Tubal Sterilization (Tubal Ligation)

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What is tubal sterilization?

Tubal sterilization is a type of surgery that keeps you from getting pregnant. It closes off your fallopian tubes (which carry an egg to your uterus each month). When the tubes are closed, sperm cannot reach the egg, so you cannot get pregnant.

Sterilization won’t make you less feminine. It doesn’t cause weight gain or the growth of facial hair. It won’t decrease your sexual pleasure or cause menopause. It’s important to know that sterilization won’t protect you against sexually transmitted infections (STIs). Always use a condom during each sexual activity to prevent STIs.

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 fallopian tube is removed.

Will sterilization hurt?

You will be given anesthetics before the procedure. The four types are general anesthesia (makes you sleep), regional anesthesia (makes you numb from the waist down), local anesthesia (acts only where applied) and IV sedation anesthesia (makes you calm). The choice of anesthetic will depend on your health and the type of sterilization being done.

When a local anesthetic is injected or regional anesthesia is given, you may feel brief discomfort. The pain is relieved with pain medicines and sedatives. You’ll be awake, but sleepy. You’ll feel little or no discomfort during the procedure.

General anesthesia is painless, but there are risks.

How will I feel after surgery?

How you feel after the operation depends on your general health, the type of procedure and your tolerance to pain. You may feel tired and have slight stomach or shoulder pain. You may feel dizzy, nauseated, bloated or gassy. Most of these symptoms last only a few days.

Contact your healthcare provider 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 go back to work after sterilization?

That depends on your general health, your attitude, your job and the type of sterilization. Recovery is usually complete in a couple of days. You may want to take it easy for 1 week or so. Avoid heavy lifting for about 1 week.

Will I still have a period?

Yes. If you were using birth control pills and your periods were irregular before you started using birth control pills, you will likely have irregular periods after sterilization.

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 (usually in your late 40s to 50s), you can expect to have irregular cycles. This happens whether or not you’ve had a tubal sterilization procedure.

How soon can I have sex again?

Ask your healthcare provider. Don’t have sex until you feel comfortable about it. You usually need to wait about a week after surgery.

You’ll have to wait at least 4 weeks if sterilization is done shortly after childbirth.

Do I need my husband’s or partner’s consent to have a tubal sterilization?

No. However, talking about the operation beforehand is usually best for most relationships.

Can sterilization be reversed?

If you think you might want to reverse the procedure someday, you should not have a tubal sterilization. Reversal procedures are complicated, 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.

Sources

Counseling Issues in Tubal Sterilization by I. Cori Baill, M.D., Vanessa E. Cullins, M.D., M.P.H., M.B.A.,Sangeeta Pati, M.D. (03/15/03, http://www.aafp.org/afp/20030315/1287.html)