When a woman decides she is done having children, she needs to consider a permanent birth control solution. But what are some contraceptive options that are permanent and safe?
Female sterilization is the most widely used method of contraception around the world. The sterilization procedures have traditionally been performed in a hospital or ambulatory surgery center. These include:
- Postpartum tubal ligation to tie the fallopian tubes after childbirth
- Laparoscopic closure of the tubes, commonly referred to as “tying the tubes”
- A vasectomy for males that blocks the vas deferens - the thin tubes in the scrotum that carry sperm from the testicles
Both postpartum and laparoscopic sterilizations involve small incisions into the abdomen while under general anesthesia. Recovery from these surgeries depends on pain tolerance, type of anesthesia used and individual healing ability
A vasectomy, performed in a doctor’s office using a local anesthetic, takes about 30 minutes. After the procedure, a man can go home the same day. Recovery time is usually a few days. There is a low risk of complications or side effects.
Another increasingly popular option with women is an in-office hysteroscopic sterilization known by the brand name Essure®.
Joshua Sampson, D.O., OB/GYN physician at Marshfield Clinic Marshfield Center, has been using this procedure for three years. He counsels all of his patients on the permanence of this irreversible option. While any female age 21 up to menopause can choose sterilization, women under age 30 have an increased risk of “post-sterilization regret,” because of changes in life situations as one gets older, he noted.
This non-surgical, hormone-free procedure is done in the doctor’s office. It involves placing a soft, flexible insert device through the vagina, cervix and uterus and into the fallopian tubes.
Over the course of a few months, the device and the body form a natural barrier that prevents sperm from reaching the egg. After three months, a simple dye test is taken to confirm that the insert is in place and the fallopian tubes are blocked. This sterilization procedure is more than 99 percent effective in preventing pregnancy.
During this three-month period, women must use some form of birth control. Women need to remember that they are not sterile until the barrier is complete, as verified by the dye test. If after three months, the barrier has not formed, the dye test must be repeated within six months of the procedure.
This method offers several advantages over the traditional, surgical methods of tubal ligation, such as no incisions, minimal anesthesia and discomfort, typically quick, 20-minute procedure, faster recovery and three-month confirmation in most cases.
“My patients like the fact that this can be done in a doctor’s office, and there is no general anesthesia,” Dr. Sampson said. “The overall surgical risk is lower with Essure compared with laparoscopic tubal ligation."
As with any procedure, there is a small risk of failure. It is not recommended that this option be used at the same time as an in-office endometrial ablation procedure used to lighten or stop menstrual flow.
“Response has been very positive,” said Dr. Sampson. “Women are pleased with the ease of placement and the convenience of no longer having to manage their birth control.”