Effect of Bilateral Tubal Ligation on Menstrual Blood flow: An Analysis of Menstrual Disorder Following the Procedure

Shabana Khokhar; Ambreen Nasir; Huma Tahseen; Hafiza Naveeda Khurshid; Saima Qurban; Samar Hussain

Shabana Khokhar Associate Professor of Obs and Gynae, Punjab Rangers Teaching Hospital Lahore
Ambreen Nasir Associate Professor of Obs and Gynae, Punjab Rangers Teaching Hospital Lahore
Huma Tahseen 3Associate Professor of Obs and Gynae, Azra Naheed Medical College, Raiwind road, Lahore
Hafiza Naveeda Khurshid Assistant Professor of Obs and Gynae, Azra Naheed medical college, Lahore
Saima Qurban Associate Professor of Obs and Gynae, RLKU Medical College, Hameed Latif Teaching Hospital Lahore
Samar Hussain Assistant Professor of Obs and Gynae, Rashid Latif Medical College /AMTH

Keywords: Menstrual abnormalities, PBAC score

Abstract

Objective: To determine the effect of bilateral tubal ligation (BTL) on menstrual blood flow by comparing menstrual abnormalities and PBAC scores between interventional (BTL) and non-interventional women.

Methodology: A comparative cross-sectional study was done at Obstetrics and Gynaecology department of Rahbar Medical College Lahore from June 2022 to June 2023. Women aged 18 t0 45 years, who have undergone BTL at least one year prior to the study and visiting the gynaecology OPD and hospital specializing in reproductive health were included. Women were equally distributed in two groups; 85 as cases (intervention of BTL) and 85 as controls (without intervention of BTL). Finally women were assessed for demographic medical history and their current menstrual pattern. PBAC (Pictorial Blood Assessment Chart) score was used to quantify menstrual bleeding and assess its severity. Data was entered and analyzed using SPSS version 26.

Results: Average age of the participants was almost similar, with Group A having a mean age of 38.87 years and Group B at 38.14 years (p=0.237). Although, a significant difference was observed in the Body Mass Index (BMI), where Group A had a higher mean BMI of 28.36 kg/m² compared to 26.26 kg/m² in Group B, (p- 0.001). Among women of Group A (Exposed), 25.9% had menstrual irregularities, compared to only 10.6% in Group B (Unexposed), indicating a statistically significant difference (p=0.001). There was no any significant association of menstrual abnormalities in BTL-exposed women with age of women, parity, and number of previous C-sections and duration of BTL (p -> 0.05).

Conclusion: Study revealed that the BTL is a safe and reliable contraceptive procedure, though it is associated with an increased incidence of menstrual irregularities and heavier menstrual flow, as indicated by higher PBAC scores in the BTL-exposed group compared to the non-exposed group. However, the majority of women in both groups did not experience menstrual irregularities or heavy menstrual bleeding.