Women who have undergone tubal sterilization are no more likely to have menstrual irregularities than those who did not have the procedure, according to a new study, which provides strong evidence that the popular birth control method offers long-term safety.

For decades, there has been concern that tubal sterilization may cause menstrual abnormalities, or so-called post-tubal-ligation-syndrome, including increased bleeding, bleeding between periods, and menstrual pain. But now, researchers of the new study say the concern is unwarranted.

"We now have compelling evidence that post-tubal-ligation-syndrome does not exist," says the study's lead author, Herbert Peterson, MD, former chief of the Women's Health and Fertility Branch at the Centers for Disease Control and Prevention in Atlanta, Georgia, and now a medical officer with the World Health Organization.

"Sterilized women were no more likely than women whose husbands underwent vasectomy to have menstrual abnormalities," says Peterson. "We have reassurance around the major issue that has been raised about the long-term safety of the procedure."

Researchers conducted annual telephone interviews with more than 9,500 women who underwent tubal sterilization and 573 women whose partners underwent vasectomy in a multi-center, five-year prospective cohort study. They found that tubal sterilization not only didn't cause increased bleeding, women who experienced heavy bleeding during menstrual cycles at baseline, and who underwent the procedure were more likely to report decreased bleeding than women who had not had the procedure.

After adjusting for age, baseline menstrual characteristics, race and ethnic background, researchers found that women who underwent sterilization were more likely to have persistent reduction in the amount of bleeding, duration of bleeding, and menstrual pain.

"The study provides further reassurance regarding long-term safety of tubal sterilization," says Peterson. But he cautions that even though the procedure is highly effective as a birth-control method, it is important for people to understand that pregnancy can occur down the road. "We need people to understand that pregnancy doesn't occur often, but it can occur many years after the procedure."

In an editorial accompanying the study published in the Dec. 7 issue of theNew England Journal of Medicine, Carolyn Westhoff, MD, associate professor of clinical obstetrics and gynecology and public health at Columbia Presbyterian Hospital in New York, New York, says that the findings have significant public health implications since more than 11 million women in the US rely on tubal sterilization to prevent pregnancy.

"We can now provide women with more reassurance about the long-term safety and acceptability of tubal sterilization," says Westhoff.

Steve Kaufman, MD, medical officer at the National Institute of Child Health and Human Development, part of the National Institutes of Health in Bethesda, Maryland, says that this study addresses the widespread concern on this issue with solid scientific data. "We can all feel even better about tubal sterilization now that we have such excellent data suggesting that post-tubal-ligation-syndrome does not exist," says Kaufman.

Kaufman says that the study also addressed another important public health issue--surgical removal of the uterus, or hysterectomy. In the past, some gynecologists treated women who had undergone tubal sterilization differently when it comes to making a decision on whether or not to have hysterectomy, according to Kaufman. "But these data certainly suggest that women who have been sterilized should be treated no differently from those who have not," says Kaufman. "The indication for hysterectomy for both groups should be the same."

(From CBSHealthWatch)