OBJECTIVE: To investigate whether women who have had a tubal ligation are more likely to experience sexual problems than other women. DESIGN: Population-based telephone survey. SETTING: Australia-wide, including cities, regional towns, and rural areas. POPULATION: A total of 3448 Australian women aged between 16 and 64 years. METHODS: Women were surveyed using random-digit dialling throughout 2004 and 2005. MAIN OUTCOME MEASURES: Prevalence of sexual problems and ratings of sexual satisfaction, relationship satisfaction, and sexual pleasure. RESULTS: From a weighted sample of 2721 women, 447 (16.4%) reported having had a tubal ligation, with 85.0% currently aged between 40 and 64 years. Having a tubal ligation was not associated with any specific sexual problem, such as physical pain during sex or an inability to reach orgasm. In fact, after controlling for age and other sociodemographic differences, sterilised women were significantly less likely than non-sterilised women to lack an interest in having sex (OR 0.69, 95% CI 0.54-0.89), to take 'too long' to reach orgasm (OR 0.69, 95% CI 0.50-0.96), to experience vaginal dryness during sex (OR 0.70, 95% CI 0.50-0.96), and to find sex unpleasurable (OR 0.64, 95% CI 0.46-0.90). Sterilised women were also more likely to experience extremely high levels of sexual satisfaction (OR 1.66, 95% CI 1.27-2.18), relationship satisfaction (OR 1.29, 95% CI 1.01-1.67), and sexual pleasure (OR 1.59, 95% CI 1.20-2.12). CONCLUSIONS: Our findings suggest no adverse effects, and possibly some benefits, for the sexual lives of women undergoing tubal ligation. These findings should be included with other educational material for couples considering sterilisation as a contraception option.