Sterilization surgery not linked to sexual problems

NEW YORK Mon Feb 15, 2010 9:52am EST

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NEW YORK (Reuters Health) - Women who have their "tubes tied" to prevent future pregnancies do not seem to have an increased risk of sexual dysfunction afterward, according to a new study.

In fact, researchers found, women in their study who'd had the procedure showed lower risks of certain sexual problems and tended to be happier with their sex lives than other women.

The surgery, known as tubal ligation, involves blocking the fallopian tubes that connect the ovaries with the uterus. It is done either right after childbirth -- through the vagina or during a cesarean section -- or via laparoscopic surgery, where one or two small incisions are made in the abdomen.

There are no physiological reasons to believe tubal ligation would cause sexual problems, but there has been little research on the subject, said Dr. Anthony Smith of La Trobe University in Melbourne, Australia, the lead researcher on the current study.

What studies there are have generally only asked women about their general sexual satisfaction, Smith told Reuters Health in an email.

For their study, Smith and his colleagues surveyed 2,721 Australian women about various sexual dysfunction symptoms and their overall satisfaction with their sex lives. Of those women, 447 -- or about 16 percent -- had had a tubal ligation, most of whom were between the ages of 40 and 64.

Overall, women who had had the procedure were less likely to report sexual problems and more likely to say they were happy with their sex lives, according to findings published in BJOG, a British medical journal.

Just over 42 percent said they lacked interest in sex, for example, compared with 51 percent of women who had not had a tubal ligation. And while 17 percent of the latter group said they "did not find sex pleasurable," only 14 percent of women in the tubal-ligation group said the same.

When the researchers accounted for other factors -- like age, education and marital status -- women who'd had a tubal ligation were roughly one-third less likely to lack interest in sex, take "too long" to reach orgasm, have vaginal dryness during sex or find sex unpleasant.

In addition, the study found, women in the tubal-ligation group generally gave higher marks to their sex lives. Thirty-six percent reported "extremely high sexual satisfaction," compared with 30 percent of women who had not had the procedure; when the researchers considered the other factors, women in the tubal-ligation group were two-thirds more likely to give such high ratings to their sex lives.

It's not clear why women who'd had a tubal ligation generally had better sexual function. But it's possible, Smith's team notes, that the women and their partners were enjoying sex more because they were free of anxiety over a potential unplanned pregnancy.

"When coupled with the effectiveness of tubal ligation and the low risks associated with the procedure," Smith said, "these findings suggest additional benefits of the procedure for women to consider when making the decision about surgical sterilization."

Of course, tubal ligation is only one method of birth control. In general, experts recommend it only for women who are sure they do not want to become pregnant in the future. And like any surgery, it carries some risks -- including bleeding or infection during the procedure, and incomplete closing of the tubes; about one in 200 women who have a tubal ligation later become pregnant.

Studies have also found that anywhere from 6 percent to 20 percent of women who have the procedure later regret their decision -- with younger women being more likely to express regrets.

SOURCE: BJOG, online January 14, 2010.

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