Long-term risk of menstrual disturbances after tubal sterilization

DeStefano, Frank; Perlman, Jeffrey A.; Peterson, Herbert B.; Diamond, Earl L.

doi:10.1016/s0002-9378(85)80073-9

Cited by 59 publications

(31 citation statements)

References 7 publications

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“…4,20 Whether tubal sterilization causes hormonal dysfunction has not been determined definitively, although many investigators have examined changes in menstrual symptoms and circulating hormone levels as markers of disrupted hormonal functioning. Increased disturbance in menstrual cycles and symptoms in sterilized women, when compared with those of either a control group or the sterilized women before the procedure, have been observed in most, [20][21][22][23][24][25][26] but not all, [27][28][29] studies. In many, 5,6,18,[30][31][32][33] but not all, 28,29,[34][35][36] of the studies that examined circulating or urinary hormone levels, women who had been sterilized had significantly lower hormone levels than those in the same women before sterilization or in control women.…”

Section: Discussionmentioning

confidence: 99%

Tubal sterilization in relation to breast cancer risk

Eliassen

Colditz

Rosner

et al. 2005

Intl Journal of Cancer

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Tubal sterilization methods may damage surrounding tissue, potentially disrupting the ovarian blood supply and hormonal functioning, and may decrease breast cancer risk. We examined this hypothesis, within the Nurses' Health Study, among 77,511 women, aged 30-55 years and free of cancer at the start of followup in 1976. We documented 4,176 cases of invasive breast cancer from 1976 to 2000. Cox proportional hazards models, adjusting for multiple breast cancer risk factors, provided rate ratios (RR) and 95% confidence intervals (CI). Overall, tubal sterilization was not associated with breast cancer risk (RR 5 0.95, 95% CI 5 0.88-1.03). However, tubal sterilizations performed from 1970 to 1974 were inversely associated with risk (RR 5 0.84, 95% CI 5 0.73-0.97), while procedures performed in other years were not associated with risk. Among women with procedures performed in 1970-1974, those who were 35 years old at the time of sterilization were at the lowest risk (RR 5 0.81, 95% CI 5 0.66-0.98), while younger women had a suggested decreased risk (RR 5 0.87, 95% CI 5 0.72-1.06). Overall, tubal sterilization was not associated with breast cancer risk. However, a modest inverse association was observed at a time when the potentially destructive unipolar electrocautery method was commonly used, providing some support for an association between lower lifetime exposure to hormones and a decreased risk of breast cancer. ' 2005 Wiley-Liss, Inc.

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Section: Discussionmentioning

confidence: 99%

Tubal sterilization in relation to breast cancer risk

Eliassen

Colditz

Rosner

et al. 2005

Intl Journal of Cancer

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“…This includes clinical reports showing that menstrual disorders (Neil et al, 1975;Sorenson and Ladehoff, 1979;DeStefano et al, 1985) and alterations in oestrogen and progesterone levels (Cattanach and Milne, 1988;Helm amd Sjoberg, 1983;Hakverdi et al, 1994) have been seen following tubal ligations. Future studies involving prospective designs may be most useful, given the potential in case-control studies, such as ours, for difficulties in recall.…”

Section: Discussionmentioning

confidence: 99%

True

et al. 2000

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SummaryAlthough it has been demonstrated in previous studies that tubal ligation can have widespread effects on ovarian function, including a decrease in the risk of subsequent ovarian cancer, few studies have evaluated effects on breast cancer risk. In a population-based case-control study of breast cancer among women 20-54 years of age conducted in three geographic areas, previous tubal ligations were reported by 25.3% of the 2173 cases and 25.8% of the 1990 controls. Initially it appeared that tubal ligations might impart a slight reduction in risk, particularly among women undergoing the procedure at young ages (< 25 years). However, women were more likely to have had the procedure if they were black, less educated, young when they bore their first child, or multiparous. After accounting for these factors, tubal ligations were unrelated to breast cancer risk (relative risk (RR) = 1.09, 95% confidence interval (CI) 0.9-1.3), with no variation in risk by age at, interval since, or calendar year of the procedure. Subjects were asked to complete a month-by-month calendar documenting all contraceptive methods used since menarche. Pregnancies and other life events were first marked on the calendar to serve as a frame of reference for changes in contraceptive behaviour over time. Information recorded on the calendar regarding the occurrence of a tubal ligation was used to compute the age at, interval since, and calendar time of the procedure.Completed interviews were obtained from 2202 of the 2558 eligible cases (86.1%) and 2009 of the 2477 eligible controls (81.1%). Reasons for non-interview included subject refusals (6.4% in cases vs 14.0% in controls), death (0.4% vs 0.2%), illness (0.6% vs 0.2%), language problems (0.3% vs 1.4%), a move outside of the study area (0.6% vs 2.3%) and other miscellaneous reasons (0.2% vs 0.8%). In addition, physician consent for interview was denied for 5.4% of the cases. Among controls, an overall response rate of 73.4% was achieved through multiplication of the telephone screener and interview response rates. To assure comparability between the cases and controls, the 29 cases who indicated on interview that they did not have a residential telephone and the 19 controls with a history of breast cancer were eliminated, leaving 2173 cases and 1990 controls available for analysis.Since the median interval between diagnosis and interview was 87 days for cases, all information on risk factors, including that pertaining to tubal ligations, was truncated at the date of diagnosis for cases or the date at completion of the telephone screener for controls. The relationship of breast cancer risk factors to tubal ligation among the controls was assessed by calculating χ 2 statistics. The relationship of tubal ligation to breast cancer risk was assessed through calculation of odds ratios to approximate relative risks (RRs). Logistic regression analyses were used to obtain maximum likelihood estimates of RRs and their 95% confidence intervals (CI) (Breslow and Day, 1980). The significance of in...

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“…WHO task force on the subject has reported extensively on the benefits of a lapster over a minilap [7]. DeStefano and co-workers have compared the morbidity between puerperal and interval procedures [8].…”

Section: Techniques In Practicementioning

confidence: 99%

Cosmetic Scar and Scope of Reversal After Puerperal Sterilisation

Rath

Chattopadhyaya

Tarneja

2000

Medical Journal Armed Forces India

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Female sterilisation is an important component of National Family Welfare Programme. The target group is best motivated during the puerperium for such a procedure. However laparoscopic sterilisation which has got some distinct advantages, is not technically feasible at this time. The authors have used a technique where the advantages of cosmetic appearance, reduced post operative morbidity and reversibility can be conferred on the puerperal women.After trying out the method individually in some cases, a formal case control study design has been made and an evaluation study has been performed in 122 cases. The technique has been found to be cosmetically more acceptable, both at clientele and peer evaluation levels (p

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Long-term risk of menstrual disturbances after tubal sterilization

Cited by 59 publications

References 7 publications

Tubal sterilization in relation to breast cancer risk

Tubal sterilization in relation to breast cancer risk

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Cosmetic Scar and Scope of Reversal After Puerperal Sterilisation

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