The Relationship Between Tubal Ligation and Subsequent Menorrhagiaand Polymenorrhagia: A Systematic Review and Meta-Analysis

Introduction:: Surgical sterilization, or tubal ligation (TL), has become one of the most common methods of contraception worldwide; however, various side effects have been reported. This systematic review and meta-analysis is the first to examine the occurrence of menorrhagia and polymenorrhea following TL in existing studies. Methods:: PubMed, Web of Science, Scopus, and ProQuest were systematically searched up to November 2024. Analysis was performed using the random-effects model. Heterogeneity among studies was assessed using the Chi-square test (χ²) and the I² statistic. Regression analyses, including Egger’s and Begg’s tests, were conducted to evaluate publication bias. The quality of the included studies was assessed using the Newcastle–Ottawa Scale (NOS). Statistical significance was defined as a p-value < 0.05, and all analyses were conducted using Stata software, version 14. Results:: We examined the association between TL and subsequent menorrhagia. The association was not statistically significant [OR: 1.55; 95% CI: 0.87–2.22; I² = 89.0%]. Similarly, the association between TL and subsequent polymenorrhea was not significant [OR: 1.36; 95% CI: 0.87–1.84; I² = 17.7%]. High heterogeneity was observed among studies examining the association between TL and menorrhagia, whereas low heterogeneity was noted for the association between TL and polymenorrhea. Discussion:: In this study, no evidence of publication bias was detected among the included studies. Furthermore, according to the Newcastle–Ottawa Scale (NOS), 11 studies were classified as high quality, which represents a key strength of this review. Conclusion:: The overall findings of this systematic review and meta-analysis did not reveal a statistically significant association between tubal ligation (TL) in women and subsequent menorrhagia or polymenorrhea. Therefore, prospective long-term cohort studies are required to draw more definitive conclusions in this area. Additionally, it is essential to investigate other potential factors that may contribute to menstrual disorders prior to performing TL.