Sexual Health: Your Guide to Birth Control: Sterilization

Birth control is a way for men and women to prevent pregnancy. There are many different methods of birth control; some types also protect against sexually transmitted diseases.

Sterilization is a permanent form of birth control that is extremely effective at preventing pregnancy. But it is difficult to reverse if you change your mind, and it does not protect against sexually transmitted diseases. Both men and women can be sterilized. For women, a tubal ligation is performed; for men, a vasectomy is performed. Women have the option of tubal ligation surgery or the placement of a new device called Essure.

What Is Essure?

Essure is a new form of permanent sterilization for women that can be performed without general anesthesia (being put to sleep).

How Is The Device Placed?

Essure is a tiny device that looks like a spring. Doctors use a thin tube to thread an Essure device through the vagina, into the uterus and then into the fallopian tubes. Thus, each woman receives two Essure devices to achieve sterilization.

A mesh-like substance that's embedded in the Essure device irritates the lining of the fallopian tubes, causing scarring that over time permanently blocks the tube.

How Effective Is Essure?

Like all birth control methods, Essure is not 100% effective. Because the scarring occurs over time, women should take another form of birth control for three months after the procedure. After this the doctor will take a special X-ray to verify that the fallopian tubes are blocked and you can rely on the inserts for birth control. The most current clinical studies show that Essure is 99.8% effective in preventing pregnancy after 4 years of follow up.

Does Essure Protect Against Sexually Transmitted Diseases?

No. Sterilization does not protect against STDs, including HIV (the virus that causes AIDS). Male latex condoms provide the best protection from most STDs.

What Is Tubal Ligation?

Tubal ligation, or female sterilization, is surgery to "tie the tubes" (fallopian tubes) of a woman, which causes permanent sterility by preventing transport of the egg (ovum) to the uterus. This also blocks the passage of sperm up the tube where fertilization normally occurs.

An estimated 700,000 American women undergo tubal ligation each year, making it the most common form of contraception in the U.S.

How Is Tubal Ligation Done?

The procedure is performed in a hospital or outpatient surgical clinic while you are anesthetized (put to sleep). One or two small incisions (cuts) are made in the abdomen at the navel, and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted. Using instruments that are inserted through the laparoscope, the fallopian tubes are burned or sealed shut. The skin incision is then stitched closed. The patient is able to return home within a few hours after the procedure. Tubal ligation can be performed immediately after childbirth through a small incision near the navel or during a cesarean delivery.