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Female and male sterilisation (vasectomy)

Sterilisation works by stopping the egg and the sperm meeting. This is done by blocking the fallopian tubes (which carry an egg from the ovary to the womb) in women or the vas deferens (the tube that carries sperm from the testicles to the penis) in men. Sterilisation is only for people who are sure they never want children or do not want more children. Sterilisation is a permanent method of contraception. There is an operation to reverse sterilisation, but it is complicated, expensive and may not work. Many health authorities will not pay for reversal on the NHS.

You may want to find out about other long-term methods of contraception which are as effective as sterilisation, but reversible. Ask your doctor, or contact your national fpa helpline.

How effective is sterilisation?

How effective any contraceptive is depends on how old you are, how often you have sex and whether you follow the instructions.

If 100 sexually active women don't use any contraception, 80 to 90 will become pregnant in a year.

There is a very slight risk that sterilisation will not work. The tubes that carry the sperm in men and the eggs in women can rejoin after sterilisation.

Male sterilisation (vasectomy) - Once a vasectomy is presumed to have worked (after two clear semen tests) about 1 in 2,000 male sterilisations fail.

Female sterilisation - The overall failure rate is about 1 in 200 depending on the method used.

Both vasectomy and female sterilisation can fail immediately or some years after the operation has been carried out. So if the woman ever thinks she might be pregnant, she should have a pregnancy test. 

What are the advantages of sterilisation?

  • It does not interfere with sex.
  • It is a permanent method of contraception. After sterilisation has worked you don't have to do anything about contraception ever again.
  • Male sterilisation is a simple operation and takes about 10-15 minutes. It is more effective than female sterilisation.

What are the disadvantages of sterilisation?

  • After a vasectomy it usually takes a few months for all the sperm to disappear from your semen. You need to use another method of contraception until you have had two semen tests which show that you have no sperm.
  • Female sterilisation involves a small operation and usually a general anaesthetic.

For both male and female sterilisation:

  • The tubes may rejoin and you will be fertile again. This is not common.
  • Sterilisation cannot be easily reversed.
  • Sterilisation does not protect you against sexually transmitted infections.

Can anyone be sterilised?

Sterilisation is for people who do not want more children or who are sure that they do not want any children. Research shows that more women and men regret sterilisation if they were sterilised when they were under 25, had no children or were not in a relationship. Because of this, young or single people may receive extra counselling.

You should get full information and counselling if you want to be sterilised. This gives you a chance to talk about the operation in detail and any doubts, worries or questions you might have. You should not decide to be sterilised if you or your partner are not completely sure or if you are under any stress, for example after a birth, miscarriage, abortion or family or relationship crisis. 

Do I need my partner's permission?

By law you do not need your partner's permission. But some doctors prefer both partners to agree to the operation after information and counselling.

Anyone having a sterilisation operation will have to sign a consent form for sterilisation.

What if I change my mind?

Sterilisation is meant to be permanent. There is a reversal operation but it is not always successful. The success of your reversal operation will depend upon how and when you were sterilised. It is not easily available on the NHS.

Male sterilisation (vasectomy)

What is a vasectomy?

The tubes (vas deferens) that carry sperm from your testicles to your penis are cut or blocked.

What is the operation like?

You will be given a local anaesthetic. The doctor will make a small cut(s) in the skin of your scrotum, to reach the tubes (vas deferens). The doctor will remove a small piece of each tube, or cut the tubes and close the ends. The cuts in your scrotum will be very small and you may not need to have any stitches. If you do, dissolvable stitches or surgical tape will be used. The operation takes about 10-15 minutes and may be done in a clinic, hospital outpatient department or doctor's surgery. 

Are there any problems?

Your scrotum may become bruised, swollen and painful. You can help this by wearing tight-fitting underpants to support your scrotum day and night for a week. You should avoid strenuous exercise for at least a week.

