If you don’t want to get pregnant in the future, you or your partner may consider sterilization as a permanent form of birth control. Many of my patients like having control over this decision and not having to worry about pregnancy.
Sterilization is the most popular form of birth control in the United States and worldwide. It can be an excellent option for anyone who doesn’t want or is finished having children.
But as with any medical procedure, you want to make an informed decision. The procedure for women is called tubal sterilization, and the procedure for men is called vasectomy. Here are some things to think about as you or your partner consider sterilization as permanent birth control.
You may hear tubal sterilization referred to as “getting your tubes tied.” This procedure may be done in a surgery center or hospital, usually with general anesthesia. Small incisions are made on the abdomen so the fallopian tubes can be seen and accessed. The tubes are then blocked off or removed. Incisions are closed with stitches.
Blocking off or removing the tubes stops an egg from moving down to where it can be fertilized by sperm. Fewer than 1 in 100 women get pregnant within 1 year of having the procedure. Also, removing the tubes may reduce the risk of ovarian cancer in the future.
Sterilization can be a good choice if you are looking for a highly effective form of birth control and don’t want to use the implant or intrauterine device, or IUD. Once it’s done, it’s done—the results of tubal sterilization are immediate and permanent.
You can have it done right after childbirth. Sterilization is a convenient option for people who know their new baby will complete their family. If you have a cesarean birth, your ob-gyn can plan to perform the sterilization at the same time.
If you have a vaginal birth, the procedure can sometimes happen before you leave the hospital. In your third trimester, confirm your plans for sterilization with your ob-gyn so you both are sure it can be done at your preferred hospital.
You will still get your period. Sterilization doesn’t affect the ovaries, uterus, or menstrual cycle. You may notice some changes in your period right after the surgery. But once you recover, your menstrual pattern should be the same as it was before.
If you want some control over your periods, particularly when or if you have them, you may want to consider using a hormonal birth control method to skip, lighten, or stop your period. This is called menstrual suppression. It’s safe and does not affect your long-term health.
You should be aware of ectopic pregnancy. Pregnancy is very rare after sterilization. But if you do get pregnant, you have a 1 in 5 chance of an ectopic pregnancy. This happens when a fertilized egg grows outside of the uterus, usually in one of your fallopian tubes. Ectopic pregnancy can become life-threatening if left untreated.
If you stop getting periods after sterilization and have symptoms of pregnancy, like nausea or breast tenderness, take a pregnancy test right away.
Some health conditions may affect sterilization surgery. Sterilization might not be a good option if you’ve had extensive abdominal surgery in the past. Too much scar tissue in that area can make another surgery challenging.
Having a high body weight may increase your risk of complications. In this case, your ob-gyn may refer you to a specialist.
Also, certain medical conditions, like heart or lung disease, may make it unsafe to have surgery. In these cases, another form of birth control may be a better option.
Vasectomy can be done in a doctor’s office or surgery center, usually using local anesthesia. One or two small incisions are made in the skin of the scrotum. This allows the vas deferens (tubes that transport sperm) to be accessed. The tubes are tied, cut, clipped, or sealed to prevent the release of sperm into a man’s semen. The incision in the scrotum is closed with stitches.
After a vasectomy, sexual function does not change. There should not be a noticeable change in the amount, color, or texture of semen.
Vasectomies are safer than tubal sterilization. The procedure is less invasive than tubal sterilization. And local anesthesia is safer than general anesthesia. Vasectomy also tends to have a shorter recovery time and fewer complications.
It doesn’t work right away. After a vasectomy, it takes 2 to 4 months for sperm to clear out of a man’s reproductive system. Your partner should schedule a follow-up visit to check that there is no more sperm in his semen (called a semen analysis). Use a backup method of birth control until you get the green light from his doctor.
There’s also a “no-scalpel” technique that does not require skin incisions. In this procedure, the vas deferens are cut the same way, but instead of making an incision in the scrotum, a special tool is used to puncture the scrotum in one place. No stitches are needed after the procedure. There is less pain afterward, and recovery time is shortened.
Sterilization does not prevent sexually transmitted infections (STIs). After sterilization you’ll need to use a condom or other barrier method to protect against STIs.
You may have heard that tubal sterilization and vasectomy are reversible. While reversal is technically possible in rare cases, it’s risky and expensive—and there is no guarantee it will work. You should consider sterilization to be a permanent form of birth control.
If you are unsure whether you want to have children in the future, there are birth control alternatives. For example, the IUD and implant are very good at preventing pregnancy and last for years. These long-acting reversible contraception (LARC) methods can be removed at any time if you wish to get pregnant, are having unwanted side effects, or simply want to try a different form of birth control.
For many people, sterilization means freedom and security. It can be the right birth control choice, no matter your age, whether you are single or in a relationship, or whether you have kids already. You are the one who knows what decision is best for you.
Still, sterilization is a major decision, one you should make without pressure from a partner or anyone else. Some research suggests that women younger than age 30 are more likely than older women to regret having the surgery. But most people do not regret their decision.
If you do not want children or any more children, talk with your ob-gyn about tubal sterilization or ask your male partner to speak with a urologist or their primary doctor about vasectomy. Your doctor should describe the procedure, risks and benefits, alternatives, answer your questions, and help you decide.
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