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pubmed:otherAbstract |
PIP: In Finland, every year a total of 11,000 female sterilizations are carried out, whereas worldwide 400 million such procedures are expected to be performed by the year 2000. In the past decade, major changes have occurred in the technical aspects of the procedure. Unilateral and bilateral endocoagulation of the Fallopian tube used to be standard procedure, but at the present time, when using the method of choice, laparoscopy, a clip ties the tube. Post-sterilization symptoms include pain (10-26% of cases), pain irrespective of menstrual cycle (6-40%), dyspareunia (4%), premenstrual tension (6-40%), and prolonged menstruation. Arterial blood flow between the uterus and Fallopian tube may be disturbed and tissue damage may result infrequently. Earlier methods of female sterilization produced more tissue damage, as clips affect blood circulation. In one study, lower abdominal circulation was measured by Doppler ultrasound and compared with nonsterilized subjects 2 days before sterilization, 2 days after, and 3 months later. The results indicated that patients whose uterine blood flow had decreased subsequently returned to the previous normal value, but in the ovaries the change was greater and return to the previous value did not occur. The author's own study used salivary samples 1 month before sterilization, 3 months after sterilization, and 1 year afterwards during a whole menstrual cycle. Total progesterone values slowly decreased 1 year after sterilization. Within the menstrual cycle, the peak of the progesterone level was the lowest 3 months after sterilization and it did not reach the pre-sterilization level. Sterilization exerts a measurable effect on the ovaries, but more investigations are needed to confirm this finding.
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