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Permanent Contraception (Sterilization)

 

Permanent contraception is for those who are sure they don't want to have a child or more children. It is a particularly common choice for women age 35 and older. Female sterilization closes a woman's fallopian tubes by blocking, tying or cutting them so an egg cannot travel to the uterus. There are two primary forms of female sterilization: a fairly new nonsurgical implant system, called Essure, and the traditional tubal ligation procedure, often called "getting your tubes tied."

  • Essure  is the first non-surgical method of female sterilization. A thin tube is used to thread a tiny spring-like device through the vagina and uterus into each fallopian tube. The device works by causing scar tissue to form around the coil, blocking the fallopian tubes, which stops the egg and sperm from joining. The procedure can be performed in your doctor's office with local anesthesia.

    It can take about three months for the scar tissue to grow, so it's important to use another form of birth control during this time.  After three months, you will have to return to your doctor's office for a special x-ray to make sure your tubes are completely blocked. In clinical studies, most women reported little to no pain, and were able to return to their normal activities in a day or two. Essure may reduce the risk of tubal (ectopic) pregnancy.


  • Tubal ligation (surgical sterilization) closes the fallopian tubes by cutting, tying, or sealing them. This stops the eggs from traveling down to the uterus where they can be fertilized. The surgery can be done a number of ways but is typically performed under general anesthesia in a hospital. Recovery typically takes four to six days. Risks include pain, bleeding, infection and other postsurgical complications, as well as an ectopic, or tubal, pregnancy.

Male sterilization is called a vasectomy. This procedure is performed in the doctor's office. The scrotum is numbed with an anesthetic, so the doctor can make a small incision to access the vas deferens, the tubes through which sperm travels from the testicle to the penis. The doctor then seals, ties or cuts the vas deferens. Following a vasectomy, a man continues to ejaculate, but the fluid does not contain sperm. Sperm stays in the system after surgery for about 3 months, so during that time, you'll need to use a backup form of birth control to prevent pregnancy. A simple test called a semen analysis can be done to check if all the sperm is gone.

Temporary swelling and pain are common side effects of surgery. A newer approach to this procedure can reduce swelling and bleeding.

Benefits and risks

Sterilization is a highly effective way to permanently prevent pregnancy—it's considered more than 99 percent effective, meaning less than one women in 100 will get pregnant after having a sterilization procedure. Some evidence suggests that women who are younger when they are sterilized have a higher risk of pregnancy. Surgery for female sterilization is more complex and carries greater risk than surgery to sterilize men, and recovery is longer. Reversing sterilization in men and women is extremely difficult, however, and often unsuccessful.

 

Source: National Women's Health Information Center (www.womenshealth.gov

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