title: Does tubal sterilization influence the subsequent risk of menorrhagia or dysmenorrhea?
abstract: OBJECTIVE
  To evaluate the relation between tubal ligation, change in menstrual cycle characteristics, and early follicular phase hormones.
  
  
  METHODS
  Cross-sectional analysis of women 36-44 years of age.
  
  
  METHODS
  The greater Boston area.
  
  
  METHODS
  Nine hundred seventy-six premenopausal women with intact uteri.
  
  
  METHODS
  A comparison of women with and without a history of tubal ligation.
  
  
  METHODS
  Menstrual and reproductive histories were self-reported. Early follicular phase blood samples were obtained to assess FSH, LH, and E(2). We compared menstrual cycle changes from the first 5 years after menarche with completion of the baseline questionnaire in women with and without a prior history of tubal ligation.
  
  
  RESULTS
  Cycle length, cycle regularity, menses length, flow volume, dysmenorrhea, and hormone levels were similar in women with and without a history of tubal ligation. However, among parous women with a history of cesarean section, those with a tubal ligation >5 years ago experienced a marginal increase in volume of menstrual flow compared with women with no tubal ligation history.
  
  
  CONCLUSIONS
  We found no significant change in menstrual cycle characteristics or hormone levels in women with or without a history of tubal ligation. However, tubal ligation may have a modest effect on the change in menstrual flow volume over time among parous women with a history of cesarean section.
authors.affiliation: Department of Obstetrics and Gynecology, the Obstetrics and Gynecology Epidemiology Center, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. bharlow@rics.bwh.harvard.edu
authors.forename: Bernard L
authors.initials: BL
authors.lastname: Harlow
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Missmer
authors.forename: Daniel W
authors.initials: DW
authors.lastname: Cramer
authors.forename: Robert L
authors.initials: RL
authors.lastname: Barbieri
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002585:Cesarean Section; D003430:Cross-Sectional Studies; D004412:Dysmenorrhea / Q000453:epidemiology*; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005498:Follicular Phase; D006801:Humans; D007986:Luteinizing Hormone / Q000097:blood; D008595:Menorrhagia / Q000453:epidemiology*; D008597:Menstrual Cycle; D010298:Parity; D012307:Risk Factors; D013246:Sterilization, Tubal / Q000009:adverse effects*
chemical_list: D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone