Hello, Thank you for your query. Based on your symptoms I would like to rule out adhesions, infection Would you clarify a few things for me? *when did you have the tubal ligation? *was it a laparoscopic procedure or an open procedure? *how old are you? *do you have any other medical issues or take any medications? *how is your urine and stools? Any digestive troubles? *how many periods have you had after the procedure? Are they regular? *do you any secretions or lubrication during Intercourse? *any vaginal discharge? I recommend : -an OBGYN consult -CT abdomen to check for adhesion and other mechanical causes for pain -blood tests (complete blood count, erythrocyte sedimentation rate, kidney & liver function tests) -urine analysis Based on this, a treatment plan will be made. It is not normal for it to hurt like this. I urge you to seek medical attention as soon as possible. Hope this helps. Please let me know if there is anything else I can help you with. Wish you good.