Occasionally, some men have bleeding, a large swelling, or an infection. In this case, see your doctor as soon as possible. Sometimes sperm may leak out of the tube and collect in the surrounding tissue (sperm granulomas). This may cause inflammation and pain immediately or a few weeks or months later. If this happens it can be treated.

Does a vasectomy have any serious risks?

Vasectomy has been available for many years. Although in the past there have been conflicting reports about vasectomy risks, research now shows that there are no known serious long-term health risks associatedwith vasectomy.

How soon can I have sex after a vasectomy? 

You can have sex as soon as it is comfortable. However, at first you will still need to use an extra method of contraception until you have had two clear semen tests. Your testicles will produce male hormone the same as before your vasectomy. Your feelings, sex drive, ability to have an erection and climax won't be affected. The only difference will be that there will not be any sperm in the semen. Sperm are still produced but are absorbed by the body. The appearance and amount of the semen and the feelings of climaxing should be the same as before.

When will a vasectomy be effective?

You need to use an extra method of contraception after the operation because sperm are left in the tubes that lead to the penis. The rate these sperm are used up varies from man to man. After eight to twelve weeks you will have two semen tests two to four weeks apart to see if the sperm have gone. You can only rely on a vasectomy for contraception after you have had two clear semen tests (no sperm are seen). 

Female sterilisation

What is female sterilisation?

Your fallopian tubes are cut, sealed or blocked by an operation. This stops the egg and sperm meeting.

What is the operation like?

There are several ways of blocking the fallopian tubes: tying (ligation); removing a small piece of the tube (excision); sealing (cauterisation), or applying clips or rings. This operation can be done in several ways. The two main methods are laparoscopy and mini-laparotomy.

Laparoscopy is the most common method of female sterilisation. You will be given a general anaesthetic, or possibly a local anaesthetic. A doctor will make two tiny cuts, one just below your navel and the other just above the bikini line. They will then insert a laparoscope which lets the doctor clearly see your reproductive organs. The doctor will seal or block your fallopian tubes, usually with clips or rings.

For a mini-laparotomy you will usually have to have a general anaesthetic and spend a couple of days in hospital. The doctor will make a small cut in your abdomen, usually just below the bikini line, to reach your fallopian tubes.

The time you stay in hospital after sterilisation depends on the anaesthetic and the method used. It can be as little as one day.

To avoid pregnancy you must use contraception right up to the time you are sterilised and until you have your first period after the sterilisation. 

  

How will I feel after the operation?

If you have a general anaesthetic you may feel unwell and a little uncomfortable for a few days. This is quite usual, and you may have to take things easy for a week or so. You may have some slight bleeding and pain. If this gets worse, see your doctor.

Your ovaries, womb and cervix are left in place so you will still release an egg each month, but it is absorbed by the body. Your sex drive and enjoyment of sex should not be affected. For many women it is improved, as they no longer fear an unplanned pregnancy.

Occasionally some women find that their periods are heavier, but this is usually because of their age or stopping the combined pill, which may have lightened their periods. You can have sex as soon as it is comfortable to do so after the operation but you will need to use contraception until your first period after the operation.

When is female sterilisation effective?

If you do not want to become pregnant you must continue to use your present method of contraception until your first period after sterilisation.  

What if I become pregnant after sterilisation?

If you become pregnant after sterilisation, there is a small risk of the pregnancy developing outside your womb, usually in the fallopian tube. This is called an ectopic pregnancy. Although ectopic pregnancies are rare, they are serious. You should see your doctor straightaway if you think you might be pregnant or have a light or delayed period or if you have sudden or unusual pain in your lower abdomen.

Where can I go for advice on sterilisation?

You can go to a family planning clinic, your GP or practice nurse. You can go to a different GP if you prefer not to see your own doctor. Or call your national fpa helpline.

All treatment you get is confidential and free. NHS waiting lists for sterilisation can be quite long depending on where you live. You can have the operation done privately.  

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