Tying Tubes Doesn't Worsen Periods

Dec. 6, 2000 -- Do women increase their risk of menstrual problems if they getsterilized by having their tubes tied? Many doctors believe so,while others disagree, and now a major study settles thisdecades-old debate.

The answer is no.

Does Tying Tubes Worsen Periods?

Surgical sterilization is considered safe and effective, butquestions have persisted about whether it makes women’s periodsworse. Some doctors have recommended hysterectomy instead to avoidthe possibility.

The menstrual condition even has a name: post-tubal-ligationsyndrome.

“After two decades of very careful study, we have good news,”said Dr. Herbert B. Peterson of the Centers for Disease Control andPrevention, which conducted the study.

The researchers found that the “syndrome” doctors have worriedabout since the 1950s simply does not exist.

Mythology Debunked

“This is another little correction to some of the mythologyabout tubal ligation,” said Dr. Carolyn Westhoff of ColumbiaUniversity, who was not involved in the research.

The study, published in Thursday’s New England Journal ofMedicine, found that women who are sterilized are no more likely todevelop menstrual problems than women who are not. If anything,they actually have shorter, less painful periods and bleed less.

In tubal sterilization — also known as tubal ligation — thefallopian tubes are cut and tied or blocked. That prevents an eggreleased by the ovaries from reaching the uterus and from gettingfertilized by sperm.

Today, sterilization is the most popular form of contraception.

With so many women choosing sterilization — 100 million aroundthe world and over 10 million in the United States alone — ”it’svery important that we understand the safety of the procedure,including whether there are any long-term complications,” Petersonsaid.

More Than 10,000 Women Studied

The five-year study tracked 9,514 women who were sterilizedbetween 1978 and 1987 and compared them with 573 women whosepartners had vasectomies between 1985 and 1987.

The women were questioned about their periods before their tubalsterilization or their partner’s vasectomy and again each year tosee if there were any persistent changes.

The sterilized women were no more likely than the unsterilizedwomen to report changes in the length of their periods or bleedingbetween periods. They were more likely to have decreases in thenumber of days of bleeding, the amount of bleeding and menstrualpain. They reported an increase in the irregularity of theirmenstrual cycles.

The researchers could think of no biologically plausible reasonwhy the sterilized women have easier periods and speculated thatthe difference could be a matter of chance.

Westhoff said the findings should be reassuring for those whochose sterilization.

“Nobody can promise that a women’s period is going to stay easyfor the rest of her life,” Westhoff said. “In fact, as women getolder, get closer to menopause, they frequently have heavierperiods, or more cramps or all sorts of unpleasant things. Butthat’s not related to tubal ligation.”