This article presents a review of the literature on post-tubal sterilization syndrome. Although studies have shortcomings they suggest the majority of women undergoing tubal sterilization do not experience changes in menstrual patterns after the procedure, but a minority do. Suggestions are made for further research, conducted from a nursing perspective. Implications for practice are suggested, given the tentative information on post-tubal sterilization syndrome.
PIP: Even though nurses care for women who complain of menstrual problems after undergoing tubal sterilization (ligation, electrocoagulation, or tubal occlusion by rings or clips), limited nursing literature exists on posttubal sterilization syndrome. Nurses should be interested in post TS syndrome, particularly in the menstrual changes and women's perceptions of these changes. Post TS syndrome consists of irregular menstrual cycles, dysmenorrhea, menorrhagia, and midcycle bleeding. Some scientists speculate that interference with the utero-ovarian blood supply and subsequent disturbance of ovarian function bring about post TS changes. Tubal ligation and electrocoagulation may be more likely to do so since they destroy more tissue than other procedures. In fact, an international study among 8486 post TS women found that those who underwent electrocoagulation were significantly more likely to experience menstrual changes than those who underwent other procedures. A case control study found much increased prevalence of abnormal cycles 49 and 87 months post TS (ligation and electrocoagulation). Yet there has not been any studies of actual pathophysiological changes in the ovary after TS. One can theorize, thought, that disturbance of the arterial blood supply may decrease the supply of follicle stimulating hormone and luteinizing hormone which in turn reduce estrogen and progesterone production. In a large multicenter study of 10,004 post TS women, as many as 30% noted either an increase or a decrease in 1 of 6 menstrual parameters. Most of these women took an oral contraceptive before TS, however. Other studied revealed that endometriosis is more likely to occur post TS than in non TS women. Health practitioners should encourage post TS women to keep a record of their menstrual cycles and to monitor irregularities. This reduce recall bias and bias associated with perceptions.