Tubal sterilization and menstrual dysfunction
Malick, J.E.; Atkins, A.H.
Journal of the American Osteopathic Association 82(2): 103-108
1982
ISSN/ISBN: 0098-6151 PMID: 7141900 Document Number: 188038
Files of 232 patients were reviewed to investigate menstrual changes after tubal sterilization, either abdominal tubal ligation, laparoscopic fulguration, or Falope ring application. The charts of patients who underwent dilation and curretage (D and C) for menorrhagia after tubal sterilization were also reviewed. A significant degree of menstrual dysfunction followed sterilization, the incidence varying with the amount of tube destroyed. The most common complaint was menorrhagia. Of patients subjected to D and C for this complaint, over 75% were bleeding from secretory or dysphasic endometria. A hypothesis for the mechanism of menstrual dysfunction after tubal sterilization and its differential incidence based on procedure was constructed. Tubal destruction leading to decreased tubal production of PGF2.alpha. and thus failure of normal luteolysis with prolonged ovarian production of progesterone could result in irregular shedding of the endometrium and therefore menorrhagia/hypermenorrhea. Those sterilization procedures that cause the least trauma to the tube appear most beneficial in the long term.