Aumento do sangramento menstrual em mulheres submetidas à laqueadura tubária: uma revisão de escopo
DOI:
https://doi.org/10.59464/2359-4632.2025.4019Palavras-chave:
Laqueadura tubária, Sangramento uterino anormal, Menorragia, Distúrbios menstruais, Esterilização femininaResumo
Objetivo: Mapear se mulheres submetidas à laqueadura tubária apresentam aumento do sangramento vaginal no período menstrual. Método: Revisão de escopo conduzida segundo as diretrizes do Joanna Briggs Institute (JBI), elaborada com base na estratégia PICO: P (população) – mulheres em idade reprodutiva submetidas à laqueadura tubária; I (intervenção) – realização de diferentes técnicas de esterilização tubária; C (comparação) – mulheres sem laqueadura ou submetidas a outras técnicas; e O (desfecho) – alterações no padrão de sangramento menstrual. A busca foi realizada em outubro de 2025 nas bases PubMed/MEDLINE, Scopus, Web of Science e Biblioteca Virtual em Saúde (BVS), com descritores controlados e termos livres em português, inglês e espanhol. Foram incluídos estudos publicados entre 2015 e 2025. Resultados: Dos 224 registros inicialmente identificados, nove estudos atenderam aos critérios de elegibilidade. As pesquisas, majoritariamente coortes retrospectivas e prospectivas, foram conduzidas em países como Irã, Estados Unidos, Turquia, Paquistão e Índia. Embora alguns estudos (Irã, 2016; Paquistão, 2020) tenham relatado aumento significativo de menorragia (≈63–67% vs 22–23% em controles), grandes coortes norte-americanas e investigações turcas não observaram elevação significativa do sangramento após a laqueadura. No conjunto, os resultados indicam que o aumento do sangramento menstrual não é universal e parece depender de fatores como técnica cirúrgica, histórico menstrual prévio e perfil hormonal. Conclusão: A relação entre laqueadura tubária e sangramento uterino aumentado permanece controversa e multifatorial. As evidências sugerem que possíveis alterações menstruais resultam mais de fatores individuais e ginecológicos do que do procedimento em si.
Referências
Youseflu S, Sadatmahalleh SJ. Psycho-sexual influence of sterilization on women’s quality of life: a path model. Health and Quality of Life Outcomes [Internet]. 2021 Mar 17 [cited 2025 Sep];19(1). Available from: https://doi.org/10.1186/s12955-021-01733-9
Almeida JD, Viana JA, Soares WSCN, Lopes SMT, Sousa HR de, Leite CL. Perfil sociodemográfico das mulheres que realizaram laqueadura tubária: uma revisão integrativa da literatura. Research Society and Development [Internet]. 2021 Nov 16 [cited 2025 Sep];10(15). Available from: https://doi.org/10.33448/rsd-v10i15.23059
Paula A, Ferreira I, Requeijo MJR. Nova Lei sobre laqueadura tubária no Brasil e seus impactos sociais: uma revisão de literatura. Research Society and Development [Internet]. 2023 Jun 12 [cited 2025 Oct];12(6). Available from: https://doi.org/10.33448/rsd-v12i6.42132
Çiçek ÖSY, SARI T. Evaluation of Changes Over Time in Menstrual Pattern After Postpartum Tubal Ligation. Cukurova Anestezi ve Cerrahi Bilimler Dergisi [Internet]. 2022 Dec 31 [cited 2025 Aug];5(3):382. Available from: https://doi.org/10.36516/jocass.1204339
Sousa GB de, Santos AFS dos, Affonso TG, Trombetta TC, Sousa LB de, Neves DBS das. Estudo da prevalência de sangramento uterino anormal na Amazônia Ocidental: aspectos clínicos e epidemiológicos. Revista Eletrônica Acervo Saúde [Internet]. 2019 Oct 7 [cited 2025 Sep];11(15). Available from: https://doi.org/10.25248/reas.e1287.2019
Erşahin SS. EFFECT OF LAPAROSCOPIC AND LAPAROTOMIC TUBAL LIGATION ON UTTERINE AND OVARİAN ARTERY DOPPLER PARAMETERS*. DergiPark (Istanbul University) [Internet]. 2022 Sep 28 [cited 2025 Aug]; Available from: https://dergipark.org.tr/tr/pub/iaaojh/issue/72546/1181482
Deniz R, Baykuş Y, Adalı Y, Uzuner MB, Öztürk Ö. Rat Modelinde Tubal Sterilizasyonun Tuba, Yumurtalıklar ve Endometrium Üzerine Etkileri. DergiPark (Istanbul University) [Internet]. 2019 Dec 1 [cited 2025 Feb]; Available from: https://dergipark.org.tr/tr/pub/kaftbd/issue/54893/752235
Sadatmahalleh SJ, Ziaei S, Kazemnejad A, Mohamadi E. Menstrual Pattern following Tubal Ligation: A Historical Cohort Study. Int J Fertil Steril. 2016 Jan-Mar;9(4):477-82. doi: https://doi.org/10.22074/ijfs.2015.4605
Carney PI, Yao J, Lin J, Law A. Occurrence of Chronic Pelvic Pain, Abnormal Uterine Bleeding, and Hysterectomy Post-procedure among Women Who Have Undergone Female Sterilization Procedures: A Retrospective Claims Analysis of Commercially Insured Women in the US. J Minim Invasive Gynecol. 2018 May-Jun;25(4):651-660. doi: https://doi.org/10.1016/j.jmig.2017.10.029
Steward R, Carney P, Law A, Xie L, Wang Y, Yuce H. Long-term outcomes after elective sterilization procedures - a comparative retrospective cohort study of Medicaid patients. Contraception. 2018 May;97(5):428-433. doi: https://doi.org/10.1016/j.contraception.2017.12.015
Ujala S, Masood A, Shaheen N. Comparison of the frequency of menorrhagia in post-tubal ligation women versus normal (non-tubal ligation) women. RMJ. 2020; 45(4): 822-825.
