Permanent Birth Control

Sterilization is a hormone-free method, so it is considered safe for people with a history of breast cancer. It does not increase the risk of breast cancer coming back or of developing a new breast cancer. This is true regardless of the breast cancer type, stage, or hormone receptor status.

There are two types of permanent birth control:

1. Tubal surgery “getting your tubes tied” (for people with a uterus/ovaries)
2. Vasectomy (for people with testes)

Both tubal surgery and vasectomy are over 99% effective. This means fewer than 1 in 100 people will get pregnant in a year.

Note: You should feel sure that you never want to get pregnant or have biological children in the future. Tubal ligation and vasectomy should be considered permanent decisions since they can be very hard to "undo" or "reverse." Reversal surgery is tricky to do and not guaranteed to work.

You really don't need to use another birth control method because tubal ligation works so well to prevent pregnancy. Condoms are a great choice if you also want protection from HIV and sexually transmitted infections (STIs).

Tubal surgery: The fallopian tubes are the “highways” that connect your uterus and your ovaries where the eggs are stored. During a tubal surgery, the fallopian tubes are cut or removed so that any released eggs cannot travel from the ovary to the uterus, and therefore, cannot join with sperm (fertilize).

Vasectomy: The vas deferens are the tubes that carry semen with sperm (cum) from the testicles to the urethra (opening in the penis). During the vasectomy, the vas deferens are cut. It will take about three months for that area to scar and block any sperm from getting through.

Vasectomy does not affect sexual function or ejaculation (cumming). Semen will still get released during ejaculation, but there will not be any sperm in it.

Tubal surgery:

You do not have to do anything after getting tubal surgery. It works right away to prevent pregnancy.

Depending on your situation, you may get “twilight sleep” or general anesthesia. There is very little scarring. You should be able to return to normal activities in a few days.

Vasectomy:

Vasectomy does not work right away. It can take a few months for the sperm to “clear” out after vasectomy. Your health care provider will check your partner’s semen to make sure the sperm are gone. Until then, you should use back-up birth control.

Vasectomy is a quick procedure that can be done in the clinic or hospital. Often, this is a “no-scalpel” same-day procedure without any cuts made. For pain control, most people get numbing medicine injected under the testes skin. Others may get “twilight sleep” or general anesthesia.

Tubal surgery that only cuts or removes the tubes (and not the ovaries) should not affect your period patterns.

In special circumstances when both tubes and both ovaries are removed, your hormone levels will drop quickly. This is also called “surgical menopause” because your periods will stop and you can no longer get pregnant.

Tubal ligation is a permanent form of birth control. After the procedure, you do not need to think about birth control.

Tubal surgery and vasectomy are safe options if you are breastfeeding or chestfeeding or cannot take hormones.

You could have swelling, pain, or discomfort right after the procedure/surgery. Other uncommon or rare risks are infection or bleeding. Very rarely, the tubes rejoin (fallopian tubes or vas deferens) and pregnancy happens.

Because tubal ligation is permanent, it should be a well-thought-out decision. People who get tubal ligation at a younger age may be more likely to regret their decision.

Tubal ligation is safe. In fact, pregnancy has a higher risk of health problems than tubal ligation.

Because tubal ligation requires surgery, there are risks including pain, bleeding, damage to organs during surgery, or infection.

No. However, correct use of condoms can prevent HIV and STIs.

If you have health insurance, including Medicaid, the procedure may be covered at low cost to you. If you pay out of pocket, the cost can be quite high.