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October 31, 1977

Sterilization and Menstrual Disturbances

JAMA. 1977;238(18):1913. doi:10.1001/jama.1977.03280190015008

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To the Editor.—  The incidence of subsequent gynecological disease, particularly dysfunctional bleeding, following sterilization by tubal ligation has been extensively studied. Whether laparoscopic tubal coagulation is associated with menstrual irregularities is still an open question.We were interested in the report discussed in MEDICAL NEWS (237:2457, 1977) where women who had sterilization by laparoscopy and diathermy appeared far more likely to suffer from menstrual irregularities.We had reported (Contraception 13:631,1976) a long-term postoperative follow-up on 93 patients who had laparoscopic tubal sterilization between 1972 and 1973. Prelaparoscopy menstrual histories were compared with menstrual histories 18 to 36 months after laparoscopic tubal cauterization. After sterilization, regular periods were reported by 78.5% of the patients; 2.1% had amenorrhea; 8.6% had preoperative menstrual irregularities unchanged after the procedure; 5.4% had changes in the menstrual cycle related to discontinuation of oral contraceptives; and only 5.4% reported abnormal periods since the sterilization procedure. Our clinical