Permanent Birth Control Options: What You Need to Know

Whether you’ve decided that parenthood just isn’t for you, or you already have all the little ones you want, surgical birth control options are for those who need something that will permanently prevent them from getting pregnant. Read on to learn more.

Vasectomy. “This is the only surgical birth control method out there for guys, and unfortunately, it’s often overlooked by gynecologists when talking to patients about their options,” says Kelly Kasper, MD, an obstetrician/gynecologist at Indiana University Health. “I counsel my patients on vasectomies because it is by far the safest form of surgical birth control and is extremely effective.”

How it works: This in-office procedure takes just a few minutes, uses local anesthesia, and is typically done by an urologist or general surgeon. It involves snipping and closing off the tubes that carry sperm from the testicles to the urethra so that the man’s ejaculate can’t fertilize an egg. “Many men may be afraid they won’t be able to get erections afterwards, but I’ve never heard of that happening,” says Dr. Kasper. Couples should use backup birth control methods until the man has about 20 ejaculations and gets a negative semen analysis, usually done after about 12 weeks.

Tubal litigation. “The most common form of surgical birth control for women is post-partum tubal ligations, often called tubals,” says Dr. Kasper. “This is for women who are absolutely certain they don’t want any more children because it is not meant to be reversible. Even though it’s a low-risk procedure, as with any surgery there still are risks, including risks to anesthesia or perforating blood vessels.” Tubals are highly effective, with only a one in 300 failure rate.

How it works: Tubal litigation can be done by your gynecologist as an in-office procedure that may take about 30 minutes and require general anesthesia. A small incision is made in the abdomen to give access to a scope that helps the doctor see your Fallopian tubes. The tubes are then blocked so an egg can’t be released and fertilized by a sperm.

Hysteroscopic tubal sterilization. “For women who aren’t great candidates for surgeries on their bellies, another permanent birth control option is a hysteroscopic tubal that we do in-office and that takes about 30 minutes,” says Dr. Kasper.  

How it works: It’s not technically surgery because a tiny camera is inserted into the vagina to help guide metal coils, which Dr. Kasper says are kind of like miniature Slinkies, to be placed inside the Fallopian tubes. In time, scar tissue forms over these implants to block eggs from being released so they can’t be fertilized. Also an extremely effective birth control solution, the downside is that you have to use backup birth control for three months while the scar tissue fully forms, and it increases your risk of ectopic pregnancy. You’ll have to go back to your doctor for a hysterosalpingogram (HSG), which is a test that uses dye to show that the Fallopian tubes are fully blocked.

Consider all of your options. “These procedures are not meant to be reversed, so if you’re not 110-percent certain that you don’t want to become pregnant ever again, don’t discount other long-lasting forms of contraception that are very safe and effective,” says Dr. Kasper.

Intrauterine devices, or IUDs, are non-surgical, reliable, and reversible options that you don’t have to think about because many last up to 10 years. IUDs are small devices that the doctor inserts into the uterus through your vagina to block eggs from being released from the Fallopian tubes. Some types of IUDs, such as ParaGard, are hormone free and may result in heavier periods, while others, such as the new Mirena, release small amounts of the hormone progestin, which may have the added benefit of lighter periods for many women. IUDs have a more than 99 percent effectiveness rate.

-- By Holly Corbett

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