Female sterilization [letter]

Ross et al. report on 3265 sterilizations performed over a 3-year period. They were only able to follow up 1204 (36.8%) of these patients and only 17% of White women and 46% of Indian women returned their questionnaire. Furthermore they state that it is unlikely that the criteria for selection affected the validity of their results. After interviewing only just over 1/3 of the patients sterilized they came to the conclusion that sterilization of young women is an innocuous operation. They state that 95% were satisfied with the results of the procedure and that only 0.25% wanted a reversal. They also state that the rate of hysterectomies performed subsequent to sterilization was only 1.2% and claim that sterilization did not adversely influence the menstrual pattern or menstrual discomfort. Coming to these conclusions after interviewing only 1/3 of the patients is completely unacceptable. May I suggest that a large percentage of the women they did not interview ended up in the hands of other gynecological clinics and practicing gynecologists. It is a well-known fact that dissatisfied patients frequently do not return to the person who originally treated them. May I further suggest that many of their uninterviewed patients ended up regretting the procedure and with a multitude of physical and psychological problems. In a short period of 2 1/2 years I have had requests from over 50 patients for reversal of sterilization and on questioning these women it has become quite evident that the clinics carrying out sterilization are oblivious of many of the complications they are causing. In only 5.2% of the patients reported on by Ross et al. was sterilization carried out on medical advice. Therefore 94.8% of the women sterilized must have been perfectly healthy and as stated in the paper most of these were under the age of 35 years. I feel therefore that a large number of healthy young women are being deprived of a normal physiological process--childbearing. I would like to suggest to these authors that before they continue on their present course of mass destruction of reproductive function in healthy young women they take heed of the words of Theodore Roosevelt who said: The greatest of all curses is the curse of sterility and the severest of all condemnations should be that of sterility wilfully created by man. (full text)