Long-term effect of tubal sterilization on menstrual indices and pelvic pain.
OBJECTIVE
To evaluate the long-term effect of tubal sterilization on menstrual indices and pelvic pain.


METHODS
Five hundred women undergoing sterilization were interviewed before sterilization, 6-10 months after surgery, and 3-4.5 years later. Four hundred sixty-six non-sterilized comparison women were interviewed in parallel. The study population consisted of low-income, ethnically and regionally diverse women from three participating institutions.


RESULTS
When women who were taking oral contraceptives were excluded, no long-term differences was found between sterilized and nonsterilized women in terms of menstrual cycles, bleeding between periods, prolonged or heavy flow, dysmenorrhea, or noncyclic pelvic pain. Hysterectomy was uncommon (3.2%), but statistically more prevalent among sterilized women (4.55%) than nonsterilized women (2.17%) (P = .019).


CONCLUSIONS
Tubal sterilization has no long-term effect on menstrual indices or pelvic pain. An increase in severe dysmenorrhea, which emerged as a disturbing but nonsignificant trend at 6-10 months, did not progress over the next 3-4.5 years. Reasons for an increased rate of hysterectomy are not clear, but may be related to a lower threshold for choosing hysterectomy as a treatment option once a woman has been sterilized.
Rulin
M C
MC
Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, Pennsylvania.
Davidson
A R
AR
Philliber
S G
SG
Graves
W L
WL
Cushman
L F
LF
D000328:Adult; D005260:Female; D006801:Humans; D007044:Hysterectomy; D008599:Menstruation Disturbances / Q000209:etiology*; D010146:Pain / Q000209:etiology*; D010388:Pelvis; D013246:Sterilization, Tubal / Q000009:adverse effects*