ABSTRACT
OBJECTIVE: Our objective was to investigate tubal sterilization and subsequent hospitalization for menstrual disorders. STUDY DESIGN: Automated discharge data were used in a population-based cohort study of 7253 women aged 20 to 49 years with tubal sterilization (1968 through 1983) at Group Health Cooperative of Puget Sound. Comparisons were with an age-matched cohort of 25,448 nonsterilized women and a nonmatched cohort of 5283 spouses of men with vasectomies. RESULTS: In the sterilization cohort, 282 had hospitalization for menstrual disorders (curettage, n = 191; hysterectomy, n = 66; nonsurgical, n = 25). Risk of hospitalization for menstrual disorders was 2.4 times greater after tubal sterilization (95% confidence interval 2.0 to 2.9). This risk was 6.1 times greater for sterilized women aged 20 to 24 years (95% confidence interval 0.72 to 3.2). Compared with the risk for nonsterilized women whose spouses had a vasectomy, the risk was 1.6 times greater (95% confidence interval 1.3 to 2.1). Hospitalization for menstrual disorders was not more common after unipolar sterilization than after other methods, as might have been expected if the menstrual disorder was related to impaired uteroovarian circulation. CONCLUSIONS: Tubal sterilization is associated with a greater risk of hospitalization for menstrual disorders. A biologic association is not supported by these results.
PIP: This study investigated tubal sterilization and subsequent hospitalization for menstrual disorders. Automated discharge data were used in a population-based cohort study of 7253 women aged 20-49 years with tubal sterilization (1968-83) at Group Health Cooperative of Puget Sound. Comparisons were with an age-matched cohort of 25,448 nonsterilized women and a nonmatched cohort of 5283 spouses of men with vasectomies. In the sterilization cohort, 282 were hospitalized for menstrual disorders (curettage, n=191: hysterectomy, n=66; nonsurgical, n=25). Risk of hospitalization for menstrual disorders was 2.4 times greater after tubal sterilization (95% confidence interval 2.0-2.9), a risk 6 times greater for sterilized women aged 20-24 years (95% confidence interval 0.72-3.2). Compared with the risk for nonsterilized women whose husbands had a vasectomy, the risk was 1.6 times greater (95% confidence interval 1.3-2.1). Hospitalization for menstrual disorders was not more common after unipolar sterilization than after other methods, as might have been expected if the menstrual disorder was related to impaired utero-ovarian circulation. Tubal sterilization is associated with a greater risk of hospitalization for menstrual disorders. A biologic association is not supported by these results.
