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[Psychosexual implications of female sterilization].


 According to data of the Italian Association for Demographic Education, from 1978 to 1991 a total of 16,000 sterilizations were carried out in patients with an average age of 36 years. There was an increasing frequency of anxiety, depression, and lack of satisfaction with sexual life, and deterioration of marital life as the consequence of the operations. Psychological improvement has been reported in only a few cases. Hysterectomy, mastectomy, abortion, and sterilization produce profound psychological effects in women. The ideal candidate for such intervention should be fully aware of the choice and be well informed about the reproductive system, and aged over 30 with at least 2 children in a stable marital relationship. A 1973 review of 80 different studies carried out in 12 different countries reported that 82% of women benefited from the operation. In a study of 180 patients in Glasgow, Scotland, psychosexual disorders were found, in only 3.6%. In a 1975 report, postoperative psychiatric disturbances in sexual life were recorded in 2% of 98 women. Another study of 94 women who were sterilized did not find any medical or psychological problems but did find patients who were completely satisfied 2 years later. In a study of 50 patients who underwent surgical sterilization by the Pomeroy technique during cesarean section, sexual behavior in the women, measured as desire, frequency of intercourse, and satisfaction, was unchanged in 47, while in 3 there were only modest variations in libido and frequency of intercourse. On the basis of these reports in the majority of cases the outcome of sterilization was favorable when assessing various gynecological problems over time. On the other hand, when the candidate is a young woman the information has to be particularly detailed and scrupulous with respect to risks and the probable irreversibility of sterilization.
