Descriptive Cross-Sectional Study on Menstrual Irregularities in Patients Undergoing Tubal Ligation: Menstrual Irregularities After Tubal Ligation

Sammia Liaqat; Afroza Abbas; Sayyeda Mehak Batool; Abida Perveen; Ameena Fatima; Sadaf Shabbir

doi:10.54393/pjhs.v7i6.3222

Authors

Sammia Liaqat Department of Obstetrics and Gynecology, Tehsil Head Quarter Hospital Bhagtanwala, Sargodha, Pakistan
Afroza Abbas Department of Obstetrics and Gynecology, Sargodha Medical College, Mian Mola Bakhsh Hospital, Sargodha, Pakistan
Sayyeda Mehak Batool Department of Obstetrics and Gynecology, Tehsil Head Quarter Hospital Silanwali, Sargodha, Pakistan
Abida Perveen Department of Obstetrics and Gynecology, Sheba Poly Clinic Deira, Dubai, United Arab Emirates
Ameena Fatima Department of Obstetrics and Gynecology, Mian Mola Bakhsh Hospital, Sargodha, Pakistan
Sadaf Shabbir Department of Obstetrics and Gynecology, Mian Mola Bakhsh Hospital, Sargodha, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v7i6.3222

Keywords:

Tubal Ligation, Menstrual Disturbances, Polymenorrhea, Gonadotropin

Abstract

Menstrual abnormalities continue to be a problematic consequence of tubal ligation, despite conflicting results from pertinent studies. Menorrhagia, metrorrhagia, polymenorrhagia, and dysmenorrhea are common disorders that may require a hysterectomy. Objective: To ascertain how frequently women who had tubal ligation experienced irregular menstruation. Methods: The Department of Obstetrics and Gynecology at Government Maula Baksh Hospital in Sargodha carried out this descriptive cross-sectional study between August 1, 2023, and January 31, 2024. The Institutional Review Board (IRB) of Government Maula Baksh Hospital in Sargodha gave its approval to the study (Reference No. CPSP/ETH/2023/001). Using non-probability consecutive sampling, 303 women between the ages of 20 and 40 who were having tubal ligation were included. Women with gynecological conditions (polycystic ovarian syndrome, endometriosis, adenomyosis, fibroid uterus), diabetes mellitus, hypertension, thyroid or cardiovascular disorders, or thyroid dysfunction were excluded. Tubal ligation was performed by a consultant gynecologist using the standard method. Patients were followed 6 months post-ligation, with menstrual irregularities self-reported via a specially designed proforma and clinically validated through menstrual diaries where possible. Results: This study found oligomenorrhea in 83 (27.4%), abnormal uterine bleeding in 61 (20.1%), dysmenorrhea in 55 (18.2%), and polymenorrhea in 37 (12.2%) post-TL. Conclusion: Oligomenorrhea is the most common menstrual irregularity post-tubal ligation, followed by abnormal uterine bleeding.

References

Goldberg JM, Falcone T, Diamond MP. Current Controversies in Tubal Disease, Endometriosis, and Pelvic Adhesion. Fertility and Sterility. 2019 Sep; 112(3): 417-425. doi: 10.1016/j.fertnstert.2019.06.021.

March CM. Female tubal sterilization: traditional and research methods. In The Handbook of Contraception: Evidence-Based Practice Recommendations and Rationales. Cham: Springer International Publishing. 2020 Sep: 193-238. doi: 10.1007/978-3-030-46391-5_11.

Nash R, Johnson CE, Harris HR, Peres LC, Joslin CE, Bethea TN et al. Race Differences in the Associations Between Menstrual Cycle Characteristics and Epithelial Ovarian Cancer. Cancer Epidemiology, Biomarkers and Prevention. 2022 Aug; 31(8): 1610-1620. doi: 10.1158/1055-9965.EPI-22-0115.

Bansal A, Dwivedi LK, Ali B. The Trends of Female Sterilization in India: An Age-Period-Cohort Analysis Approach. BioMed Central Women's Health. 2022 Jul; 22(1): 272. doi: 10.1186/s12905-022-01857-0.

Zucchini C, De Sanctis P, Facchini C, Di Donato N, Montanari G, Bertoldo V et al. Performance of Circulating Placental Growth Factor as a Screening Marker for Diagnosis of Ovarian Endometriosis: A Pilot Study. International Journal of Fertility and Sterility. 2015 Dec; 9(4): 483.

