Menstrual Complaints Rise with Increasing Years Since Tubal Sterilization

Abstract

Data from the Collaborative Review of Sterilization initiated in 1978 in the United States were used. 8044 women enrolled in the study. Before surgery the women were interviewed to collect demographic medical and obstetric information. The study included data on 5070 women who had an interval sterilization between 1978 and 1983 at 1 of 12 medical centers located in 6 US states. Most participants were aged 30 or older at the time of sterilization. Significant changes occurred in menstrual functioning by the 5th year compared with the 1st year: the percentage of women who had more pain during menstruation increased from 27% to 35%; those who reported heavier bleeding increased from 41% to 49%; and those who experienced spotting increased from 7% to 10%. In contrast 1 year after sterilization only 27% of the women reported high levels of menstrual pain 41% had a heavier flow and 7% had spotting between periods. Cycle length had decreased significantly from 28.1 days per cycle to 27.9. Women who had undergone unipolar coagulation reported having the longest cycles while women sterilized with the spring clip had the shortest cycles. Those who had undergone thermocoagulation were most likely to have irregular cycles. Statistically significant associations were: black women reported less spotting and irregular cycles and fewer days of bleeding than did white women; women who were older when they were sterilized experienced less pain and more regular menstruation than did those who were younger; women with more lifetime pregnancies had less pain and shorter cycles than those with fewer pregnancies; and women who used an IUD before sterilization had fewer days of bleeding than those who used no contraceptive method. It is noted that use of the pill or an IUD before sterilization may confound the effects of sterilization. It was not clear whether the menstrual changes were related to sterilization aging or other factors since the women served as their own controls.