A 1998 review of over 200 articles in the English literature showed that evidence of a post-tubal sterilization syndrome (abnormal bleeding and/or pain, changes in sexual behavior and emotional health, increased premenstrual distress) was inconclusive for women over 30 years of age. The risk for women 20–29 years of age with pre-existing histories of menstrual dysfunction may be increased, "although they do not appear to undergo significant hormonal changes".[4] A 1993 study done in Japan found the symptoms of the post-tubal ligation syndrome to be mild, and simple symptomatic treatment to be sufficient in most cases
Worldwide, female sterilization is used by 33% of married women using contraception,[6] making it the most common contraceptive method.[7] As of June 2010, there is a recent decline of tubal ligation procedures in the United States after two decades of stable rates, possibly explained by an improved access to a wide range of highly effective reversible contraceptives.