Yilmaz FY, Yenigul NN. Impact of tubal ligation during cesarean section on ovarian reserve and menstrual pattern. Journal of Reproductive Medicine. 2021; 66(6): 383-8
Taşkömür AT, Erten Ö. The effect of tubal ligation surgery during cesarean operation on dysmenorrhoea, dyspareunia and menstrual cycle. J Gynecol Obstet Hum Reprod. 2021 Jun;50(6):102054. doi: https://doi.org/10.1016/j.jogoh.2020.102054
Gariepy AM, Lewis C, Zuckerman D, Tancredi DJ, Murphy E, McDonald-Mosley R, Sonalkar S, Hathaway M, Nunez-Eddy C, Schwarz EB. Patient-Centered Safety Outcomes After Hysteroscopic Compared With Laparoscopic Sterilization. Obstet Gynecol. 2022 Mar 1;139(3):423-432. doi: https://doi.org/10.1097/AOG.0000000000004690
Cicek OSY, Sari T. Evaluation of changes over time in menstrual pattern after postpartum tubal ligation. J Cukurova Anesth Surg, 2022; 5(3): 382-8. doi: https://doi.org/10.36516/jocass.1204339
Verma P, Saxena S, Gunjan, Hiremath RN, Sinha P. Comparative study on menstrual disorders in post-tubal ligated and non-ligated women. J Family Med Prim Care. 2023 Oct;12(10):2482-2487. doi: https://doi.org/10.4103/jfmpc.jfmpc_880_23
Edelman A, Boniface ER, Male V, Cameron S, Benhar E, Han L, et al. Association between menstrual cycle length and covid-19 vaccination: global, retrospective cohort study of prospectively collected data. BMJ Medicine [Internet]. 2022 Sep 1 [cited 2025 Oct];1(1). Available from: https://doi.org/10.1136/bmjmed-2022-000297
Dorjee K, Sadoff R, Mansour FR, Dorjee S, Binder EM, Stetson M, et al. Menstrual disturbance associated with COVID-19 vaccines: A comprehensive systematic review and meta-analysis. PLoS ONE [Internet]. Public Library of Science; 2025 May 16 [cited 2025 Sep];20(5). Available from: https://doi.org/10.1371/journal.pone.0320162
Al-Husban N, Kaadan D, Foudeh J, Ghazi T, Sijari Y, Maaita M. Factors affecting the use of long term and permanent contraceptive methods: a Facebook-focused cross-sectional study. BMC Women s Health [Internet]. 2022 Jun 2 [cited 2025 Oct];22(1). Available from: https://doi.org/10.1186/s12905-022-01784-0
Depes D de B, Mata MVM da, Pereira AMG, Martins JA, Araújo MP de, Lopes RGC, et al. Comparative study of the levonorgestrel intrauterine system and laparoscopic hysterectomy for the treatment of heavy menstrual bleeding in enlarged uteri. Einstein (São Paulo) [Internet]. 2023 Jan 1 [cited 2025 Oct];21. Available from: https://doi.org/10.31744/einstein_journal/2023ao0033
Mackenzie ACL, Chung S, Hoppes E, Mickler AK, Cartwright AF. Measurement of changes to the menstrual cycle: A transdisciplinary systematic review evaluating measure quality and utility for clinical trials. medRxiv (Cold Spring Harbor Laboratory) [Internet]. 2024 Apr 5 [cited 2025 Oct]; Available from: https://doi.org/10.1101/2024.04.04.24305348
Memorias del 32 Congreso Nacional de Investigación e Innovación en Medicina: libro de resúmenes. Medicina Universitaria [Internet]. 2024 Aug 16 [cited 2025 Jul];26(91). Available from: https://doi.org/10.24875/rmu.m24000090
Shams T, Alhashemi H, Fallatah AA, Alkhalid AM, Alhazmi FM, Yunus MKB, et al. Outcomes of etonogestrel subdermal contraceptive implants. Saudi Medical Journal [Internet]. 2024 Mar 1 [cited 2025 Oct];45(3):261. Available from: https://doi.org/10.15537/smj.2024.45.3.20230840
Sawyer G, Howe LD, Fraser A, Clayton G, Lawlor DA, Sharp GC. Menstrual cycle features in mothers and daughters in the Avon Longitudinal Study of Parents and Children (ALSPAC). Wellcome Open Research [Internet]. 2023 Nov 24 [cited 2025 Aug];8:386. Available from: https://doi.org/10.12688/wellcomeopenres.19774.3
