Background
Tubal ligation (TL) is
recommended for women who have completed their family planning. The existence
of the menstrual disorders following this procedure has been the subject of
debate for decades. This study was conducted to identify the relationship
between tubal ligation and menstrual disorders.
Materials and Methods
A historical cohort
study was carried out on 140 women undergoing tubal ligation (TL group) and on
140 women using condom as the main contraceptive method (Non-TL group). They
aged between 20 and 40 years and were selected from a health care center in Rudsar,
Guilan Province, Iran, during 2013-2014. The two groups were comparable in
demographic characteristics, obstetrical features and menstrual bleeding
pattern using a routine questionnaire. A validated pictorial blood loss
assessment chart (PBLAC) was also used to measure the menstrual blood loss.
Results
Women with TL had more
menstrual irregularity than those without TL (24.3 vs. 10%, P=0.002). Women
with TL had more polymenorrhea (9.3 vs. 1.4%, P=0.006), hypermenorrhea (12.1
vs. 2.1%, P=0.002), menorrhagia (62.9 vs. 22.1%, P<0.0001) and menometrorrhagia
(15.7 vs. 3.6%, P=0.001) than those without TL. There is a significant
difference in the PBLAC score between women with and without TL (P<0.0001).
According to logistic regression, age odds ratio [(OR=1.08, con- fidence
interval (CI):1.07-1.17, P=0.03)], TL (OR=5.95, CI:3.45-10.26, P<0.0001) and
cesarean section (OR=2.72, CI:1.49-4.97, P=0.001) were significantly associated
with menorrhagia.
Conclusion
We found significant
differences in menstrual disorders between women with and without TL.
Therefore, women should be informed by the health providers regarding the
advantages and disadvantages of TL before the procedures.
Comparison of menstrual disorders between groups
| Parameters | Non-TL | TL | Sig |
|---|---|---|---|
| Menstrual irregularities* | 14 (10) | 34 (24.3) | 0.002a |
| Oligomenorrhea* | 12 (8.6) | 21 (15) | 0.12a |
| Polymenorrhea* | 2 (1.4) | 13 (9.3) | 0.006a |
| Hypermenorrhea* | 3 (2.1) | 17 (12.1) | 0. 002a |
| Metrorrhagia* | 9 (6.4) | 12 (8.6) | 0.64a |
| Menorrhagia* | 31 (22.1) | 88 (62.9) | <0.0001a |
| Menometrorrhagia* | 5 (3.6) | 22 (15.7) | 0.001a |
| PBLAC score** | 87.91 ± 51.06 | 137.72 ± 90.91 | <0.0001b |
*; n (%), **; Values are mean ± SD, a; Chi-square test, b; T test, TL; Tubal ligation, and PBLAC; Pictorial blood loss assessment chart.
Full article at: http://goo.gl/m3gdFa
By:
1 Department of Midwifery and Reproductive Health, Faculty of
Medical Sciences, Tarbiat Modares University, Tehran, Iran
2 Department of Biostatistics, Faculty of
Medical Sciences, Tarbiat Modares University, Tehran, Iran
3 Department of Nursing, Faculty of Medical
Sciences, Tarbiat Modares University, Tehran, Iran
* Corresponding Address:P.O. Box: 1415-111, Department of
Midwifery and Reproductive Health, Faculty of Medical Sciences, Tarbiat Modares
University, Tehran, Iran,
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