Assessment of Menstrual Irregularities in Reproductive Women Post Tubal Ligation

Abstract

Objective: To compare menstrual disorders between post-tubal ligated and non-ligated women, and to compare endometrial histopathology between the two groups to evaluate menstrual disorders.

Study Design: Prospective cohort study.

Setting: Department of Obstetrics and Gynecology, Nishtar Hospital, Multan, Pakistan.

Period: 9^th April 2022 to 9^th July 2023.

Material and Methods: A purposive sampling technique was used to enroll 210 women aged 30 to 50 years, divided into two groups of 105 women each: Group 1 (post-tubal ligated) and Group 2 (non-tubal ligated). Each group was further subdivided into patients with and without abnormal uterine bleeding (AUB). A detailed menstrual history, general and systemic examination, routine investigations, and pre-menstrual endometrial biopsy were performed. Statistical analysis was conducted using the Chi-square test, with categorical variables expressed as frequencies and percentages. Exact p-values were calculated, and a p-value of less than 0.05 was considered statistically significant.

Results: In the case group, polymenorrhea was observed in 38.89% and menorrhagia in 29.63% of patients, whereas in the control group, polymenorrhea was observed in 39.22% and menorrhagia in 31.37% of patients. The differences were not statistically significant (p = 1.000). Proliferative endometrium was the most common histopathological finding in both groups (42.59% of cases vs. 41.18% of controls, p = 1.000). No significant associations were found between tubal ligation status and age (p = 0.315), parity (p = 0.995), endometrial thickness (p = 0.825), or time since tubal ligation (p = 0.200).

Conclusion: The incidence of menstrual disorders does not differ significantly between post-tubal ligated and non-ligated women. Patients concerned about the effects of tubal ligation on their future menstrual patterns should be counseled that the procedure has no adverse impact on menstrual function or endometrial histopathology. Large-scale, multi-center studies with extended follow-up periods are recommended to confirm these findings.

Keywords: Abnormal uterine bleeding, post-tubal sterilization syndrome, tubal ligation, menstrual disorders, endometrial histopathology, Pakistan.