HEALTH & WELLNESS
Tubal Ligation: The Most Extreme Form of Birth Control
Known by medical and colloquial names like female vasectomy and getting tubes tied, tubal ligation is a form of female birth control. Unlike most types of contraceptive strategies, this method is intended to be a permanent form of birth control.
Simply put, ligation refers to the tying up of tubes, specifically the Fallopian tubes, to prevent the descent of fertilized eggs from implanting into the uterus, resulting in pregnancy. To be clear, tubal ligation is not a hysterectomy, wherein the ovaries, Fallopian tubes and uterus are removed.
Since your ovaries are still present, you will still continue to menstruate regularly. In most cases, the intensity of a period isn’t more or less severe.
Why Do Women Get Tubal Ligation Done?
While it may seem like a drastic and expensive solution to an easy to address the problem, there are many reasons why women may invest in tubal ligation.
When it comes to women who are certain that they do not want to get pregnant, this method is ideal. Ligation is meant to be permanent and is highly effective at preventing pregnancy.
Similarly, this method is excellent for couples who are in a committed relationship, want to forego traditional birth control and determine that they do want to engage in a sexual relationship, but don’t want to have children.
Alternatively, tubal ligation is a good procedure to consider if you know or suspect that pregnancy may pose a severe threat to your health. Women who may want to use a donor egg, but don’t want to risk getting pregnant with their own eggs due to the risk of passing on a genetic disorder, tubal ligation is an ideal option.
Lastly, tubal ligation has been used as an ideal birth control method. However, with more reversible options, which have also become cheaper, rates of tubal ligation have declined in some regions.
How Is the Procedure Performed?
There are over half a dozen types of tubal ligation techniques, but are generally minimally invasive and don’t require extensive puncturing of the skin. Examples of specific methods include:
Bipolar coagulation – This is the most common technique used and it is done with an electric current to seal the Fallopian tubes.
Monopolar coagulation – Similar to bipolar coagulation, this method cauterizes the tubes, but also damages the tubes further from the seal site, even cutting off the tubes entirely.
Tubal clip or ring – This method involves the sealing the tubes with a clip or ring. When using the former tool, eggs are prevented from descending into the uterus. The tubal ring technique involves doubling the Fallopian tubes.
Fimbriectomy – In this method, the surgeon removes part of the Fallopian tube, thus preventing the transfer of eggs to the uterus.
Pomeroy tubal ligation – Similar to the clip or ring method, in this technique, a surgeon twists a tube using a suture. Once sutured the tube is cut and cauterized.
Irving’s procedure – A surgeon sutures two sections of each Fallopian tubes and the section in the middle is removed. The new “ends” of the tubes are then connected to the uterus.
Can This Procedure Be Reversed?
While vasectomies are intended to be permanent it is possible to restore fertility. Through microsurgery, a surgeon can repair the Fallopian tube with the specific method varying depending on the procedure used.
Since there are several types of female sterilization and restorative techniques, the success rate of reversals varies greatly. Other factors which influence the efficacy of tubal litigation reversal are the experience of the surgeon, time between vasectomy and the reversal and the woman’s age, among others.
Alternatively, if eggs were preserved, fertilized prior to the procedure, or an egg donor is used, in vitro fertilization can be used to induce pregnancy.
Tubal Ligation Side Effects
Keep in mind, female vasectomies are a minimally invasive procedure, but like every other kind of surgery, does bear some risks and side effects.
During surgery, there is a risk of surrounding tissues and organs being damaged. Although your anesthesiologist should know your metabolism, so the risks are mitigated, some individuals do have varying reactions to anesthesia. Reactions can include difficulty fighting off pneumonia or development of heart problems.
Though this shouldn’t be an issue with most surgeons, there are instances of incomplete or failed tubal closure, which may lead to other complications, including pregnancy. It is worth noting that, if a woman does become pregnant after getting their tubes tied, there is an increased risk of ectopic pregnancy occurring.
After surgery, internal bleeding or infection may develop if there were surgical complications. However, ligation does not affect the endocrine system and consequently the release of your hormones.
Some women in their twenties who have a history of menstrual dysfunction are susceptible to developing complications, though older women and individuals with normal menstrual cycles are not. However, most research indicates that the physical side effects of tubal ligation are mild in most individuals.
Rarely, some women may develop feelings of regret. As previously mentioned, tubal ligation can be reversed.
As your recovery continues, you will menstruate as usual. Once you are fully healed, you should be able to resume having sex normally and, barring any surgical complications, shouldn’t give you any future problems being intimate. In fact, some women report that their sex lives actually improve after getting their tubes tied since they no longer have to stress over becoming pregnant.
Tubal Ligation Effectiveness
Since ligation physically severs the Fallopian tubes and prevents eggs from entering the uterus, this method is one of the most effective forms of birth control. Although there are rare and curious exceptions, tubal ligation prevents pregnancy for life in nearly all cases.