Tubal ligation, menstrual changes, and menopausal symptoms.

One of the problematic effects of tubal sterilization is menstrual changes or disorders, although the results of studies in this area have been inconsistent and inconclusive. Recently, there has been growing evidence that tubal sterilization protects against ovarian cancer, possibly through physiological transformations that result in ovarian dysfunction and decline. This report explores the possibility that the biological mechanism of ovarian dysfunction and decline may affect the menstrual and menopausal changes that result from hormonal imbalances. Using data from a homogeneous population of college alumnae assessed for health status, athletic history, and lifestyle characteristics, we focused on a premenopausal subgroup of women in the age range of 40-44 years and with at least one pregnancy. Multivariate analyses were performed to compare sterilized women (n = 56/516, 11%) in this subgroup with nonsterilized women (89%). The two groups were alike in mean age, mean parity, body mass index, smoking history, physical activity levels, and athletic status. Factors that significantly distinguished sterilized women from nonsterilized women were perimenopausal symptoms, such as flushing, sweating, breast pain, vaginal dryness, and pain associated with menstrual cycles.