Brief Answer:
It can be hormonal imbalanceor infection.

Detailed Answer:

Hi,

I can think of following possibilities for your sufferings after removal of Merina followed by tubal ligation-
1- Merina being a hormonal IUD(containing hormone Progestin).. is known to have various side effects like irregular menses,bloating stomach , breast signs ,cramps in stomach&psychological upsets.
After removal of device there is hormonal imbalance &the exaggarated symptoms are observed .. &may remain for few weeks after removal.It usually settles in few weeks naturally.¬hing except symptomatic management(rest,hot packs on abdomen,pain medicine like Ibuprofen OTC is needed.
2... But the deep pain in vagina /anus with painful intercourse(which is actually not advised within 1 month of procedure), concerns me more for it can be due to pelvic inflammation&infection(set in before or after surgical removal of device .. if it was needed)
Deep vaginal swab, USG with vaginal probe are the tests to find it.. followed by a course of suitable antibiotic &anti inflammatory drugs.
* In this scenario I would suggest for consultation of your gynecologist for her expert advise &treatment.
*Personal care-it consists of rest(avoiding sex till healed )/ perfect genital hygiene/ hot packs ... no doushes.../ light but nutritious food.. containing lot of vitamin C,omega3 fatty acids,/plenty of water/physical and psychological relaxation &strict following of expert's prescription.
Thus expert advise after pin pointing cause and self care would help you get rid of the problem.
I hope that helps you. Any more information you need please feel free to ask.
In case you don't have any follow up query... please grade the answer before closing the query.
Thanks.

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