What Is Tubal Sterilization?
Where is the Surgery Performed?
How Tubal Sterilization Works
A Permanent Method of Birth Control
Deciding if Sterilization is Right for You
Your Partner Also May Want to Consider Sterilization
Sterilization Methods
Abdominal Procedures
Tubal Sterilization is Low-Risk Surgery
Questions and Answers About Tubal Sterilization
| What is Tubal Sterilization? |
Tubal sterilization is a permanent method of birth control for women. More and more women today choose sterilization. These procedures can provide highly effective birth control method for the remainder of a woman’s reproductive years. Sterilization does not decrease a woman's sexual pleasure. Women who have completed their families or women who do not want children often choose sterilization.
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| Where is the Surgery Preformed? |
Planned Parenthood Golden Gate does not perform tubal sterilization, however we will offer referals for tubal sterilization. Pre-operative and post-operative visits are done at one of our health centers, but the surgery is performed at a surgical center.
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| How Tubal Sterilization Works |
Tubal sterilization is a surgical operation. It closes off the fallopian tubes, where eggs are fertilized by sperm. When the tubes are closed, sperm cannot reach the egg, and pregnancy cannot happen.
Sterilization does not affect femininity. It is very unlikely that sterilization will affect your sexual organs or your sexuality. No glands or organs will be removed or changed. All of your hormones will still be produced. Your ovaries will release an egg every month. Your menstrual cycles will most likely follow their regular pattern.
Sterilization is more than 97-99% effective over the 10 years following the procedure. The rates depend on the type of procedure used. About one out of three of these pregnancies is ectopic (developing in the fallopian tubes) and may require emergency surgery.
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| A Permanent Method of Birth Control |
You and your partner will need no other birth control method after a successful tubal sterilization. It may be possible to reverse it in some cases, but your decision not to have a child in the future must be firm. You must be absolutely sure you will never change your mind or regret your choice-no matter how your life changes.
Sterilization will not cause symptoms of menopause (change of life) or make menopause happen earlier.
Reasons for Considering Sterilization:
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You want to enjoy having sex without causing pregnancy.
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You don’t want to have a child in the future.
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You and your partner agree that your family is complete, and no more children are wanted.
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You and your partner have concerns about the side effects of other methods.
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Other methods are unacceptable.
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Your health would be threatened by a future pregnancy.
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You don’t want to pass on a hereditary illness or disability.
Reasons Against Considering Sterilization:
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You may want to have a child in the future.
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Your partner, friends, or family are pressuring you - You must want the operation.
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You have problems that may be temporary - marriage or sexual problems, short-term mental or physical illnesses, financial worries, or being out of work.
Sterilization is not a good solution for problems such as these:
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You have not considered possible changes in your life, such as divorce, remarriage, or death of children.
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You have not discussed it fully with your partner.
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| Deciding if Sterilization is Right for You |
Consider all other methods before you choose sterilization. Birth control pills, Depo-Provera (injection), and IUDs (intrauterine devices) can be similarly effective. Most women can use them with little risk of serious complications. Other methods, such as diaphragms, cervical caps, periodic abstinence, withdrawal, male or female condoms, spermicide foams, creams, jellies, and suppositories, are not as effective as sterilization. But they have very few serious side effects, if any.
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| Your Partner Also May Want to Consider Sterilization |
Sterilization for men is called vasectomy. Vasectomy is simpler, costs less, and has fewer risks than tubal sterilization. But vasectomy must also be considered permanent. So, think carefully about what sterilization will mean for both of you before you make your decision.
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Sterilizations are done in hospitals or in clinics with surgical units. They are done under local (patient awake) or general (patient asleep) anesthesia. Closing the tubes for sterilization can be done in several ways. Sometimes the tubes are closed off by tying and cutting (tubal ligation), sealing (cautery), or applying clips, clamps, or rings. Sometimes, a small piece of the tube is removed.
A woman's health condition may indicate which procedure is better suited for her. Previous surgery and body weight are two factors to consider when choosing the best and safest method. Women who have had certain types of abdominal surgery may not be able to have tubal sterilization. Consult your health care provider if you have any questions.
More than half of all sterilizations are performed shortly after childbirth or abortion. (The decision to combine sterilization with other procedures needs to be made in advance.)
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Laparoscopy
Laparoscopy is one of the two most common methods of sterilization. First the abdomen is inflated with an injection of harmless gas (carbon dioxide). This allows the organs to be seen clearly. Then the surgeon makes a small incision near the navel and inserts a laparoscope (a rod-like instrument with a light and a viewing lens) for locating the tubes. The surgeon also may insert an instrument for closing the tubes, usually through a second small opening. Sometimes only one incision and one instrument are used. The procedure can be performed in outpatient surgical clinics. It takes 20 to 30 minutes. Very little scarring occurs. Women usually go home the same day. She may have sexual intercourse as soon as she feels comfortable about it.
Mini-laparotomy
Mini-laparotomy is another common method of sterilization. It is often performed after childbirth. No gas or visualizing instrument is used in mini-laparotomy. A small incision is made in the lower abdomen, just above the pubic hair. (If the operation takes place within 48 hours of delivery, the incision is made just below the navel.) The surgeon locates the tubes, then ties, clips, or uses electrocautery to block them off. The incision is then closed. Women usually recover in a few days. Doctors will advise when sexual intercourse can be resumed. There are other rarely used procedures such as laparotomy (major surgery), and some vaginal procedures. None of these procedures are done at Planned Parenthood Golden Gate.
