Background:  To control the burning issue of rising trend in global population, Family planning methods play a major role. Tubal sterilization which is a permanent method of family planning is one of the most popular contraceptive choices in the majority of developing countries. Tubal sterilization is the commonest method of family planning. Following the tubal sterilization procedure, there has been discussions’ regarding the existence of the post-tubal-ligation syndrome for decades.

Methods: In this prospective cohort study, 50 women with Pomeroy type of tubal ligation as the study group and 50 women with no previous tubal ligation as the control group were recruited with the objective of assessing menstrual abnormalities.

Results: Menstrual abnormalities were not significantly different between the case and control groups (p = 0.8). The abnormal uterine bleeding frequency differences in two different age groups (30-39 and 40-45 years old) were also statistically insignificant (p = 0.91).

Conclusion: Tubal sterilization does lead to menstrual irregularities.

Keywords: Tubal Ligation, Menorrhagia, Dysmenorrhea.

1. International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3). India, Mumbai. 2005-6;1:1-24.
2. Shobeiri MJ, Atashkhoii S. The risk of menstrual abnormalities after tubal sterilization: a case control study. BMC Womens Health 2005. May;5 (1):5.10. 1186/1472-6874-5-5.
3. Ludermir AB, Machado KM, Costa AM, Alves SV, Araújo TV. Tubal ligation regret and related risk factors: findings from a case-control study in Pernambuco State, Brazil. Cad Saude Publica 2009. Jun;25(6):1361-1368.
4. Ozerkan K, Aydin G, Koc I, Uncu Y, Uncu G. Menstrual pattern following tubal sterilization. Med Sci Monit 2010. Apr;16(4):CR197-CR201. 
5. Malhotra N, Chanana C, Garg P. Post-sterilization regrets in Indian women. Indian J Med Sci 2007. Apr;61(4):186-191
6. Padhye S, Karki C. Voluntary surgical contraception: a study on level of satisfaction.Nepal Med Coll J 2003. Jun;5(1):18-21. 
7. Fagundes ML, Mendes MC, Patta MC, Rodrigues R, Berezowski AT, de Moura MD, et al. Hormonal assessment of women submitted to tubal ligation. Contraception2005.Apr;71(4):309-314
8. Peterson HB, Jeng G, Folger SG, Hillis SA, Marchbanks PA, Wilcox LS, U.S. Collaborative Review of Sterilization Working Group The risk of menstrual abnormalities after tubal sterilization. N Engl J Med 2000. Dec;343(23):1681-1687.10.1056/NEJM200012073432303 
9. Harlow BL, Missmer SA, Cramer DW, Barbieri RL, Barbieri RL. Does tubal sterilization influence the subsequent risk of menorrhagia or dysmenorrhea? Fertil Steril 2002. Apr;77(4):754-760.
10. MacKenzie IZ, Thompson W, Roseman F, Turner E, Guillebaud J. A prospective cohort study of menstrual symptoms and morbidity over 15 years following laparoscopic Filshie clip sterilisation. Maturitas  2010. Apr;65(4):372-377 Published online 27 Jan 2010.10.1016/j.maturitas.2010.01.005 
11. Mall A, Shirk G, Van Voorhis BJ. Previous tubal ligation is a risk factor for hysterectomy after rollerball endometrial ablation. Obstet Gynecol 2002. Oct;100(4):659-664.
12. Huber AW, Mueller MD, Ghezzi F, Cromi A, Dreher E, Raio L. Tubal sterilization: complications of laparoscopy and minilaparotomy. Eur J Obstet Gynecol Reprod Biol2007. Sep;134(1):105-109Published online 26 Jul 2006.
13. Moore CL, Vasquez NF, Lin H, Kaplan LJ. Major vascular injury after laparoscopic tubal ligation. J Emerg Med 2005. Jul;29(1):67-71.10.1016/j.jemermed.2005.01.009
14. Moradan S, Gorbani R. Is Previous Tubal Ligation a Risk Factor for Hysterectomy because of Abnormal Uterine Bleeding? Oman Med J. 2012 Jul;27(4):326-8.

Lt Col Prashant Sharma

Command Hospital