Permanent

Permanent forms of Birth Control

Permanent contraception is commonly known as sterilization. Permanent forms of birth control prevent a female from becoming pregnant or a male from releasing sperm. Sterilization, one of the most effective forms of birth control, is performed for those who have made the conscious choice that they do not want any children or their family is already complete. While these surgical contraceptive options are intended to be permanent, reversal is possible with subsequent surgery. A tubal ligation is the cutting, tying, or sealing of a female's fallopian tubes. A vasectomy is the cutting, tying, or sealing of a male's vas deferens. Tubal implants are a newer sterilization option for females. A hysterectomy is a surgical procedure where a woman's uterus is removed, and it can be considered a third form of permanent contraception. This surgery is only used to treat serious medical conditions, like cancers of the uterus, ovaries, cervix, and endometrium, or for endometriosis.

Tubal Ligation and Tubal Implants

Tubal ligation is a relatively invasive surgical procedure where the fallopian tubes (passageways that transport eggs from the ovaries to the uterus) are permanently cut, tied, and/or blocked. A newer, less-invasive nonsurgical technique utilizes a small metal coiled tubal implant. One implant is inserted into each fallopian tube. Over a period of time, scar tissue forms around these implants, and there is permanent blockage of the tubes. The majority of women are able to go home a few hours after either of these procedures. Some facts to note concerning female sterilization include:

  • Normally, female sterilization is at least 99 percent effective in preventing pregnancy.
  • Sterilization does not alter normal hormonal levels.
  • Menstrual periods still occur following sterilization.
  • Other contraceptives will need to be used, until the next menstrual period or for three months after, depending on the technique performed.
  • There is a small risk of complications including internal bleeding, infection, and/or organ damage.
  • There is a slight chance that the procedure will not be successful. Rarely, blocked tubes can rejoin right away or years after.
  • If surgery fails, there can be an increased risk for an ectopic pregnancy, where the fertilized egg implants outside the uterus, typically within a fallopian tube.
  • Female sterilization is difficult to reverse.
  • A tubal ligation or tubal implants do not protect against sexually transmitted diseases (STDs).

Vasectomy

A vasectomy is a minor, outpatient procedure where the tubes that transport sperm from the male testicles to the seminal fluid are cut and blocked so semen no longer contains sperm cells. These tubes are called the vas deferens. Having a vasectomy does not prevent a man from obtaining erections or enjoying sexual intercourse. Males should undergo up to two sperm count tests postoperatively, before using it as a reliable birth control method. Some facts to note concerning male sterilization include:

  • Typically, vasectomies are considered more than 99 percent effective in preventing pregnancy.
  • Male sterilization is considered a permanent type of contraception, as reversal procedures are difficult and/or often not successful.
  • Other contraceptives are required for a minimum of eight weeks post-surgery, since sperm can remain in the vas deferens.
  • Side effects can include bruised, swollen, and/ or painful scrotum. Rarely, men may have ongoing pain within the testes.
  • There is a slight risk of postoperative infection.
  • A vasectomy does not protect against the transmission of sexually transmitted diseases (STDs).

Hysterectomy

A hysterectomy is a surgical procedure where a woman's uterus is removed (completely or partially). This procedure can be considered a permanent form of contraception, since she no longer has periods and cannot become pregnant following surgery. During a hysterectomy, a surgeon may also remove the fallopian tubes and ovaries, where hormones and eggs are produced. If a hysterectomy patient has not reached menopause, and she keeps both of her ovaries, she may experience menopause earlier than most women. However, if the ovaries are removed during the hysterectomy surgery, she will definitely enter menopause because of the drop in estrogen levels and lack of egg production.

There are three main types of hysterectomies:

  • Partial Hysterectomy: Removal of the upper part of the uterus but not the cervix.
  • Total Hysterectomy: Removal of the entire uterus and cervix.
  • Radical Hysterectomy: Removal of the entire uterus, tissue on both sides of the cervix, and upper portion of the vagina.

There are several reasons why a hysterectomy is done. These include:

  • Cancer. Cancers of the uterus, endometrial tissues, ovaries, or cervix.
  • Fibroids. These are benign tumors that grow in the uterine walls.
  • Endometriosis. This is a condition where the uterine lining grows outside of the uterus onto the fallopian tubes, ovaries, and/or other pelvic/abdominal organs. This can be an extremely serious condition causing very painful periods, as well as bleeding in between times.
  • Prolapsed uterus. This is where the uterus slips from its normal position downwards into the vagina.
  • Chronic pelvic pain. The procedure is a last resort when the pelvic pain originates in the uterus.
  • Abnormal vaginal bleeding. This is caused by abnormal hormonal levels, cancer, or fibroids.

Resources

  • National Institute of Health (2013). What are the different types of contraception?http://www.nichd.nih.gov/health/topics/contraception/conditioninfo/Pages/types.aspx
  • Office on Women's Health (2013). Hysterectomy fact sheet. Retrieved from:http://womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.cfm
  • WebMD (2013). Birth control methods. Retrieved from:http://www.webmd.com/sex/birth-control/birth-control-birth-control-methods?page=2

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