Hysteroscopic Sterilization via polyester fibers
The hysteroscopic sterilization is a newer approach to sterilization where the procedure is done through the vagina, and instruments are passed through the cervix to access the tubes. An attached spring containing polyester fibers that has an outer coil is released into the tube and forms a blockage. This method allows your bodys cells to react to this coil to create the blockage and it takes up to 3 months after the procedure to block the tubes. A special xray dye test called a Hysterosalpingogram (HSG) is needed 3 months after surgery to show that the tubes are blocked. This procedure can also be done in surgical centers and in some cases at a regular doctor’s office.
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| Tubal Sterilization is Low-Risk Surgery |
Complications can occur with any kind of surgery.
The complications that can occur during or after sterilization are:
Infection is rare, but it occurs more frequently after non-hysteroscopic sterilization performed through the vagina. Infections are treated with antibiotics. Very rarely, the bowel or blood vessels are injured. Major surgery may be required to repair this.
Complications may develop in 1 to 4 percent of sterilizations performed through the abdomen. They may develop in 2 to 13 percent of sterilizations performed through the vagina. Deaths resulting from tubal sterilization are extremely rare - the rate is about 1-2 per 100,000 procedures.
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| Questions and Answers About Tubal Sterilization |
Q. Will sterilization end an existing pregnancy?
A. No. Sterilization will not be performed if you are pregnant.
Q. Will it cause menopause?
A. No. Sterilization does not cause menopause or any of its symptoms.
Q. Will it prevent menopause?
A. No. You will still experience menopause later in life.
Q. Will it prevent sexually transmitted infections?
A. No.
Q. Will I still have a period?
A. Yes. Most menstrual cycles and flow are the same after the surgery as they were before. Women who have had their tubes cauterized occasionally may have more menstrual disturbances. Also, if you were using birth control pills or other forms of hormonal contraceptives before the surgery, it may take a while for your cycle to return to normal.
Q. What happens to the eggs?
A. An egg is released each month. It dissolves and is absorbed by the body, the same way other dead and unused cells are absorbed naturally by the body throughout life.
Q. Will I be as feminine?
A. Yes. The hormones that affect hair, voice, sex drive, muscle tone, breast size, etc. are still made in your ovaries. They will still flow throughout the body in the bloodstream.
Q. Will I gain weight or develop facial hair?
A. No. Sterilization does not cause weight gain or facial hair.
Q. Will it hurt?
A. A general or local anesthetic will be used. The choice depends on your physical condition and the method of sterilization being used. Local anesthesia is much safer than general anesthesia. There is less risk of serious complications, including death. However, the differences in risk are small, and most surgeons feel it is easier to do the procedure with general anesthesia.
General anesthesia is entirely painless. When a local anesthetic is injected, you may feel some discomfort. The pain is relieved with medications and sedatives. You will remain conscious but sleepy. You will feel little or no discomfort during the procedure.
Q. How will I feel after?
A. The discomfort you feel after the operation depends on your general health, the type of operation, and your tolerance of pain. You may feel tired and have slight abdominal pain. You may occasionally feel dizzy, nauseous, bloated, gassy, pain in the shoulder, or abdominal cramping. Most or all of such symptoms will last one to three days.
Contact your doctor immediately if you:
Q. How soon can I have sexual intercourse again?
A. Ask your doctor's advice. Do not have intercourse until you feel comfortable about it. It usually takes about a week after abdominal sterilization. You will have to wait at least four weeks after a vaginal sterilization or sterilization after childbirth.
Q. Will sterilization decrease my sexual pleasure?
A. No. In fact, many women and men report that they have less tension about unwanted pregnancy after sterilization. They feel that the lack of tension increases their sexual pleasure.
Q. Can sterilization be reversed?
A. If you are thinking about reversal, don't have a tubal sterilization. Reversal procedures require complicated surgery and cost thousands of dollars. Even though tubes can sometimes be rejoined, pregnancy cannot be guaranteed. Many women cannot even attempt reversals because there is not enough of their tubes left in the reproductive tract.
Q. How soon can I go back to work after sterilization?
A. That depends on your general health, attitude, job, and the method of sterilization that you have. With the most common methods-mini-laparotomy and laparoscopy-recovery is usually complete in a day or two. You may want to take it easy for the next week or so. In any case, you should avoid heavy lifting for about one week.
Q. Is it legal to sterilize anyone who doesn't want it?
A. No. Sterilization is legal for mentally competent, adult women and men in all 50 states only if it is voluntary. No mentally competent person can be forced to have the operation. It is also illegal to deny, or threaten to deny, welfare benefits to women and men who choose to remain fertile.
Q. Can anyone become sterilized?
A. Under some circumstances-if a person is single or childless-sterilization may be difficult to arrange, and certain federal programs have minimum age requirements and mandatory waiting periods after a consent has been signed. Policies and practices vary with individual doctors and hospitals, and from place to place. After a careful assessment, Planned Parenthood Golden Gate will provide referral for any woman who we feel has made a mature and informed decision.
Q. Do I need my husband or partner's consent?
A. No. However, discussing the operation beforehand is usually best for most relationships.
Q. How can I get a sterilization?
A. Contact any of the following:
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Your local Planned Parenthood health center for a referral
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Outside the San Francisco Bay Area, call 1-800-230-PLAN or enter your zip code (link to plannedparenthood.org zip code) for the Planned Parenthood center nearest you.
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Your family health care provider
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Your local hospital
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Your local public health department
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You may also contact:
Q. How much does a tubal sterilization cost?
A. Cost depends on a number of different factors, and funding is available in some cases.
More information on Tubal Sterilization.
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