Evaluation of influencing factors on tubal sterilization regret: a cross-sectional study

Background: The aim of this study is to evaluate the menstrual pattern, sexual function, and anxiety, and depression in women with poststerilization regret, and potential influencing factors for regret following tubal ligation [TL] in Iranian women

Materials and Methods: In this cross-sectional study, 166 women with TL were subdivided into two groups including women with poststerilization regret [n=41] and women without poststerilization regret [n=125]. They were selected from a health care center in Guilan province [Iran] during 2015-2016. Menstrual blood loss was measured using the Pictorial Blood Loss Assessment Chart [PBLAC] and through a self-administered questionnaire. In addition, sexual function was assessed by the Female Sexual Function Index [FSFI], and psychological distress was measured by employing the Hospital Anxiety and Depression Scale [HADS]. Student's t test and Chi-square test were used to reveal the statistical differences between the two groups. We used logistic regression to determine the influencing factors associated with regretting sterilization

Results: Women with poststerilization regret had more menorrhagia [78 vs. 57.6%, P=0.03] than those who did not regret sterilization. A significant difference was found in sexual dysfunction in orgasm [P=0.02], satisfaction [P=0.004], pain [P=0.02], and total FSFI scores [P=0.007] between the two groups. Also, there was a significant difference between the two groups in anxiety, depression and total scores HADS [P=0.01]. In the logistic regression model, age of sterilization [odds ratio [OR=2.67], confidence interval [CI]: 1.03-7.81, P=0.04]], pre-sterilization counseling [OR=19.92, CI: 6.61-59.99, P<0.001], score of PBLAC [OR=1.01, CI: 1.004-1.01, P=0.001], the number of days of bleeding [OR=1.37, CI: 1.01-1.99, P=0.04], and the length of menstrual cycles [OR=0.91, CI: 0.84-0.99, P=0.03] were significantly associated with regretting sterilization

Conclusion: Complications due to sterilization are the main causes of regret; therefore, it is necessary to pay due attention to mentioning the probable complications of the procedures such as menstruation disorders, sexual dysfunction, and anxiety and depression in women during pre-sterilization counseling

Women's sexual and reproductive health care needs assessment: an Iranian perspective

Background: Reproductive health problems are a leading cause of women's ill health and mortality worldwide. There is a need to investigate sexual and reproductive health care needs in different societies and cultural contexts. Despite the success in health care promotion in the Iranian health care system, women still need to receive sexual health care and appropriate HIV/AIDS services. However, studies on the sexual and reproductive health care needs of Iranian women are lacking.

Aims: This study aimed to investigate the sexual and reproductive health care needs of women referred to health care centres in an urban area of the Islamic Republic of Iran.

Methods: We carried out a cross-sectional study in 2013 on 514 women living in an urban area in the north of the Islamic Republic of Iran. Taking into consideration ethical principles, data were collected using the Sexual and Reproductive Health Care Needs Assessment Questionnaire.

Results: The findings showed a greater need for the provision of care by practitioners in the sexual history and activities domain [73%] compared with other domains. Also, the woman's age and the location where she sought treatment and care for sexually transmitted infections were predictors of sexual activities needs.

Conclusions: Owing to the high prevalence of women's referral to health care centres seeking treatment of sexual disorders, there is a need for the provision of sexual counseling centres and services promoting women's reproductive health care

Menstrual pattern following tubal ligation: a historical cohort study

Background: Tubal ligation [TL] is recommended for women who have completed their family planning. The existence of the menstrual disorders following this procedure has been the subject of debate for decades. This study was conducted to identify the relationship between tubal ligation and menstrual disorders

Materials and Methods: A historical cohort study was carried out on 140 women undergoing tubal ligation [TL group] and on 140 women using condom as the main contraceptive method [Non-TL group]. They aged between 20 and 40 years and were selected from a health care center in Rudsar, Guilan Province, Iran, during 2013-2014. The two groups were comparable in demographic characteristics, obstetrical features and menstrual bleeding pattern using a routine questionnaire. A validated pictorial blood loss assessment chart [PBLAC] was also used to measure the menstrual blood loss

Results: Women with TL had more menstrual irregularity than those without TL [24.3 vs. 10%, P=0.002]. Women with TL had more polymenorrhea [9.3 vs. 1.4%, P=0.006], hypermenorrhea [12.1 vs. 2.1%, P=0.002], menorrhagia [62.9 vs. 22.1%, P<0.0001] and menometrorrhagia [15.7 vs. 3.6%, P=0.001] than those without TL. There is a significant difference in the PBLAC score between women with and without TL [P<0.0001]. According to logistic regression, age odds ratio [[OR=1.08, confidence interval [CI]:1.07-1.17, P=0.03]], TL [OR=5.95, CI: 3.45-10.26, P<0.0001] and cesarean section [OR=2.72, CI:1.49-4.97, P=0.001] were significantly associated with menorrhagia

Conclusion: We found significant differences in menstrual disorders between women with and without TL. Therefore, women should be informed by the health providers regarding the advantages and disadvantages of TL before the procedures