Permanent contraception is a highly effective birth control method and you will most likely never have to use another form of contraception again.
Despite this, the number of people choosing them on the NHS has decreased dramatically in recent years.shows that from 2009 to 2015 the amount of vasectomies has halved, whilst female sterilisation rates have decreased by 26%.
While effective, it’s not a reversible procedure and it’s a huge decision. So for that reason, it’s important to know all the facts and how it works. Keep reading to learn more about permanent methods of contraception and whether it’s right for you at HealthExpress.
Permanent contraception is a form of contraception that, as the name suggests, lasts for the rest of your life. Methods are available for both men and women, and it involves permanently altering the reproductive organs. It requires a simple procedure. For men, the procedure is known as a vasectomy, whilst for women it is known as female sterilisation.
A vasectomy is the name for male sterilisation. It’s a minor surgical procedure that involves cutting, blocking or sealing the vas deferens tube. This tube typically carries sperm from the testicles and out of the body through ejaculation. By sealing this tube, the semen will contain no sperm which means a woman’s egg cannot be fertilised
There are two main types of vasectomy.
|Conventional vasectomy||No-scalpel vasectomy|
While both types are safe and suitable for most men, your doctor may recommend you one type over the other.
The risk of complications with a vasectomy is low and most men will make a full recovery in a week or two.
Some common side effects after a vasectomy include:
Taking over-the-counter painkillers and wearing tight underwear to support the scrotum will alleviate some discomfort. However, men should avoid having sex, exercise or any heavy lifting for at least a week after the procedure.
12 weeks after a procedure, the man will have to have your semen tested for sperm count. This is to confirm that the semen is sperm-free.
A small percentage of men will continue to have traces of sperm in their semen, but these sperm are more immobile and therefore less likely to fertilise an egg.
Men will need to use an alternative form of contraception (e.g barrier contraception) until you know your sperm count is low, as it takes a while for semen to be completely sperm-free.
In rare cases, the tubes may naturally rejoin themselves. However, the overall failure rate of vasectomies is extremely low, as low as.
Surgical female sterilisation is the equivalent of vasectomy but for women. Like the vasectomy, it requires a simple procedure which involves blocking the fallopian tubes, the tube that links the uterus (womb) and the ovaries. This is a procedure known as tubal occlusion or tubal ligation.
What this does is it prevents the egg from travelling down the fallopian tubes and into the uterus. The ovaries will continue to produce eggs, but they will naturally be absorbed into the body.
There used to be an additional type of sterilisation available known as hysteroscopic sterilisation, in which a small implant was inserted into the fallopian tubes sold under the brand name Essure. However, the device used for this procedure has since been discontinued.
Tubal occlusion can be done in two ways. Which one a woman has will depend on their medical history, but both procedures are similar.
The most common way is a laparoscopy, where a small cut is made near the belly button. However, certain women cannot have this procedure due to risk of complications, such as women who are overweight, have recently had abdominal surgery or have a history of PID (pelvic inflammatory disease). These women will instead have a mini-laparotomy, where a cut is made above the pubic hairline.
In both procedures, a surgeon then inserts a small camera (a laparoscope) so they can clearly see your fallopian tubes.
The fallopian tubes are are then sealed in one of several ways, including by:
As sterilisation does not affect your hormone levels or your menstrual cycle like other birth control options, you will still get your period each month. It shouldn’t change your periods in any way, but if you do notice any differences, you should consult your healthcare provider.
Most women who have the surgery can go home the same day, once they have recovered from the anaesthesia. Even still, It’s normal to feel some discomfort for a few days.
Some common side effects include:
If your symptoms persist or get worse, you should consult the specialist who performed the surgery.
A rare but serious complication of sterilisation is an ectopic pregnancy. An ectopic pregnancy is where a fertilised egg implants in the fallopian tube instead of the womb. The most common cause of ectopic pregnancy after sterilisation is if the tubes grow back together over time.
If you notice that you miss a period, have sharp pains in the pelvis or have any irregular vaginal bleeding, consult your doctor.
Like a vasectomy, laparoscopic tubal occlusion has a very low failure rate. It is estimated that the failure rate is as low as, and certain sealing methods may have an even lower failure rate.
In the rare case where the procedure doesn’t work, the fallopian tubes may need to be removed completely. This is a procedure known as salpingectomy. This procedure may also be used if you experience any complications from sterilisation.
Both male and female sterilisation should be considered as a permanent birth control method. While both procedures can technically be reversed, it’s not an easy procedure and it’s not always successful.
If reversal is unsuccessful, you can always try fertility treatments such as IVF. However, like sterilisation reversal, there’s no guarantee it will be successful.
You can be sterilised at any age and your doctor will refer you for the procedure if they believe it is in your best interests.
However, given the irreversible nature of the procedure, if you are under 30 and don’t have any children, they will encourage you to consider your options seriously before opting for sterilisation. Healthcare professionals do have the right to refuse you for the procedure if they do not believe that it is in your best interests.
If you have any doubts about the procedure, it’s likely that it is not suitable for you and you should discuss alternative options with your doctor or a professional at a sexual health clinic.
If you’re not looking for a long-lasting method of birth control but not something permanent, there are alternatives. The best option for you are a group of contraceptives called long-acting reversible contraceptives (LARC). They can last for years in some cases, but can be removed or changed at any time.
|Long-acting reversible contraceptives|
IUD (intrauterine device)
Also known as the “copper coil”, the IUD is a small T-shaped device that releases copper into the womb.
IUS (intrauterine system)
A hormonal version of the IUD. A small T-shaped device that releases progesterone into the womb.
An injection that releases progesterone into the bloodstream.
Small plastic rod that is inserted under the skin in your arm and releases progesterone.
Permanent methods are available and are highly effective. They’re a great option if that’s what you want. However, the decision should not be made lightly. The procedures are irreversible and could significantly impact your life and mental health if you change your mind. If you’re not sure, consider a non-permanent and long-lasting method like LARC instead.