Female sterilisation (also known as tubal occlusion) involves blocking or sealing the fallopian tubes, which link the ovaries to the womb (uterus). While sterilisation is meant to be permanent, there are reversal operations, but they are not always successful.
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.
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.
Sterilisation is over 99% effective at preventing pregnancy.
Sterilisation is a fairly minor operation, with many people 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.
Female sterilisation works by preventing eggs from travelling down the fallopian tubes. This means the eggs cannot meet sperm, and fertilisation cannot happen.
There are two types of sterilisation operation:
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:
You will need to use contraception until your operation and for four weeks afterwards.
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:
Following the proceedure, it is normal to feel uncomfortable and unwell if you have been given general anaesthetic. You may also experience cramps and vaginal bleeding.
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 people 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.
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.
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.
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.
Yes, sterilisation is available on the NHS.
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 until the time of your operation.
If blocking the fallopian tubes has been unsuccessful, the tubes may be completely removed. Removal of the tubes is called salpingectomy.
No, you should still go through normal menstrual cycles. Sterilisation does not change your hormones.
You should talk to your GP or sexual health clinic.
There are advantages and disadvantages of both procedures, your gynaecologist will discuss these with you.
It is very difficult to reverse female sterilisation and is not always possible. Reversal is not usually available on the NHS.
