Effects of Tubal Sterilization on Women's Sexuality and Risk Factors Causing Sexual Dysfunction
Journal of Academic Research in Medicine
INTRODUCTION It is stated that many psychosocial and cultural factors play a role in the development of sexual dysfunction in women. When these factors are evaluated, it is observed that sexuality is a multidimensional and multidisciplinary process that is derived from psychosocial, cultural, behavioral, and organic reasons and that sexual function disorders develop within this versatile network of relationships (1). It is estimated that physiological, hormonal, structural, and psychological
... nd psychological changes caused by surgical interventions related to reproductive organs may lead to several sexual problems among women (2). Previous studies have shown that many surgical interventions, particularly hysterectomy, negatively affect the body image, self-respect, femininity characteristics, and sexual functions of women (3). The tubal sterilization operation is the most commonly used permanent contraception method worldwide (4). The incidence of tubal sterilization in Turkey was determined to be 5.7% based on a previous study (5). In the performed studies, it has been reported, albeit with different results, that many problems such as post-tubal ligation syndrome, menstrual dysfunction, pelvic pain, and sexual dysfunction have been experienced by patients following tubal sterilization (6). In this study, we aimed to investigate the effect of tubal sterilization on female sexuality and the risk factors leading to sexual dysfunction among women aged between 26 and 40 years who were admitted to our gynecology outpatient clinic. METHODS This case control study was performed at the İstanbul Şişli Education and Research Hospital Obstetrics and Gynecology Department between May 2012 and October 2012. The study was started after obtaining Şişli Ethics Committee approval and written consents from all the included patients. In total, 100 women who were sexually active, who were at a reproductive age and were aged between 26 and 40 years, and who had undergone tubal sterilization surgery at least one year ago were enrolled in the study as the tubal sterilization group. The sociodemographic characteristics of the women in this group and their previous surgical histories were recorded. Detailed physical examinations were performed, and women who had gynecological diseases, who had a chronic disease history, whose BMI was above 40 kg/m 2 , who did not have an active sexual life, who did not have a sexual activity within the last one month, who were in the postmenopausal period, who were using oral ABSTRACT Objective: The aim of this study was to evaluate the incidence of sexual dysfunction and associated risk factors in women who had undergone tubal sterilization and those who had not undergone tubal sterilization. Methods: In this case-controlled sectional study, 100 women who underwent tubal sterilization were included as the case group and 100 women who were healthy, reproductive, and sexually active were included as the control group. A detailed medical and sexual history was taken from all the patients, and they were evaluated by filling the Female Sexual Function Index (FSFI) form in order to determine the status of sexual function. In 200 cases, the relationship of age, marital status, income level, number of births, alcohol use, cigarette smoking, and BMI with the FSFI scores was investigated by regression analysis. Results: While the rate of sexual dysfunction was 82% in the tubal sterilization group, it was found to be 32% in the control group (p<0.001). In the tubal sterilization group, desire, arousal, lubrication, orgasm, satisfaction, and pain scores were reported to be significantly lower than those in the control group (p<0.001). According to logistic regression analysis, in women whose monthly income was <$500 (OR 4.331); whose marital status was single, widowed, or divorced (OR 13.769); whose parity was >2 (OR 3.462); and who had undergone BTL (OR 7.876) were found to have an increased risk of sexual dysfunction. Conclusion: The termination of fertility, which is one of the most significant abilities of women, by tubal sterilization seems to be an important factor for sexual dysfunction, especially in the presence of risk factors.