Menstrual Irregularities Post Tubal Ligation     : Menstrual Irregularities Post Tubal Ligation

Hafiza  Yasmeen Abbas; Farah  Liaqat; Erum  Memon; Zaib-un-Nisa  Qureshi; Kauser  Karim; Nazish  Ali

doi:10.54393/pbmj.v5i7.631

Authors

Hafiza Yasmeen Abbas Baqai Medical University, Fatima Hospital, Karachi
Farah Liaqat Baqai Medical University, Fatima Hospital, Karachi
Erum Memon Jinnah Medical & Dental College, Karachi
Zaib-un-Nisa Qureshi Life Line Hospital, Karachi
Kauser Karim Chiniot Mother & Child Hospital, Karachi
Nazish Ali Baqai Medical University, Fatima Hospital, Karachi

DOI:

https://doi.org/10.54393/pbmj.v5i7.631

Keywords:

Sterilization, Menstruation, Contraception, Polymenorrhea, Tubal ligation

Abstract

The most popular form of family planning is tubal ligation. Decades-long debates have surrounded the possibility of the post-tubal ligation syndrome of menstrual irregularities. Objective: To study the frequency of menstrual irregularities after tubal ligation in women attending gynecological outpatient department of a tertiary care hospital setting. Methods: A cross sectional study was conducted on 126 females who had history of post tubal ligation syndrome. Cases were verified and data were collected. Duration and length of menstrual cycle was noted. Laboratory examination was done. Duration of tubal ligation was also noted. Their age, name and hospital registration number were also noted down. A control group of 50 healthy females was made for the comparison of menstrual disturbance. Result: The patients mean age was 39.5±3.4 years. Maximum of the patients 71(56.3%) of the patients had age between 37 to 42 years. The duration of tubal ligation observed in 118 (93.7%) of the patients more than or equal to 1 year. Type of menstrual disturbance such as polymennorrhea in 76(60.3%), menorrhagia in 51(40.5%) and intermenstrual bleeding in 9(7.1%) of the patients respectively. Final outcome menstrual irregularity was presented in 74 (58.7%) of the patients. Age group with menstrual irregularity was presented in 40(53.5%) patients versus 31 (43.7%) patients who had absent menstrual irregularity. Similarly, duration of tubal ligation was compared with menstrual irregularity and presented in 69(58.5%) of the patient compared with 49(41.5%) patients who had absent menstrual irregularity. Conclusion: The older group of patients has high prevalence of menstrual irregularities.

References

MacKay AP, Kieke BA Jr, Koonin LM, Beattie K. Tubal sterilization in the United States, 1994-1996. Family Planning Perspectives. 2001 Aug; 33(4):161-5. doi: 10.2307/2673719

Ashfaq G, Kaku F, Ahmed M. Female sterilization and its effect on women health. Pakistan Journal of Medical Research 2003; 42: 160-66.

Peterson HB, Jeng G, Folger SG, Hillis SA, Marchbanks PA, Wilcox LS. The risk of menstrual abnormalities after tubal sterilization. New England Journal of Medicine. 2000 Dec; 343(23):1681-7. doi: 10.1056/nejm200012073432303

Von Mering R, Merki GS, Keller PJ. Is there a place for tubal ligation in modern contraception?. Gynakologisch Geburtshilfliche Rundschau. 2003 Jan; 43(1):25-30. doi: 10.1159/000067166

Zakherah MS, Sayed GH, El-Nashar SA, Shaaban MM. Pictorial blood loss assessment chart in the evaluation of heavy menstrual bleeding: diagnostic accuracy compared to alkaline hematin. Gynecologic and Obstetric Investigation. 2011; 71(4):281-4. doi: 10.1159/000320336

Kajaia N, Binder H, Dittrich R, Oppelt PG, Flor B, Cupisti S, et al. Low sex hormone-binding globulin as a predictive marker for insulin resistance in women with hyperandrogenic syndrome. European Journal of Endocrinology. 2007 Oct; 157(4):499-507. doi: 10.1530/EJE-07-0203.