Verma P, Saxena S, Hiremath RN, Sinha P. Comparative Study on Menstrual Disorders in Post-Tubal Ligated and Non-Ligated Women. Journal of Family Medicine and Primary Care. 2023 Oct; 12(10): 2482-7. doi: 10.4103/jfmpc.jfmpc_880_23.

Glasier A, Bhattacharya S, Evers H, Gemzell‐Danielsson K, Hardman S, Heikinheimo O et al. Contraception After Pregnancy. Acta Obstetricia Et Gynecologica Scandinavica. 2019 Nov; 98(11): 1378-1385. Doi: 10.1111/aogs.13627.

Itriyeva K. The Normal Menstrual Cycle. Current Problems in Pediatric and Adolescent Health Care. 2022 May; 52(5): 101183. doi: 10.1016/j.cppeds.2022.101183.

Dreisler E, Frandsen CS, Ulrich L. Perimenopausal Abnormal Uterine Bleeding. Maturitas. 2024 Jun; 184: 107944. doi: 10.1016/j.maturitas.2024.107944.

Harini R, Gowri S, Vinayakamurthy N. Impact of BMI on Puberty Menorrhagia in the Modern Era: A Prospective Analysis in a Tertiary Care Centre. Journal of Contemporary Clinical Practice. 2025 Jan; 11: 95-102.

Rodriguez MB, Lethaby A, Low C, Cameron IT. Cyclical Progestogens for Heavy Menstrual Bleeding. Cochrane Database of Systematic Reviews. 2019; 8.

Akgör U, Kırat S, Tok C. The Effects of Tubal Sterilization on Menopausal Age in a Cohort of Postmenopausal Women. Deneysel ve Klinik Tıp Dergisi. 2021 Sep; 38(4): 589-593. doi: 10.52142/omujecm.38.4.34.

Shaikh S. Assessment of Menstrual Disturbances Resulting from Tubal Sterilization. Journal of Surgery Pakistan. 2019 May; 24(1): 34-37.

Abbas HY, Liaqat F, Memon E, Qureshi ZU, Karim K, Ali N. Menstrual Irregularities Post Tubal Ligation: Menstrual Irregularities Post Tubal Ligation. Pakistan Bio-Medical Journal. 2022 Jul: 89-93. doi: 10.54393/pbmj.v5i7.631.

Stein RI, Ma Y, Phelan J, Roberts ET, Johnston KJ, Orav EJ et al. Growth of Chronic Condition Special Needs Plans Among Dual-Eligible Beneficiaries, 2011–24: Health Affairs. 2025 Mar; 44(3): 304-312. doi: 10.1377/hlthaff.2024.00651.

Chen K, Bai Y, Ma Y, Chen J, Huang Y, Yang F et al. Subsequent Pregnancy Outcomes Following Conservative Management for Placenta Accreta Spectrum Disorders: An Ambispective Cohort Study. The Journal of Maternal-Fetal and Neonatal Medicine. 2025 Dec; 38(1): 2477782. doi: 10.1080/14767058.2025.2477782.

Zhu Y, Gong Y, Liu P. Supportive Care Needs, Quality of Life, And Social Support Among Laryngeal Cancer Patients Undergoing Total Laryngectomy: A Cohort Study. The Journal of Laryngology and Otology. 2025 Nov: 1-23. doi: 10.1017/S0022215125103770.

Uppal T, Lanzarone V, Mongelli M. Sonographically Detected Caesarean Section Scar Defects and Menstrual Irregularity. Journal of Obstetrics and Gynaecology. 2011 Jul; 31(5): 413-416. doi: 10.3109/01443615.2011.577252.

Bagga SS, Tayade S, Lohiya N, Tyagi A, Chauhan A. Menopause Dynamics: From Symptoms to Quality of Life, Unraveling the Complexities of the Hormonal Shift. Multidisciplinary Reviews. 2025; 8(2): 2025057. doi: 10.31893/multirev.2025057.

Orisaka M, Kawamura H, Yoshida Y. COVID‐19 Testing of Pregnant Women in Japan. Journal of Obstetrics and Gynaecology Research. 2021 Jan; 47(464): 10-111. doi: 10.1111/jog.14567.