The Risk of Menstrual Abnormalities After Tubal Sterilization

Background Tubal sterilization is the most commonly used method of family planning. In 1990 the corresponding percentage of married women in reproductive age who used sterilization was 22% in developing countries and the corresponding percentage in developed countries was 11%. These women represented 44% and 18% of all contraceptive users in developing and developed countries, respectively. Questions regarding the existence of a post tubal ligation syndrome of menstrual abnormalities continue. Questions arose initially when Williams and colleagues reported in 1951 that sterilized women had a higher than expected occurrence of menorrhagia and metrorrhagia [1]. After that the existence of a post-tubal-ligation syndrome of menstrual abnormalities has been debated for decades [2]. Many authors have investigated the sequelae of female sterilization [2-9]. Increased premenstrual distress, heavier and more prolonged menstrual bleeding, and increased dysmenorrhea have been reported [3]. However, failure to control for use of oral contraceptives, age, obesity, parity, interval since sterilization, or type of sterilization may have effects on the results of these studies [1,3]. Because of the importance of this debate, we compared the occurrence of menstrual abnormalities in women with and without a prior history of tubal ligation. Methods This cross sectional case control study has been carried out on 500 women at Al-zahra hospital during 1999 to 2001 to assess the effect of tubal sterilization on the menstrual cycle. 260 women with abnormal uterine bleeding referred for diagnostic curettage, and 240 healthy women under the coverage of the hospital family planning center were selected randomly, and all were assessed for tubal ligation.