invasive laparoscopic surgery. Extensive abdominal scarring from prior surgeries can also complicate matters.

Discuss optimal surgical approach for your unique case with doctors beforehand.

Post-Op Considerations

After any surgery, women with PCOS often face slowed recovery times and higher complication risks including:

Bleeding
Infection
Blood clots
Poor wound healing

Extra incision care, early ambulation, and post-discharge monitoring helps minimize problems.

What About Tubal Ligation Reversal?

A small number of women regret permanent contraception later on and consider tubal reversal.

For patients with PCOS, attempted reversal may not automatically restore fertility however. This depends on the original tubal damage, the woman’s age, whether she has other infertility factors besides PCOS, and more.

IUI, IVF, or choosing a surrogate may still be needed to successfully conceive after ligation reversal.

Carefully weigh options before permanent sterilization when fertility hopes still exist. Your gynecologist can advise if reversible long-term birth control like IUDs may better suit your situation.

Seeking Tubal Ligation with PCOS

Tubal ligation offers reliable contraception for those with PCOS finished expanding their families. But consider both short and long-term physical and emotional consequences before this permanent step.

Discuss all pros and cons openly with your gynecologist. Also talk with your partner, trusted friends, and women who’ve undergone the procedure. This ensures you make a fully informed decision that’s right for you.

FAQs

Does tubal ligation help PCOS symptoms?

No, getting your tubes tied does not treat PCOS itself or resolve related issues like excess hair growth, ovarian cysts, or irregular periods on its own. Hormone levels usually remain unchanged.

Can you still get pregnant after getting tubes tied with PCOS?

While rare, pregnancy is still possible after tubal ligation, including for those with PCOS. The risk is under 1%, but ectopic pregnancy chances are higher if conception accidentally occurs.

Is tubal ligation with PCOS covered by insurance?

Most insurers cover sterilization procedures to some extent. Those with gynecological disorders like PCOS may qualify for full coverage under the ACA when done for contraception purposes. Verify your plan details.

What are signs of successful tubal ligation?

After the tubes are successfully tied, you should notice: no pregnancy after 3 months despite intercourse, lighter periods that may fully stop over time, and no changes in existing PCOS symptoms. Follow up with your gynecologist as needed.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.