Sterilisation (female)

Benefits

  • You don’t have to think about contraception again
  • Does not affect hormones within your body
  • Usually a minor operation where women can return home the same day
  • No effect on sex drive or ability to enjoy sex.

Sterilisation involves blocking or sealing the fallopian tubes, which link the ovaries to the womb (uterus). Sterilisation is meant to be permanent – though there are reversal operations, they are not always successful. In recent years, many more couples in their 30s and 40s are opting for efficient and long lasting contraceptives instead of sterilisation, as more couples are choosing to have families later in life.

Join ThePow forum

Thinking about female sterilisation? Join the conversation.

Share your story, ask others or tag @Dr_Paula on our contraception forum ThePOW.

How it works

Sterilisation is a fairly minor operation, with many women returning home the same day. There are two types of operation, one which blocks the fallopian tubes, for example, using clamps or rings, and the other using an implant to create scar tissue which eventually blocks the tubes. Read more about the options in our Questions section.

Female sterilisation works by preventing eggs from travelling down the fallopian tubes. This means a woman's eggs cannot meet sperm, and fertilisation cannot happen.

1
2
3

Things to consider

You need to use contraception right up to and for 1- 3 months after the operation, depending on what procedure you have.

You can usually resume sex within about a month of the operation, but it can be a little uncomfortable, so take it gently.

Your periods will continue to be as regular as they were before sterilisation. Occasionally, some women find that their periods become heavier. This is usually because they have stopped using hormonal contraception, which may have lightened their periods previously.

Sterilisation does not protect against STIs, so you may need to use condoms if you think you are at risk of infection.

What if?

You’re not sure about whether you want to have children or not:

Once you are sterilised it is very difficult to reverse the process, so it's important to consider the other options available before making your decision. Sterilisation reversal is not usually available on the NHS.

Suitability

You can be sterilised at any age. However, if you are under 30, particularly if you do not have children, you will be offered the opportunity to discuss your choices before you commit to having the procedure.

You should only be sterilised if you are certain that you do not want to have any, or any more, children. If you have any doubts, consider another method of contraception until you are completely sure.

Clinicians do have the right to refuse to refer you for the procedure if they do not believe that it is in your best interests.

Side effects & risks

Common Rare
Short term:

Feeling unwell and uncomfortable for a few days after general anaesthetic (if required).

Need some time off work.

Slight vaginal bleeding and/or cramps.

Any surgery has slight risk of infection.
Long term:

It is possible, though rare, for sterilisation to fail, resulting in pregnancy. If this happens, there is a small increased risk of ectopic pregnancy.

Questions?

Who should I talk to if I am considering getting sterilised?
Thumb up 19

You should talk to your GP or sexual health clinic.

Thumb up 22   Thumb down 3

Is sterilisation available on the NHS?
Thumb up 140

Yes, sterilisation is available on the NHS

Thumb up 161   Thumb down 21

Is sterilisation reversible?
Thumb up 31

It is very difficult to reverse female sterilisation and is not always possible. Reversal is not usually available on the NHS.

Thumb up 34   Thumb down 3

Does sterilisation affect emotions, hormones or sex drive?
Thumb up 50

No, you should still go through normal menstrual cycles. Sterilisation does not change your hormones.

Thumb up 52   Thumb down 2

Am I protected against pregnancy straight away after sterilisation?
Thumb up 59

No. After tubal sterilisation, you will need to use contraception for one month afterwards.

After Hysteroscopic sterilisation, you will need to use contraception for three months afterwards.

Do also ensure you use contraception up till the time of your operation.

Thumb up 61   Thumb down 2

How does the operation work?
Thumb up 60

There are two types of sterilisation operation:

Tubal – using clips or rings

First, your surgeon will need to access and examine your fallopian tubes. Laparoscopy is the most common method: the surgeon makes a small cut in your abdominal wall near your belly button and inserts a laparoscope (a small flexible tube that contains a tiny light and camera). The camera allows the surgeon to see your fallopian tubes clearly by relaying images to a monitor.

Blocking the tubes can be done in three ways:

  • Applying clips – plastic or titanium clamps are closed over the fallopian tubes
  • Applying rings – a small loop of the fallopian tube is pulled through a silicone ring, then clamped shut
  • Tying and cutting the tube – this destroys 3-4cm (1-1.5 inches) of the tube.

You will need to use contraception until your operation and for four weeks afterwards.

Hysteroscopic sterilisation (fallopian implants)

The National Institute for Health and Care Excellence (NICE) has published guidance about hysteroscopic sterilisation. In the UK, the brand name of the hysteroscopic sterilisation technique is Essure.

The implants are usually inserted under local anaesthetic.

A narrow tube with a telescope at the end, called a hysteroscope, is passed through your vagina and cervix. A guidewire is used to insert a tiny piece of titanium metal (called a microinsert) into the hysteroscope, then into each of your fallopian tubes. This means that the surgeon does not need to cut into your body.

The implant causes the fallopian tube to form scar tissue around it, which eventually blocks the tube.

You should carry on using contraception until an imaging test has confirmed that your fallopian tubes are blocked. This can be done with one or more of the following:

  • A hysterosalpingogram (HSG) – a type of X-ray that is taken after a special dye has been injected to show up any blockages in your fallopian tubes
  • A hysterosalpingo-contrast-sonography (HyCoSy) – a type of ultrasound scan involving injecting dye into your fallopian tubes.

Thumb up 63   Thumb down 3

What will the recovery after the sterilisation be like?
Thumb up 127
  • Once you have recovered from the anaesthetic, passed urine and had something to eat, you will be allowed home. If you leave hospital within hours of the operation, ask a relative or friend to pick you up, or take a taxi
  • If you have had a general anaesthetic, do not drive a car for 48 hours afterwards as your reaction times and judgement may not be back to normal
  • You may be prescribed painkillers. If the pain or bleeding gets worse, seek medical attention.

Caring for your wound

If you had tubal occlusion to block your fallopian tubes, you will have a wound with stitches where the surgeon made an incision (cut) into your stomach. Some stitches are dissolvable and disappear on their own, and some will need to be removed. If your stitches need removing, you will be given a follow-up appointment for this.

If there is a dressing over your wound, you can normally remove this the day after your operation. After this, you will be able to have a bath or shower as normal.

Thumb up 136   Thumb down 9

How will I know which method of sterilisation is best for me, Tubal or Hysteroscopic?
Thumb up 29

There are advantages and disadvantages of both procedures, your gynaecologist will discuss these with you.

Thumb up 37   Thumb down 8

What happens if the sterilisation is unsuccessful?
Thumb up 42

If blocking the fallopian tubes has been unsuccessful, the tubes may be completely removed. Removal of the tubes is called salpingectomy.

Thumb up 45   Thumb down 3

Where can I get it?

A sexual health clinic or GP will ask about your circumstances and provide information and counselling before agreeing to refer you for the procedure. In some areas, waiting lists for sterilisation on the NHS can be quite long. You can pay to have the operation done privately.

You should only be sterilised if you are certain that you do not want to have any, or any more, children. If you have any doubts, consider another method of contraception until you are completely sure.