Birth Control and Sterilization

Birth control, like sterilization, 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, or STDs.

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 STDs. 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 device called Essure.

What Is Essure?

Essure is a form of permanent sterilization for women that is hormone-free. Placement of the device is a procedure done in the doctor's office without the need for general anesthesia (being put to sleep).

How Is Essure Placed?

Essure is a tiny birth control 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 two fallopian tubes. Thus, each woman receives two Essure devices.

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?

Clinical studies have found that Essure is 99.8% effective in preventing pregnancy. Because the scarring occurs over time, women should take another form of birth control for three months after the procedure. During this time, they may experience changes in their monthly period or experience discomfort in their lower belly. After a few months, 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.

What are Concerns with Essure?

After hysteroscopic sterilization with Essure, some women have problems. These can include changes in their monthly period, pain in the lower belly, or allergic reactions to the metal in the coil. If you have had any of these problems in the past, talk to your doctor or nurse about them before having the procedure.

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Does Essure Protect Against STDs?

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 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, and a device similar to a small telescope (called a laparoscope) is inserted. The fallopian tubes are cut, tied, clamped, banded or sealed shut. The skin incisions are then stitched closed. The patient is able to return home within a few hours after the procedure. Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or during a cesarean delivery.

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?

Tubal ligation 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, and a device similar to a small telescope (called a laparoscope) is inserted. Using instruments that are inserted through the laparoscope, the fallopian tubes are cut, tied, clamped, banded or sealed shut. The skin incisions are then stitched closed. The patient is able to return home within a few hours after the procedure. Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or during a cesarean delivery.

How Effective Is Tubal Ligation?

Tubal ligation and tubal implants are not 100% effective at preventing pregnancy. There is a slight risk of becoming pregnant after tubal ligation.

Does Tubal Ligation Protect Against STDs?

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

What Is a Vasectomy?

A vasectomy, or male sterilization, is a simple, permanent sterilization procedure for men. It's generally safer and less painful than sterilization in women. The operation, usually done in a doctor's office, requires cutting and sealing or blocking the vas deferens, the tubes in the male reproductive system that carry sperm. A vasectomy prevents the transport of sperm out of the testes. This surgery does not affect the man's ability to achieve orgasm or ejaculate. There will still be a fluid ejaculate, but there will be no sperm in the fluid.

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How Effective Is a Vasectomy?

Except in rare cases, this procedure is nearly 100% effective.

Does Vasectomy Protect Against STDs?

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

How Is a Vasectomy Done?

A vasectomy is usually done in the surgeon's office while the man is awake, but is relatively pain-free since local anesthesia is used. A small incision is made in the upper part of the scrotum, under the penis. The tubes (vas deferens) that carry sperm are tied off and cut apart, burned or blocked with surgical clips. The skin incision is stitched closed. The patient is able to return home immediately.

There is a non-surgical technique that some doctors use. In a "no-scalpel" vasectomy, the doctor feels for the vas deferens under the skin of the scrotum and holds it in place with a small clamp. Then a special instrument is used to make a tiny puncture in the skin and stretch the opening so the vas deferens can be cut and tied. No stitches are needed to close the punctures, which heal quickly by themselves.

What Happens After the Vasectomy?

After a vasectomy, you will probably feel sore for a few days. You should rest for at least one day. However, you can expect to recover completely in less than a week. Many men have the procedure on a Friday and return to work on Monday.

Are There Side Effects of a Vasectomy?

Although vasectomy complications such as swelling, bruising, inflammation, and infection may occur, they are relatively uncommon and almost never serious. Nevertheless, men who develop these symptoms at any time should inform their doctor.

When Can a Man Have Sex Again After a Vasectomy?

You can resume sexual activity within a few days after a vasectomy, but birth control should be used until a test shows that your semen is free of sperm. Generally, this test is performed after you have had 10-20 post-vasectomy ejaculations. If sperm are still present in the semen, you will be asked to return at a later date for a repeat test. Once sperm are absent from the ejaculate, other forms of contraception may be discontinued. The chance of pregnancy, however, is not zero. Due to a process known as spontaneous recanalization (tubes rejoining), pregnancies may occur after vasectomy, although this is very rare.

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What Are the Disadvantages of a Vasectomy?

The chief disadvantage of a vasectomy is its permanence, although this is also considered the chief advantage. The procedure itself is simple, but reversing it is difficult, expensive, and can be unsuccessful. But, it is possible to store semen in a sperm bank to preserve the possibility of producing a pregnancy at some future date. However, doing this is costly, and the sperm in stored semen do not always remain viable (able to cause pregnancy).

For all of these reasons, doctors advise that a vasectomy be undertaken only by men who are prepared to accept the fact that they will no longer be able to father a child. The decision should be considered along with other contraceptive options and discussed with a professional counselor. Men who are married or in a serious relationship should also discuss the issue with their partners.

Although it is extremely effective for preventing pregnancy, a vasectomy does not offer protection against AIDS or other STDs. Consequently, it is important that vasectomized men continue to use condoms, preferably latex, which offer considerable protection against the spread of disease.

Another disadvantage is the immune reactions to sperm that some men develop after a vasectomy, although current evidence indicates that these reactions do not cause any harm.

 

Does a Vasectomy Affect Sexuality?

No. A vasectomy does not affect the production or release of testosterone, the male hormone responsible for a man's sex drive, beard, deep voice, and other masculine traits. The operation also has no effect on sexuality. Erections, climaxes, and the amount of ejaculate remain the same.

Occasionally, a man may experience sexual difficulties after a vasectomy, but these almost always have an emotional basis and usually can be alleviated with counseling. More often, men who have undergone the procedure, and their partners, find that sex is more spontaneous and enjoyable once they are freed from concerns about accidental pregnancy.

Does a Vasectomy Increase a Man's Risk of Prostate Cancer?

Some research studies have led to questions about the link between vasectomies and prostate cancer. The most current research shows that a vasectomy does not increase a man's risk of developing prostate cancer and that this concern should not be a reason to avoid having one.

 

 

WebMD Medical Reference Reviewed by Traci C. Johnson, MD on December 8/, 016

Sources

SOURCES:
The American Cancer Society. Vasectomy.com. Essure. Feminist Women's Health Center.

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