Sterilization

Sterilization

An image of a cord tied in a knot

Sterilization is permanent birth control. It’s one of the most effective kinds of birth control available, but it’s also the biggest commitment. Sterilization is for people who are sure they will never want to get pregnant or get someone else pregnant. There are sterilization procedures both for people with a uterus, ovaries, and fallopian tubes (this procedure is called tubal ligation) and for people with testicles and a penis (this procedure is called vasectomy). Neither of these types of sterilization affects sexual pleasure or performance, and you can still orgasm after sterilization.

Types of Sterilizations

Incision

For women, Laparoscopy, Mini-laparotomy, and Laparotomy are sterilization procedures that require an incision. Because these methods are surgical, they involve anesthesia. Recovery times vary from 1-2 days to a few weeks.

For men, an incision-based vasectomy takes about 20 minutes. It requires a shot of local anesthetic, then a doctor makes one or two incisions to the scrotum and blocks the tubes so sperm are kept out of his seminal fluid. No sperm, no pregnancy.

Non-incision

Essure was a procedure for women that did not involve surgery or anesthesia. The fallopian tubes were reached through the vagina, and micro-inserts were placed there. These inserts caused scar tissue to grow that blocked the tubes. Recovery for this procedure was “same-day” and wasn’t expected to impact normal activities, but it took several months for the scar tissue to form and make this method effective. Essure was no longer sold after the end of 2018.

The no-scalpel vasectomy method for men involves a tiny puncture that reaches his tubes, where they are then tied off, cauterized, or blocked. There’s no scarring, no stitches, and this procedure is known for healing quite fast without complications.

Details
Sterilization is permanent birth control. It’s one of the most effective kinds of birth control available, but it’s also the biggest commitment. Sterilization is for people who are sure they will never want to get pregnant or get someone else pregnant. There are sterilization procedures both for people with a uterus, ovaries, and fallopian tubes (this procedure is called tubal ligation) and for people with testicles and a penis (this procedure is called vasectomy). Neither of these types of sterilization affects sexual pleasure or performance, and you can still orgasm after sterilization.
Thanks to the Affordable Care Act, if you have health insurance, [chances are good that you’ll be able to get this method with no out-of-pocket cost](http://bedsider.org/features/257). ####Prices: * **This method may be [free or low-cost for you](http://bedsider.org/free_birth_control)** * **With Medicaid:** Free * **With insurance:** [Free for women under most plans](http://bedsider.org/features/257). For men seeking a vasectomy, there may be a co-pay or you may have to pay a percentage of the cost of the procedure. * **Without insurance:** At full price, sterilization for women can cost anywhere from $500 - $5,000; a vasectomy can cost as much as $1,000. (But once it's done, you never have to pay for birth control again.) Depending on your income, you may be able to go to [a low-cost clinic](http://bedsider.org/free_birth_control) to get a sterilization procedure at reduced cost. * **Payment assistance:** Some hospitals and health centers may offer assistance to women who don’t earn a lot of money but make too much to qualify for Medicaid. Contact the women’s health departments at nearby hospitals or your local Planned Parenthood health center to find out if assistance is available. You can also ask about Title X funding, Medicaid waivers, or other programs that could reduce the cost of sterilization.

There are three sterilization methods available today: Laparoscopy, Mini-laparotomy, and Laparotomy. Laparotomy is the most major surgery of the three, but it’s also the least common. It requires a hospital stay for a couple of days and the recovery time can take weeks. Laparoscopy and Mini-Laparotomy are less intense, don't necessarily involve overnight hospitalization, and recovery time is faster. Sterilization is effective immediately.

There are positive and negative things to say about each and every method. And everyone's different—so what you experience may not be the same as what your friend experiences.

The Positive

* Have all the sex you want without ever worrying about pregnancy * Do it once, and never have to think about it again * No hormones introduced into your body

The Negative

* A very rare risk that your tubes may reconnect themselves—which could lead to a pregnancy * Possible complications with surgery, like bleeding, infection or a reaction to anesthesia
Do you have questions about Sterilization? Visit Bedsider.org for answers to many of the most popular questions about this method of birth control.