Chao M, Menon C, Elgendi M. Menstrual cycles during COVID-19 lockdowns: A systematic review and meta-analysis. Frontiers in Reproductive Health [Internet]. Frontiers Media; 2022 Aug 9 [cited 2025 Oct];4. Available from: https://doi.org/10.3389/frph.2022.949365
Rezende GP, Yela DA, Benetti‐Pinto CL. Prevalence of abnormal uterine bleeding in Brazilian women: Association between self-perception and objective parameters. PLoS ONE [Internet]. 2023 Mar 13 [cited 2025 Sep];18(3). Available from: https://doi.org/10.1371/journal.pone.0282605
Jeon B, Baek J. Menstrual disturbances and its association with sleep disturbances: a systematic review. BMC Women s Health [Internet]. BioMed Central; 2023 Sep 1 [cited 2025 Oct];23(1). Available from: https://doi.org/10.1186/s12905-023-02629-0
Smaardijk VR, Jajou R, Kant A, Hunsel F van. Menstrual disorders following COVID-19 vaccination: a review using a systematic search. Frontiers in Drug Safety and Regulation [Internet]. Frontiers Media; 2024 Jan 31 [cited 2025 Sep];4. Available from: https://doi.org/10.3389/fdsfr.2024.1338466
Leal CRV, Vannuccini S, Jain V, Dolmans M, Sardo ADS, Al‐Hendy A, et al. Abnormal uterine bleeding: the well-known and the hidden face. Journal of Endometriosis and Uterine Disorders [Internet]. 2024 Apr 1 [cited 2025 Oct];6:100071. Available from: https://doi.org/10.1016/j.jeud.2024.100071
Tian Y, Bai B, Wang L, Zhou Z, Tang J. Contributing factors related to abnormal uterine bleeding in perimenopausal women: a case–control study. Journal of Health Population and Nutrition [Internet]. 2024 Apr 18 [cited 2025 Aug];43(1). Available from: https://doi.org/10.1186/s41043-024-00540-4
Dabbousi AA, Masri JE, Ayoubi LME, Ismail O, Zreika B, Salameh P. Menstrual abnormalities post-COVID vaccination: a cross-sectional study on adult Lebanese women. Irish Journal of Medical Science (1971 -) [Internet]. 2022 Jul 26 [cited 2025 Oct];192(3):1163. Available from: https://doi.org/10.1007/s11845-022-03089-5
Segarra I, Menárguez M, Roqué MV. Women’s health, hormonal balance, and personal autonomy. Frontiers in Medicine [Internet]. Frontiers Media; 2023 Jun 30 [cited 2025 Aug];10. Available from: https://doi.org/10.3389/fmed.2023.1167504
Abebe M, Melaku G, Hareru HE, Tebeje TM. Abnormal uterine bleeding and its associated factors among reproductive-age women who visit the gynecology ward in Dilla University General Hospital, Southern Ethiopia, 2022. BMC Women s Health [Internet]. 2024 May 9 [cited 2025 Oct];24(1). Available from: https://doi.org/10.1186/s12905-024-03128-6
Graziottin A, Cuccarollo A, Franchi MP, Uccella S. Patologie mestruali e contraccezione: principi di personalizzazione della scelta terapeutica. L Endocrinologo [Internet]. 2022 Oct 1 [cited 2025 Aug];23(5):503. Available from: https://doi.org/10.1007/s40619-022-01155-9
Vannuccini S, Clemenza S, Cassioli E, Rossi E, Castellini G, Ricca V, et al. Uterine Fibroids, Perceived Stress, and Menstrual Distress: a Key Role of Heavy Menstrual Bleeding. Reproductive Sciences [Internet]. 2022 Dec 5 [cited 2025 Jul];30(5):1608. Available from: https://doi.org/10.1007/s43032-022-01126-3
leon RG de, Baaske A, Albert A, Booth A, Racey CS, Gordon S, et al. Higher Perceived Stress during the COVID-19 pandemic increased Menstrual Dysregulation and Menopause Symptoms. medRxiv (Cold Spring Harbor Laboratory) [Internet]. 2022 Jul 31 [cited 2025 Oct]; Available from: https://doi.org/10.1101/2022.07.30.22278213
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