title: Tubal ligation does not affect hormonal changes during the early menopausal transition.
abstract: BACKGROUND
  To determine if women with a bilateral tubal ligation (BTL) were more likely to experience hormonal changes indicative of the transition to menopause or an increase in menopausal symptoms compared to women without a BTL.
  
  
  METHODS
  Menopausal symptoms and hormone profiles of 134 women reporting a BTL were compared throughout the course of a 4-year follow-up study to 172 women without a BTL. Generalized linear regression models for repeated measures were used to estimate the independent effect of BTL on menopausal symptoms and hormonal levels adjusted for covariates.
  
  
  RESULTS
  Forty-four percent of women reported a BTL and over one-half of women with a BTL experienced hot flashes. Women with a BTL had similar hormonal levels over the study period compared to women without a BTL. In addition, no relationship was found between BTL and any of the menopausal symptoms, including hot flashes, decreased libido or increased anxiety adjusting for age, race, body mass index (BMI), education, menopausal status and parity.
  
  
  CONCLUSIONS
  These findings document that women with a BTL have similar changes in sex hormone levels over the perimenopausal period compared to women without a BTL independent of other covariates. In addition, the reporting of menopausal symptoms was similar between the groups.
authors.affiliation: Department of Biostatistics and Epidemiology, Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-6021, USA. dnelson@cceb.med.upenn.edu
authors.forename: Deborah B
authors.initials: DB
authors.lastname: Nelson
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Ellen W
authors.initials: EW
authors.lastname: Freeman
authors.forename: Clarisa R
authors.initials: CR
authors.lastname: Gracia
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Langan
mesh_terms: D000328:Adult; D001007:Anxiety / Q000209:etiology; D003687:Dehydroepiandrosterone / Q000097:blood; D004958:Estradiol / Q000097:blood; D005260:Female; D005640:Follicle Stimulating Hormone / Q000097:blood; D005500:Follow-Up Studies; D006728:Hormones / Q000097:blood*; D019584:Hot Flashes / Q000209:etiology; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D007986:Luteinizing Hormone / Q000097:blood; D008593:Menopause / Q000097:blood*; D008875:Middle Aged; D015999:Multivariate Analysis; D015143:Philadelphia; D011863:Radioimmunoassay; D013246:Sterilization, Tubal / Q000009:adverse effects*; D013739:Testosterone / Q000097:blood
chemical_list: D006728:Hormones; D013739:Testosterone; D003687:Dehydroepiandrosterone; D004958:Estradiol; D007986:Luteinizing Hormone; D005640:Follicle Stimulating Hormone