Female sterilization is one of the safest methods of contraception. It is even safer than taking the birth control pill. However, the procedure should be well considered, as it is difficult to reverse. In addition, the operation, which takes place under general anesthesia, can cause side effects such as injury to the peritoneal ligaments. In general, the procedure is much more complicated than male sterilization – which has almost no risks. Learn more about the procedure, risks and costs of female sterilization here.
Artificial infertility
Sterilization is a procedure through which artificial infertility is created. Thus, the surgery is considered a method of contraception. A female sterilization is also called tubal sterilization. In men, on the other hand, it is called a vasectomy. In women, ovulation continues to occur as usual after sterilization. However, the egg no longer travels through the fallopian tube towards the uterus, but into the abdominal cavity. There it is broken down by the body. Sterilization is considered a very safe method of contraception. Statistically, only 1 in 1,000 women becomes pregnant after the procedure (Pearl index: 0.1). This makes the method even safer than contraception using the birth control pill. The latter has a Pearl index of 0.1 to 0.9. Hormone production, menstrual cycle and sex drive are not affected by a successful procedure. Some women even feel significantly more desire for sex after the surgery because they no longer fear an unwanted pregnancy. Others, however, suffer from the fact of being infertile. Therefore, it is definitely important to take enough time for the decision.
Procedure of sterilization
Female sterilization, unlike male vasectomy, is performed under general anesthesia and takes about 60 minutes. Thus, this procedure also involves the typical risks of general anesthesia, such as disturbances of the cardiovascular system, respiratory problems, hoarseness and sore throat, as well as nausea and vomiting. The surgery can be performed either as an outpatient or inpatient procedure. The procedure is often performed by means of an abdominal endoscopy, and less frequently by means of an abdominal incision. In the sterilization itself, different methods are also distinguished. In most cases, the fallopian tubes are closed by a plastic or metal clamp (clip method) or sclerosed by heat (thermocoagulation). In some cases, a section of the fallopian tubes is also cut. A relatively new procedure is the Essure method, which does not require general anesthesia or surgery. In this procedure, soft microcoils are inserted into the fallopian tubes during a uterine endoscopy. The coils stimulate the growth of connective tissue, which can lead to a blockage of the fallopian tubes after three months at the earliest. Whether there is already safe contraceptive protection can be determined by an X-ray examination.
Female sterilization: side effects and complications.
While male sterilization has few risks and few side effects, women may experience significantly more complications – including the following:
- Heavier, irregular periods
- Ectopic pregnancies
- Damage to the peritoneal ligaments
If damage to the peritoneal ligaments occurs, this may result in an undersupply of the ovaries. This, in turn, may cause premature onset of menopause.
Reversing sterilization
Every woman should think carefully about whether or not she really wants to undergo sterilization. This is because the procedure is very difficult – much more difficult than for men – to reverse. Since sterilization is also associated with more risks in women, the procedure should only be performed if it is really necessary and makes sense. In general, it is easier to reverse sterilization with certain methods than with others. For this reason, it is essential to seek advice on this subject from your attending physician before undergoing the operation. During the operation – called refertilization – the scarred areas on the ovaries are removed and the ends are then sewn together again. Since this requires a lot of experience, the surgery is only offered by specialized doctors.
Refertilization not always successful
Even if refertilization is successful, the likelihood of becoming pregnant is lower than before sterilization. Depending on the method used, between 30 and 75 percent of affected women become pregnant again. However, the risk of ectopic pregnancy is increased after the procedure. If there is a desire to have a child despite sterilization, artificial insemination is sometimes preferred instead of refertilization. Because of the far-reaching consequences, many doctors do not advise childless women to undergo sterilization until after the age of 35. This is because in younger women, the desire to have children may change again after the age of 30. Statistics show that many women who undergo sterilization at a very young age later regret this decision.
Does health insurance cover the cost?
Today, the cost of female sterilization is usually not covered by health insurance. This is especially true if the procedure is performed only because of personal life planning. Exceptions to this rule are tubal sterilizations that are medically necessary. In this case, the costs are covered by the health insurance. Private insurance companies also usually only cover the costs if the procedure is performed for health reasons. The cost of a sterilization is between 600 and 1,500 euros. Medical reasons can be, for example, if the birth of a child would be too dangerous for the woman because of her physique. Other health reasons, such as dangerous hereditary diseases due to which women should not have children, are also accepted.
