Female sterilisation

Abstract

Adverse effects of female sterilisation are a popular subject for media focus; however, in reality modern techniques mean that the benefits outweigh the risks.

PIP: The author updates a 1986 review conducted by Paterson of the long-term sequelae of female sterilization. This review encompasses all English-language papers on the sequelae of tubal sterilization as listed in Index medicus over the period 1984-94. The adverse effects of female sterilization have been sporadically reported including increased frequency of menorrhagia, dysmenorrhea, oligomenorrhea, polymenorrhea, and a higher incidence of subsequent gynecological surgery or hysterectomy. No consistent pattern exists, however, to the events and some studies do not reflect any adverse changes. It may be held that female sterilization is unlikely to have a significant association with any consistent pathological change. Moreover, the review found several methods of sterilization to be lumped together, eliminating the possibility of drawing any conclusions about the newer, less invasive method of tubal clipping, which should be the method of choice for the 1990s. There may be some adverse effects of sterilization in some women, but one must consider the incidence of such effects in the context of the risk-benefit ratio. The author argues that for women who understand the procedure, the benefits of laparoscopic sterilization far outweigh the risks.