Aww mama, I understand the worry! 4 weeks post-CS with tubal ligation can still have some tenderness kasi maraming ginawa sa area, pero if it's feeling like dysmenorrhea-level pain, I'd really suggest checking with your OB soon para ma-rule out any complications like infection or adhesions, better safe than sorry talaga, especially after major surgery. A few of us moms had lingering crampy sensations after CS, pero if it's getting worse or you have fever, please don't wait, go straight to the doctor na!