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Information from Your Family Doctor
Deciding About Tubal Sterilization
Am Fam Physician. 2003 Mar 15;67(6):1301-1302.
What is tubal sterilization?
Tubal sterilization is a type of surgery that helps keep you from getting pregnant. It closes off your fallopian tubes (where your eggs can be fertilized by sperm). When the tubes are closed, sperm can't reach the egg, so you can't get pregnant.
Sterilization won't make you less feminine. It doesn't cause weight gain or facial hair. It won't decrease your sexual pleasure or cause menopause. Sterilization won't protect you against sexually transmitted diseases (STDs). Use a condom during each sex act to prevent STDs.
What are some reasons to choose sterilization?
You want to have sex without worrying about getting pregnant.
You don't want to have a child in the future.
You and your partner agree that your family is complete, and you don't want more children.
You and your partner have concerns about the side effects of other birth control methods.
Other birth control methods are unacceptable to you.
Your health would be in danger if you got pregnant.
You don't want to pass on a genetic illness or disability.
You and your partner agree that it is better for you to have tubal sterilization than for him to have a vasectomy.
What are some reasons to avoid sterilization?
You may want to have a child in the future.
You're being pressured by your partner, friends, or family. Only you can know whether sterilization is right for you.
You have problems that may be short-term. For example, problems with sex or your marriage, short-term mental or physical illnesses, or being out of work.
You haven't thought about possible changes in your life, such as divorce, remarriage, or death of children.
You haven't talked about it with your partner or anyone else you think should help you make the decision.
How is sterilization done?
Closing the fallopian tubes for sterilization can be done in several ways. Tubal ligation is when the tubes are closed off by tying and cutting. They also can be closed by sealing (cautery) or by applying clips, clamps, or rings. Sometimes, a small piece of the tube is removed.
Will I still have a period?
Yes. After the procedure, your period cycles will stay the same. If you were using birth control pills and your periods were irregular before you started using birth control pills, you should return to irregular patterns.
Also, as women get older, their periods change. How often your period occurs, how long it lasts, and the amount of bleeding will vary. As you near menopause (late 40s to 50s), you can expect to have irregular cycles. This happens whether or not you've had a tubal sterilization procedure.
Will sterilization hurt?
You will be given anesthetics before the procedure. The four types are general (makes you sleep), regional (makes you numb from the waist down), local (acts only where applied), and IV sedation (makes you calm). The choice will depend on your health and the type of sterilization being done. Local and regional anesthetics are much safer than general anesthetics. There is much less risk of serious problems, including death.
General anesthesia is painless. When a local anesthetic is injected or regional anesthesia given, you may feel brief discomfort. The pain is relieved with medicines and sedatives. You'll be awake, but sleepy. You'll feel little or no discomfort during the procedure.
How will I feel after surgery?
How 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 stomach pain. You may feel dizzy, nauseated, bloated, or gassy, and you may have shoulder pain or stomach cramps. Most of these symptoms last one to three days.
Contact your doctor right away if you:
Develop a fever
Bleed from an incision
Have severe stomach pain that won't stop
Have fainting spells
How soon can I have sex again?
Ask your doctor. Don't have sex until you feel comfortable about it. It usually takes about a week after surgery. You'll have to wait at least four weeks if a sterilization is done shortly after childbirth.
Can sterilization be reversed?
If you think you might have to reverse the procedure some day, don't have a tubal sterilization. Reversal procedures are complicated, are often not successful, are expensive, and are usually not covered by health insurance. Even though tubes sometimes can be rejoined, pregnancy isn't guaranteed. Many women can't try reversals because there's not enough of their fallopian tubes left.
How soon can I go back to work after sterilization?
That depends on your general health, attitude, job, and the type of sterilization. Recovery is usually complete in a day or two. You may want to take it easy for one week or so. Avoid heavy lifting for about one week.
Do I need my husband's or partner's consent?
No. However, talking about the operation beforehand is usually best for most relationships.
How can I get a sterilization?
For information, call your family doctor, your local hospital or public health department, or call Planned Parenthood (1-800-230-PLAN).
This handout is provided to you by your family doctor and the American Academy of Family Physicians. Other health-related information is available from the AAFP online at http://familydoctor.org.
This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.
Copyright © 2003 by the American Academy of Family Physicians.
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