Post Tubal Ligation “Flutter” by, Susan Bucher, BSN
Some women report after tubal sterilization (tubal ligation, clips, etc.) having at times the sensation of a flutter or kicking. This sensation is similar to that of quickening (early fetal movements). I myself had this sensation on and off for a period of time and many other post tubal women report having had this same sensation. Some women when experiencing this sensation will buy and do a home pregnancy test because the sensation is so similar to that of quickening. This occurrence (fluttering/kicking sensation after tubal ligation) has not been studied or reported by the mainstream medical community.
I contend that these sensations are related to fasciculation. Fasciculation (twitching: a type of muscle spasm) can occur in any muscle group but is most common in the eyelids, arms, legs, and feet. Muscle spasms often result from inflammation that occurs when a muscle and the surrounding tissue and nerves are injured.
The fallopian tube is made of 3 smooth muscle layers. The innermost (obliquely arranged), the middle (circular), and the outermost (longitudinal) which extends into the fimbriae. Arteries and veins also are made of muscle tissue and are subjected to spasms. When a blood vessel cramps it is called a vasospasm. Vasospasm can cause a narrowing of the blood vessel diameter which can ultimately occlude the vessel and lead to tissue death (necrosis). In the case of an artery that leads to an ovary that vasospasms the tissue death would be that of the ovary. Falling estrogen levels also can play a part in muscle spasms (another reason for hormone testing).
Another theory (one that the ACOG would want us to believe) to explain the fluttering sensation is that it is gas. Again, I experienced this sensation and am a nurse so I’m qualified to report. The experience and sensation for me definitely was not gas. Gas is painful, followed in time by the release of gas. This sensation was more of a quickening sensation, that of a tickle or kicking sensation that a woman feels when she first has sensation of fetal movements. Some describe it as a butterfly flutter sensation. This is a sensation that most post tubal women know because most post tubal women have had children and have experienced quickening.
While the sensation is similar to quickening it was still a little different. For me the sensation was not painful, but everyone is different and some women do report pain and discomfort with the sensation. The sensation for me (when it did occur) would last at times continuously for a few minutes upwards to an hour (similar to the time duration and intensity of that of an average eye twitch).
In my journal I noted having these sensations start about 1 ½ years after my tubal ligation. I had these episodes of fluttering on and off sometimes 4 or 5 times a week, then over about 6 months’ time it disappeared. Other women report having this sensation on and off for a number of years after their sterilization. Everyone is different, so all women may not have fluttering (spasms). Some women may have flutters but never feel the sensation. For other women, the flutters may start sooner or later after their tubal ligation, may last longer or shorter in duration, and they may be stronger or weaker in intensity.
The true cause and nature of the post tubal flutter sensation may never be fully known or explained, but it is known that tubal sterilization can affect the blood supply to the ovaries and can cause hormonal imbalances in women. For this reason I and other advocates and health experts suggest that all post sterilized women undergo hormone testing in order to monitor their hormone health. With further study it would be helpful to learn if women who experience the fluttering go into menopause sooner than those who do not experience the sensation.
NOTICE: To ALL WOMEN who have undergone tubal ligation, Essure, salpingectomy or any type of female tubal sterilization for the purpose of birth control.
All women are encouraged to reply. The type of sterilization does not matter. Women who have gone on to have a “tubal reversal”, Essure reversal, hysterectomy, etc… are also invited to take the survey as ALL health and outcomes are being analyzed.
Support Informed Consent for Female Sterilization (Tubal Ligation, Essure, Clips)
Study Abstract: "Tubal sterilization is among the most frequently used methods of contraception in the United States. Depending on the type of tubal sterilization procedure, the mesosalpingeal vascular arcade, a source of collateral ovarian blood flow, is variably interrupted."
STUDY CONCLUSION(S): To our knowledge, this is the first study to evaluate the impact of tubal sterilization on ovarian reserve using serum AMH, a marker directly related to the primary follicle pool. Our results suggest an association between tubal sterilization and reduced ovarian reserve. Further study is necessary to delineate a possible relationship between type of tubal sterilization and ovarian reserve parameters.
