Female Sterilisation

Female sterilisation is a long-term form of contraception that involves an operation to surgically alter the fallopian tubes to prevent future pregnancy. As it doesn’t require any ‘topping-up’ the way some other forms of contraception do, it can sometimes be referred to as a permanent method of contraception. In reality, female sterilisation can be reversed, but it can be very difficult to do so.


How female sterilisation works

During ovulation, an egg is released from the ovary. As it travels through the fallopian tubes to reach the womb, it may be fertilised by sperm and progress into pregnancy. Alternatively, the unfertilised egg will be discarded along with the shredded uterus lining in a period.

Female sterilisation prevents pregnancy by blocking the fallopian tubes so eggs cannot enter the womb. Eggs will still be released by the ovaries, but they will be naturally absorbed into the body. As the sperm cannot reach the egg, it cannot be fertilised, and so pregnancy is prevented.

Sterilisation for women does not affect the menstrual cycle, and will not prevent you from getting periods. The operation can be carried out at any stage in your cycle. You’ll need to continue using contraception until your first period after the surgery.


How is female sterilisation carried out?

The blocking of the fallopian tubes is referred to medically as ‘tubal occlusion’. There are three ways in which this can be done:

  • Tying, cutting or removing a section of the fallopian tube
  • Clamping the tube with a small ring
  • Applying titanium or plastic clips to the tubes to act as clamps

Whichever method is used, the operation is simple and you should be able to go home the same day. The procedure involves a small incision made between your belly button and pubic hairline (laparoscopy). This is so that a camera can be inserted to help the surgeon see your fallopian tubes. Then the tubal occlusion will be carried out, leaving minimal external scarring.

If the above procedure isn’t successful, doctors may recommend the total removal of the fallopian tubes. This is known as salpingectomy and is a more complex operation. If this method is needed, your medical team will advise you on the associated risks and procedures.

Before the operation, you’ll be given a pregnancy test. This is to negate the risk of an undiscovered pregnancy becoming ectopic as a result of the surgery.


Who can have female sterilisation? 

Sterilisation for women is available for almost any woman who wants it. However, there are procedures you’ll have to go through before you can have the operation. This is because sterilisation is difficult to reverse. You need to be sure it’s what you want as it may not be possible to go back on the decision you make at this stage.

This may include counselling, during which you and your partner (if applicable) can discuss any worries you may have and ask questions about the procedure and aftermath. It’s best if you can come to an agreement about having female sterilisation, but legally you do not need your partner’s permission to have the operation done. However, your GP can refuse to refer you to a specialist to have the procedure carried out if they feel it isn’t in your best interests.


How effective is female sterilisation? 

Female sterilisation is believed to be over 99% effective at preventing pregnancy. As it doesn’t require the individual to remember to do something like taking a pill or applying a patch, the effectiveness of the method can’t be affected by the individual not using the contraceptive correctly or forgetting to use it.

However, the operation isn’t always successful. Although it’s rare, there is a possibility that the fallopian tubes may heal and become functional again. This can happen immediately after the operation, or it may occur years later. In the event of a failed operation, you may be at an increased risk of a fertilised egg implanting outside of the womb (ectopic pregnancy).

Additionally, female sterilisation has no effectiveness when it comes to protection from sexually transmitted infections (STIs). In order to prevent infections such as these, you’ll need to use a barrier method of contraception that protects against STIs, such as condoms.


Advantages and disadvantages of female sterilisation 

Female sterilisation is a long-term method of contraception - but unlike other long-term methods such as the intrauterine device (IUD) or intrauterine system (IUS), reversing female sterilisation is difficult. For this reason, it’s advised that you don’t enter into female sterilisation without considerable forethought. Additionally, female sterilisation reversal operations aren’t usually funded by the NHS, so you would likely need to seek private services.

Like most other surgical procedures, female sterilisation carries a small risk of complications such as internal bleeding, damage to other tissue within the body and infection. However, this is a very small risk, and your medical team should advise you on symptoms to look out for so you can be treated quickly if you do experience complications.

In addition to the main advantage of not having to remember to use contraception to avoid pregnancy, female sterilisation can also be beneficial for women who cannot use hormonal contraception. Female sterilisation shouldn’t affect your hormone levels or sex drive and doesn’t interfere with sex in the way that certain other types of contraception might. However, it cannot protect you against STIs.


Where to get more information about female sterilisation

You can get information about female sterilisation, including places near you where you could have the operation done, from a range of places, including:

  • Contraceptive clinics
  • Some young people’s services
  • Genitourinary medicine (GUM) or sexual health focused clinics
  • GP surgeries