Female Sterilisation

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What is sterilisation?

Sterilisation is a permanent method of contraception. For women this is done by blocking the Fallopian tubes so that the sperm cannot reach the egg and begin a pregnancy. There are two main methods of female sterilisation. They are tubal ligation and Essure.

If you are absolutely certain that you do not want children in future, sterilisation is an excellent option. It’s important to make sure that you are certain before making such a big decision.

If you are considering sterilisation, ask yourself:

  • Why do you want sterilisation?
  • How does your partner feel?
  • If your current relationship ended, would your feelings change?
  • How would you feel if something happened to the children you have now?

You can discuss which method is most suitable for you with your general practitioner or a SHine SA doctor, and you will need a referral to a specialist.

If you want the Essure sterilisation you will need to see a specialist trained in this procedure. SHine SA has a list of these specialists.

Periods and menopause are not affected by tubal ligation or Essure. It also has no direct effect on sexual intercourse or sexual desire.

What is the procedure for tubal ligation?

You will need a general anaesthetic for this operation. Two 1 cm cuts are made in the abdomen, one below the navel and the other to the side. For a laparoscopy, a small telescope is inserted to find the Fallopian tubes. The tubes are then closed off by clips or rings. For most women this operation is performed as day surgery, although rest is needed the next day.

Sometimes an operation called a laparotomy may be done. A single longer cut is made above the pubic hair line. The Fallopian tubes are then closed off. This operation usually requires a 1 or 2-day stay in hospital.

How soon is the operation effective?

The operation is effective immediately after the procedure, but contraception should be used right up to the time of the operation.

How effective is it?

Tubal ligation is very effective (99.5%). If a pregnancy does occur there is an increased chance of ectopic pregnancy (a pregnancy forming within the Fallopian tube instead of the uterus).

What are the side effects?

The general anaesthetic can cause nausea or tiredness and the operation may cause some abdominal or shoulder pain. Painkillers can help but the pain can last for a couple of days. As with any operation, complications such as infection can occur, but they are uncommon.

After a laparoscopy you can return to work after 1-2 days and you can have sexual intercourse 2-3 days after the operation if you feel ready. If you have had a laparotomy you may take longer to return to normal.

How much does tubal ligation cost?

There is no charge in public hospitals. Private hospitals charge a fee for hospital stay, surgery and anaesthetic. Most health funds cover these fees, but there may be a gap to pay.

Can tubal ligation be reversed?

It is sometimes possible to restore the Fallopian tubes but it involves complex surgery and is not always successful. It is really important to think of sterilisation as permanent.

 

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What is the procedure for Essure?

This is a method of sterilisation which involves putting a fine wire coil into the Fallopian tubes.

The small coils are inserted while the woman is awake. Local anaesthetic is used to numb the cervix and a hysteroscope (a fine flexible telescope) carrying the coil is put through the cervix. The coil is then directed towards the entrance of the Fallopian tubes and inserted into the tube.

As the hysteroscope is withdrawn the coil is lodged in the tube. Over the next 2 to 3 months the tube closes around the coil, blocking the Fallopian tubes permanently.

How soon is the operation effective?

Essure is effective 3 months after the operation. Contraception should be used until then.

How effective is it?

The operation is very effective (98.5%) and is checked with a special x-ray at 3 months.

What are the side effects of Essure?

Some minor menstrual cramps may be experienced.

How much does Essure cost?

There is no charge in public hospitals. However, it is not available in all public hospitals. Private health funds cover the device and insertion, but there may be a gap to pay.

Can Essure be reversed?

This procedure cannot be reversed. Removing the coils destroys the tubes.

 

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