American Journal of Epidemiology Vol. 135, No. 12: 1368-1381
Copyright © 1992 by The Johns Hopkins University School of Hygiene and Public Health
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Menstrual Function after Tubal Sterilization
1Division of Reproductive Health, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control Atlanta, GA
2Department of Biostatistics, School of Public Health, Harvard University Boston, MA
Reprint requests to Dr. Lynne S. Wilcox, Women's Health and Fertility Branch, Division of Reproductive Health, Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, 1600 Clifton Road N. E., Mailstop K34, Atlanta, GA 30333.
More than 10 million women In the United States have undergone tubal sterilization. There has been concern that this procedure may increase the risk of later menstrual dysfunction. The Collaborative Review of Sterilization (CREST) is a large, multicenter, prospective study of tubal sterilization in the United States. This report describes CREST participants who were interviewed immediately before sterilization and again in annual poststerilization interviews for up to 5 years between 1978 and 1988. The authors analyzed reported changes in six menstrual cycle characteristics for 5, 070 women undergoing interval sterilizations. Longitudinal, multivariate regression was used to adjust for baseline menstrual function and other potential confounders. Five years after sterilization, 35% of the CREST participants reported high levels of menstrual pain, 49% reported heavy or very heavy menstrual flow, and 10% reported spotting between periods. In contrast to the fifth year, the first year of follow-up was similar to presterilization menstrual function; in the first year, 27% of participants reported high menstrual pain, 41% reported heavy menstrual flow, and 7% reported spotting. These findings may be affected by aging of the cohort and other study limitations, but they suggest that if tubal sterilization leads to changes in menstrual function, such changes may take some time to develop. Am J Epidemiol 1992; 135: 1368–81
menstruation; menstruation disorders; sterilization, tubal
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