Sterilization

Sterilization is a procedure to cut, tie or block the tubes through which the sperm (in a male) or egg (in a female) must pass from the place in the body where they are formed (testicle in a male or ovary in a female) to the place where fertilization occurs.

Female Sterilization

In women, sterilization involves either cutting or tying the tubes (tubal ligation) or blocking the tubes (Essure, Adiana).

With (brand names) Essure or Adiana, a procedure is done to place a tiny device into the fallopian tubes around which scar tissue grows and after about three months the tubes are blocked. The original procedure is done in the doctors’ office or clinic. After three months, a follow up test is done in a hospital to make sure the tubes are blocked. A backup birth control method is necessary until the test results show that the tubes are completely blocked.

In Tubal Ligation, called “getting your tubes tied,” a surgical procedure is performed to cut, burn (cauterize), or block (with rings, bands or clips) the fallopian tubes which prevents travel of the egg down the fallopian tube after ovulation (release of egg from the ovary). The surgery is effective immediately.

Sterilization does not protect against sexually transmitted infections, including HIV/AIDS. Sterilization has a very low failure rate.

Male Sterilization – Vasectomy

Vasectomy is a minor surgery to cut the vasa deferentia, the tubes that carry sperm. This operation keeps sperm from mixing into the semen when men ejaculate. Without sperm, fertilization of an egg cannot occur and pregnancy is prevented. Vasectomies are usually done in a clinic or doctor’s office and are much simpler procedures than female sterilization. Vasectomies are 99.9% effective as birth control. They do not protect against sexually transmitted infections, including HIV/AIDS.

During a vasectomy, local anesthesia is used. The doctor makes a very small opening in the skin of the scrotum. This allows the sperm tubes or vasa deferentia to be seen and cut. The procedure itself takes about 15 minutes.

Men usually rest at the clinic after the procedure then go home the same day. Post surgery bruising and swelling are normal and usually goes away within a few days to a week. Ice packs and painkillers can ease swelling and discomfort. It is recommended that men take two days off and perform only light activities for a week. For two days, it is helpful to wear scrotal supports and not bathe. It may take a week for men to feel comfortable resuming sexual activity. Men should report bleeding, pain, fever, or chills to their doctor.

Vasectomies are not effective right away. The sperm that were already in the tubes before the operation need to be ejaculated. This may take about a month or 10 to 30 ejaculations. It’s important to use other forms of birth control until follow-up tests show two negative sperm counts.

Few long-term complications occur. Very rarely, the cut ends of the vas deferens rejoin and allow sperm to flow into the semen again. This can lead to an accidental pregnancy. Unprotected intercourse before two negative sperm counts can also lead to pregnancy.

Men are able to fully enjoy sex after having a vasectomy. Hormonal levels and the feeling of orgasm stay the same. The amount of semen produced or fluid ejaculated does not noticeably change.

Deciding

Sterilization is considered permanent. The decision to have it done should not be made lightly. Ask yourself: Would you change your mind if major changes in your life occurred, including a separation, or even the death of a partner or child? Consider as many possibilities as you can before making your decision. Know your options.

Advantages

  • Permanent birth control
  • Immediately effective
  • Allows sexual spontaneity
  • Requires no daily attention
  • Does not reduce pleasure
  • Not messy
  • Cost-effective in the long run

Disadvantages

  • Does not protect against sexually transmitted infections, including HIV/AIDS
  • Requires in-office surgery or doctor-provided procedure and follow-up
  • Has risks associated with surgery
  • Not considered reversible, male sterilization potentially easier to reverse than female sterilization
  • Possible feelings of regret
  • Possibility of Post Tubal Ligation Syndrome

History of Abuse

Sterilization has a long history of abuse in the United States and around the world. In the past, many women of color and poor women were sterilized without their knowledge or were refused medical care unless they consented to be sterilized. It was once common to automatically sterilize all physically disabled people. Sterilization has  been proposed as a solution to poverty. It is vital that sterilization be voluntary and provided with full informed consent. Forced or coerced sterilization is a violation of human rights.

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