Kriplani A, Singh BM, Lal S, Agarwal N. Efficacy, acceptability and side effects of the levonorgestrel intrauterine system for menorrhagia. International Journal of Gynecology and Obstetrics. 2007 Jun; 97(3):190-4. doi: 10.1016/j.ijgo.2007.01.009

Narvekar N, Critchley HO, Cheng L, Baird DT. Mifepristone-induced amenorrhoea is associated with an increase in microvessel density and glucocorticoid receptor and a decrease in stromal vascular endothelial growth factor. Human Reproduction. 2006 Sep; 21(9):2312-8. doi: 10.1093/humrep/del182

Gokyildiz S, Aslan E, Beji NK, Mecdi M. The Effects of Menorrhagia on Women's Quality of Life: A Case-Control Study. ISRN Obstetrics and Gynecology. 2013 Jul; 2013:918179. doi: 10.1155/2013/918179

Carmona F, Cristóbal P, Casamitjana R, Balasch J. Effect of tubal sterilization on ovarian follicular reserve and function. American Journal of Obstetrics and Gynecology. 2003 Aug; 189(2):447-52. doi: 10.1067/s0002-9378(03)00487-3

Ozerkan K, Aydin G, Koc I, Uncu Y, Uncu G. Menstrual pattern following tubal sterilization. Medical Science Monitor. 2010 Apr; 16(4):CR197-201

Uppal T, Lanzarone V, Mongelli M. Sonographically detected caesarean section scar defects and menstrual irregularity. Journal of Obstetrics and Gynaecology. 2011 Jul; 31(5):413-6. doi: 10.3109/01443615.2011.577252

Shobeiri MJ and Atashkhoii S. The risk of menstrual abnormalities after tubal sterilization: a case control study. BMC Womens Health. 2005 May; 5(1):5. doi: 10.1186/1472-6874-5-5

Demographic P. Health Survey 2006-07. National Institute of Population Studies, Pakistan; and, Macro International.

Dede FS, Dilbaz B, Akyuz O, Caliskan E, Kurtaran V, Dilbaz S. Changes in menstrual pattern and ovarian function following bipolar electrocauterization of the fallopian tubes for voluntary surgical contraception. Contraception. 2006 Jan; 73(1):88-91. doi: 10.1016/j.contraception.2005.07.007

Kelekci S, Yorgancioglu Z, Yilmaz B, Yasar L, Savan K, Sonmez S, et al. Effect of tubal ligation on ovarian reserve and the ovarian stromal blood supply. The Australian and New Zealand Journal of Obstetrics and Gynaecology. 2004 Oct; 44(5):449-51. doi: 10.1111/j.1479-828X.2004.00269.x

Westhoff C and Davis A. Tubal sterilization: focus on the U.S. experience. Fertility and Sterility. 2000 May; 73(5):913-22. doi: 10.1016/s0015-0282(00)00481-7

Harlow BL, Missmer SA, Cramer DW, Barbieri RL. Does tubal sterilization influence the subsequent risk of menorrhagia or dysmenorrhea?. Fertility and Sterility. 2002 Apr; 77(4):754-60. doi: 10.1016/s0015-0282(01)03253-8

Cattanach JF and Milne BJ. Post-tubal sterilization problems correlated with ovarian steroidogenesis. Contraception. 1988 Nov; 38(5):541-50. doi: 10.1016/0010-7824(88)90157-6

Orshan SA, Furniss KK, Forst C, Santoro N. The lived experience of premature ovarian failure. Journal of Obstetric and Gynecologic and Neonatal Nursing. 2001 Mar-Apr; 30(2):202-8. doi: 10.1111/j.1552-6909.2001.tb01536.x

Jahanian Sadatmahalleh SH, Ziaei S, Kazemnejad A, Mohamadi E. Evaluation of Influencing Factors on Tubal Sterilization Regret: A Cross-Sectional Study. International Journal of Fertility and Sterility. 2018 Jun; 12(3):200-206. doi: 10.22074/ijfs.2018.5272

Yasmeen S, Fatima T, Kouser S, Anwar K. Post Ligation Syndrome/Menstrual Disorders after Tubal Ligation. Journal of The Society of Obstetricians and Gynaecologists of Pakistan. 2018 Sep; 8(2):81-4.

Chhabra S and Mishra S. Menstrual abnormalities in women with tubal sterilization. EC Gynaecology. 2017; 6:2-7.