Pros and Cons of Permanent Birth Control: What Are Your Options?

pros and cons of permanent birth control

As a former OB/GYN nurse and Health Educator, one of my jobs was to counsel women on their options for birth control. When women are confident that they’ve completed their families, many inquire about their permanent birth control options and whether or not they should opt for one. We’re going to analyze the four available options for permanent birth control, including the pros and cons for each. Here are some questions to ask yourself when deciding if one of these methods is right for you:

  • Am I done having children?
  • Am I happy with the current birth control method that I’m using?
  • How does my partner feel?
  • Is there a chance I’d want children in the future under different circumstances?
  • Am I comfortable using hormonal birth control methods instead?

When it comes to permanent birth control methods, there are three options for women — tubal ligation, salpingectomy, and fallopian tube occlusion. There is also the option for men to have a vasectomy, which is a procedure that prevents the release of sperm.

Let’s delve a little deeper and learn more about each method. Here are the pros and cons of permanent birth control: 

Method 1: Tubal Ligation

What Is It? 

Also known as “getting your tubes tied,” a tubal ligation is a surgical procedure where the fallopian tubes are blocked or cut. The procedure is usually completed in a hospital or outpatient surgical center, with either general or spinal anesthesia. 

Is It Reversible?

It can be, but according to John Hopkins School of Medicine, “only about 50-80% of women are able to become pregnant after having their fallopian tubes reattached.” A tubal ligation should be treated as a permanent birth control method.

Pros:

  • Sex without the fear of conception (it’s a pretty slim chance when done correctly!)
  • No need for long-term birth control methods such as an IUD 
  • You’re protected from pregnancy without synthetic hormones found in many birth control methods 

Cons:

  • Not easily reversible — if you change your mind, there is often no going back
  • One out of every 200 women might become pregnant after a tubal, with an increased risk of ectopic pregnancy
  • Potential risks such as bleeding or infection from the procedure 
  • Often painful recovery for the patient 

Method 2: Salpingectomy

What Is It? 

A saplingectomy refers to the surgical removal of the fallopian tube — it’s similar to a tubal ligation in both the procedure and recovery. It is often completed as an alternative to a tubal ligation in order to reduce the risk of ovarian cancer, since a lot of ovarian cancer originates in the fallopian tubes. A saplingectomy can be a full or partial removal of the tubes. 

Is It Reversible?

No, it is not. 

Pros:

  • May decrease your risk of ovarian cancer
  • No hormonal side effects

Cons:

  • Fairly new procedure for sterilization, all long-term side effects are not yet known
  • Risks (though rare) similar to tubal ligation, such as bleeding and infection 

Method 3: Surgical or Nonsurgical Birth Control — Essure Fallopian Tube Occlusion

What Is It?

There are three types of fallopian tube blockages — proximal (near the uterus), medial (in the middle of the tube), and distal (at the end of the tube). Essure is an example of a fallopian tube occlusion, where a flexible insert is placed into each fallopian tube. Over the next three or so months, a barrier forms around the inserts. This scar tissue keeps the sperm from reaching the egg so that pregnancy does not occur. Though Essure can sometimes be performed in an outpatient setting, it is usually done in the operating room under anesthesia. 

Is It Reversible?

It can very rarely be reversed by highly specialized doctors but should be considered a permanent birth control method. 

Pros:

  • It is sometimes a minimally invasive procedure, depending on whether or not it is done in the operating room 
  • No hormones 
  • Quick recovery — women report feeling “back to normal” within 24 hours
  • Over 99% effective at preventing pregnancy 

Cons:

  • Possible side effects from the procedure, such as infection, bleeding, blood clots, or damage to nearby organs
  • Newer procedure, not as much data and studies showing long-term safety and effects 
  • Many women have reported detrimental long-term side effects such as chronic pelvic pain, painful menstruation, abdominal bloating, migraines, and fatigue from Essure 
  • You must follow up three months after the procedure for a hysterosalpingogram, which is an xray of the uterus, fallopian tubes, and surrounding area — these are often painful 

Method 4: Vasectomy 

What Is It?

A vasectomy is a simple outpatient procedure for a male where the vas deferens (the tube that carries the sperm) is cut and tied, thus preventing sperm from mixing with semen and being released upon ejaculation. The male testes do continue to make sperm even after a vasectomy, but the sperm die, disintegrate, and are absorbed by the body. 

Is It Reversible?

A vasectomy should be considered a form of permanent birth control, but it is often reversible. However, doing so requires a very specialized physician and can be very expensive. 

Pros:

  • Simpler and more effective than a tubal ligation
  • Fast recovery for the patient 
  • Can be performed as an outpatient procedure
  • Fewer complications than a tubal
  • More cost effective than other permanent birth control methods
  • No effect on male hormones or sexuality

Cons: 

  • Risk of minor complications such as sperm granuloma or congestion, which usually resolve by the body over time
  • Risk of pregnancy if sterilization is not properly achieved

 

The Bottom Line

Is permanent birth control right for you? The answer is that it depends. There are pros and cons to each of the four methods, and the only people who can make the right decision for your family are you and your partner. Make sure to seek the guidance of your OB/GYN to discuss the above factors, as well, and be sure to take your health history and family planning goals into consideration. 

 

, ,

No comments yet.

Leave a Reply