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



Abdi F ; Zaheri F ; Jenabi E ; Momenzadeh F
Source: Current Women's Health Reviews Published:2026

Abstract

Introduction: Surgical sterilization or Tubal Ligation (TL) of women has become one of the most common prevention methods in the world. However, various complications have been proposed for it. This systematic review and meta-analysis is the first study to examine menorrhagia and polymenorrhea after TL among observational studies. Methods: PubMed, Web of Science, Scopus, and ProQuest were systematically evaluated up to November 2024. Analysis was conducted using the Random-Effects Model. Heterogeneity was assessed across studies using the Chi-Square Test (Χ²) and the I² statistic. We also conducted regression tests, including Egger's and Begg's tests, to assess publication bias. The quality of the included studies was evaluated based on the Newcastle-Ottawa Scale (NOS). Statistical significance was set at p < 0.05 using Stata 14. Results: We examined the association between TL and subsequent menorrhagia. The association between TL and subsequent menorrhagia was not significant (OR: 1.55 (95% CI: 0.87, 2.22; I2=89.0%)). 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 on the association between TL and subsequent menorrhagia, whereas low heterogeneity was observed among studies on the association between TL and subsequent polymenorrhea. Discussion: In this study, no evidence of publication bias was detected among the included studies. Additionally, using the Newcastle–Ottawa Scale (NOS), 11 studies were classified as high-quality. These factors are key strengths of this systematic review. Conclusion: The findings of this systematic review and meta-analysis did not report a statistically significant association between TL in women and subsequent menorrhagia or polymenorrhea. Therefore, prospective, long-term cohort studies are needed to show more definitive results in this area. It is also essential to investigate other confounding factors to menstrual irregularities prior to performing TL. © 2026, Bentham Science Publishers