Permanent Birth Control: Sterilization Options

Permanent Birth Control: Sterilization Options

If you don’t want any – or any more – children, sterilization can ease your pregnancy worries for good. Here’s an overview of permanent birth control procedures.

Sex can be stressful for couples who don’t want any, or any more, children. If you’re content with the size of your family, permanent birth control may be an option for you. Sterilization procedures can keep pregnancy worries at bay for good.

Permanent birth control procedures

Sterilization is an option for both men and women. The only procedure for men is a vasectomy. Women can choose tubal ligation (also called tubal sterilization or “getting your tubes tied”) or Essure (tubal microinserts).

Vasectomy. During this surgery, the vas deferens (vasa) are tied, cut or sealed. The vas deferens are the small tubes sperm travel through when they leave the testes to enter the penis. A vasectomy stops sperm from being released during ejaculation. Fluid (semen) will still be released, but it won’t contain sperm. Having a vasectomy will not affect erections or sensation during sex.

This procedure can be done in a doctor’s office or hospital. You’ll be able to go home the same day as surgery. Side effects include pain, swelling and discomfort in the few days after the vasectomy. You can have sex again as soon as you feel ready.

A vasectomy does not work right away. You must use a backup method of birth control until your follow-up doctor visit. Sperm may still be in the tubes in the penis. At your appointment, your doctor will do a sperm count. Once seminal fluid contains no sperm (about one to three months after the procedure), the vasectomy will be effective. More than one sperm count may be needed to make sure that pregnancy can be prevented.

Tubal ligation is surgery that closes the fallopian tubes. The tubes are tied, cut or sealed. As a result, the egg won’t be able to move down the fallopian tubes. And, there will be no way the sperm can reach the egg. You will still get your period and the procedure won’t affect sexual sensation.

The surgery requires anesthesia. Tubal ligation is usually done laparoscopically through several small incisions in your abdomen. It can also be done through a single large incision in your abdomen such as after a cesarean delivery (C-section). The procedure can be done through the same incision used to deliver the baby. Side effects are usually mild and go away within a couple days. They can be:

  • Abdominal discomfort or cramps
  • Tiredness
  • Dizziness
  • Nausea
  • Gassy or bloated feelings

Tubal ligation is effective right away. There is no need to use backup birth control.

Essure is a nonsurgical sterilization option. Tiny metal coils (called microinserts) are inserted into both fallopian tubes. Scar tissue builds up around these coils during the next three to six months. The scar tissue blocks the eggs from passing through the fallopian tubes so they cannot be fertilized by sperm. Sperm is also blocked from going up into the fallopian tubes.

Local anesthesia is used to numb part of your body during the procedure (you’ll stay awake). The microinserts will be placed into your vagina, through the cervix and uterus and then into your fallopian tubes. The whole procedure lasts about 15 minutes. Side effects usually last only a few days and may be:

  • Cramping
  • Pain
  • Vaginal bleeding or spotting

Essure is not effective right away. Use backup birth control until your three-month follow-up doctor appointment. During this visit, your doctor will take an x-ray to make sure your tubes are fully blocked.


All types of sterilization are highly effective in preventing pregnancy. They work more than 99 percent of the time.

Pros and cons

Like all types of birth control, permanent methods have several pluses and minuses:


  • Very effective pregnancy prevention.
  • Do not have to worry about birth control for the rest of your life.
  • Does not affect sexual sensation.
  • Can often go home the same day as the procedure.


  • Does not protect against sexually transmitted diseases (STDs). Unless you are in a monogamous relationship and both you and your partner have tested negative for STDs, also use a barrier method of contraception, like the condom.
  • Considered irreversible. Only have these procedures if you are 100 percent sure that you’re done having children.
  • Can be costly. Female sterilization procedures cost a few thousand dollars. Vasectomies range from several hundred to $1000. They may or may not be covered by your health insurance provider.
  • Sterilization may not be safe for people with certain medical problems.
  • All surgeries have risks. Vasectomy is usually less risky than tubal ligation. Though rare, serious side effects like infection or a reaction from anesthesia can occur.
  • Tubal microinserts are a relatively new procedure, so further research is needed to find out long-term effects.

Making the decision

Electing to have permanent birth control is a personal choice. Do not rush into the decision or opt for it during a time of stress.

Sterilization is lifelong contraception. If there’s even the slightest chance you may want children one day, look into reversible birth control methods. Studies show that women younger than 30 are most likely to regret sterilization. Discuss any concerns with your doctor.

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