Unintended pregnancies are common worldwide, including in the US and EU nations. Almost half of all pregnancies are unintended. Unintended does not necessarily mean unwanted, but it means unplanned.
The use of oral contraceptives (among women) remains the most preferred method of family planning globally. However, its failure rate is high for various reasons.
Moreover, women who are not planning to have any child in the future find this method least comfortable. Further, there are worries about the side effects of oral contraceptives.
Tubal ligation involves tying up the tubes so that female egg cannot travel via fallopian tubes to uterine.
Permanent closure of fallopian tubes makes pregnancy almost impossible. This kind of surgical procedure can be done post-partum or via laparoscopy.
It is mostly regarded as an irreversible method – thus, women planning to have tubal ligation have lots of questions. Notably, its effect on their menstrual cycle, on hormonal health.
Tubal ligation is regarded as a very safe way of preventing unwanted pregnancies. It is commonly used in Asia and the US [1], where almost one-fourth of women undergo this procedure in their lifetime. Although, this way of family planning is much less common in the EU nations.
Tubal ligation was first proposed as a method of female sterilization way back in the early 19th century. Yet, this method gained use in practice only after the 1960s.
Since then, many questions have been raised regarding its effect on the hormonal health of females, its impact on the menstrual cycle.
Does tubal ligation alter the menstrual cycle?
Since the mid of the 20th century, many doctors have raised a question about post-tubal ligation syndrome as some women reported changes in the cycle after the surgery.
However, modern medicine does not recognize the existence of post-tubal ligation syndrome. This does not mean that the period is not altered; however, alterations are not severe enough to cause significant discomfort or health hazard.
In fact, tubal ligation may have certain health benefits. In some women with severe pain and bleeding during their cycles, ligation may help improve the symptoms.
Further, data shows that tubal ligation reduces the risk of ovarian cancer [2].
So, how does tubal ligation affect the menstrual cycle?
Well, most studies have shown mixed results. Generally, smaller and shorter studies did not show much difference [3] between the women who had undergone tubal ligation and those who have not.
This means that most women may not see any significant changes in their menstrual cycle. Moreover, it is vital to understand that menstrual changes are common in most women during their lifetime.
Nonetheless, keeping in mind the irreversible nature of this procedure, it is critical to know all the differences that tubal ligation can make. After all, changes would be forever, and the decision of tubal ligation is not an easy one.
More extensive or prolonged clinical studies show that tubular ligation can change the menstrual cycle. Fortunately, for most women, these changes are acceptable [4]. As in most cases, it may result in reduced bleeding, less pain, and so on.
One of the most extensive clinical trials intended to put an end to all the questions regarding the effect of tubal ligation on the menstrual cycle was done in the US and was called the U.S. Collaborative Review of Sterilization [5].
In this study, 9514 women, who had undergone sterilization, were followed up for five years. The pattern of the menstrual cycle in these women was compared with 573 women whose partners have undergone a vasectomy.
The study has an extended follow-up period of 14 years. After five years, only women with sterilization were followed up.
The study found that women with sterilization were less probable to bleed heavily during the menstrual cycle when compared to those not undergone sterilization.
In the tubal ligation group, pain in menses was reduced. Tubal ligation also reduces days of bleeding and the probability of intermenstrual bleeding.
It means that tubal ligation does change the menstrual cycle. It can result in cycle irregularities. Women with tubal ligation are more probable to report changes in the length of the menstrual cycle, amount of pain, and bleeding during the period.
But, as one can see, most of the reported irregularities are not severe. Some women may even welcome such changes.
For some women, such variations or irregularities may be helpful. Tubal ligation may be especially suitable for women prone to heavy bleeding and pain during their cycles.
In conclusion, one can say that irregularities caused by tubal ligation are not very common; these irregularities do not cause any severe discomfort. These changes are not related to increased risk of diseases or severe hormonal changes.
Why do changes in the menstrual cycle occur after tubal ligation? This is something that doctors are not very clear about.
They have proposed multiple theories like changes in ovarian blood supply in some women, or just changes in ovarian function due to blockage of fallopian tubes.
To sum up, when going for tubal ligation, expect some changes in the cycle after the procedure. However, be confident that the procedure is safe.
Changes in the menstrual cycle won’t be severe and would not cause any discomfort over the long run.
References
- Bartz D, Greenberg JA. Sterilization in the United States. Rev Obstet Gynecol. 2008;1(1):23-32. [link]
- Piek JM, Diest PJ van, Zweemer RP, Kenemans P, Verheijen RH. Tubal ligation and risk of ovarian cancer. The Lancet. 2001;358(9284):844. doi:10.1016/S0140-6736(01)05992-X
- shobeiri MJ, AtashKhoii S. The risk of menstrual abnormalities after tubal sterilization: a case control study. BMC Womens Health. 2005;5(1):5. doi:10.1186/1472-6874-5-5
- Do Menstrual Problems Increase After Tubal Ligation? Am Fam Physician. 2001;64(1):153. [link]
- Peterson HB, Jeng G, Folger SG, Hillis SA, Marchbanks PA, Wilcox LS. The Risk of Menstrual Abnormalities after Tubal Sterilization. N Engl J Med. 2000;343(23):1681-1687. doi:10.1056/NEJM200012073432303
Dr. Preet Pal SB is a physician (M.D. Medicine) with a specialization in diabetes (Fellowship in diabetes, Royal Liverpool Academy). He has a particular interest in metabolic disorders, considering that they are rising in every corner of the world, more so in India.