Sterilization for Women

Brand Names

Adiana and Essure

What it is

Sterilization is a form of birth control for women, designed to be permanent. Choosing to be sterilized is decision that should be made with careful consideration. It is not a choice to make in haste.

Once a medical professional has ensured that sterilization is the best option for you, they can complete the procedure in one of several ways. One course is to tie or cut the fallopian tubes. This method is called tubal ligation but is commonly referred to as “getting your tubes tied.” The tubes can be sealed with an instrument utilizing an electric current. They can additionally be closed with clamps, clips or rings. By sealing off or blocking the fallopian tubes, the egg cannot make its way to the uterus during ovulation and sperm cannot pass through the tubes to reach and fertilize the egg. All of these options are known as incision methods, because they require the healthcare provider to make an incision site to access the fallopian tubes.

Another method is to put tiny inserts into the tubes – a non-incision method. Tissue will then grow around the inserts and block the tubes. This method has two brands of insert: Essure and Adiana.

How it Works

The incision method, also called Laparoscopy, begins with your healthcare professional giving you a general, regional or local anesthesia. Next your abdomen will be inflated with an injection of harmless gas so the doctor can see your organs clearly. A small cut is made near your navel so a laparoscope can be inserted to locate the fallopian tubes. Usually through a second small opening, your healthcare provider may insert an instrument to close the tubes. In some instances, only one incision is needed.

A mini-laparotomy is also a common form of sterilization. This method is commonly performed after childbirth. No gas or laparoscope is necessary. A small incision is made just above the pubic hair or just below the navel. Through this, the healthcare professional locates the tubes and ties, clips or uses a probe with an electrical current to block them off.

During the insert procedure of Adiana or Essure, your cervix will be numbed by a local anesthesia, and you may be given another medication to reduce discomfort. A hysteroscope is inserted into the vagina and through the cervix. Heat is applied to each fallopian tube and then two inserts, each the size of a grain of rice, are placed in the heated spots. For those who choose the insert method, another form of birth control must be used for the first three months until it is shown that Adiana or Essure have worked.

Effectiveness

• Tubal ligation is 99% effective at preventing pregnancies for the first year. With passing years the effectiveness can be diminished, as the fallopian tubes can sometimes reform or reconnect.
• Essure is 99.7% effective at pregnancy prevention.
• Adiana it is about 98% effective at pregnancy prevention.

Cost

The national average cost of sterilization ranges from $1,500 to $6000.

Benefits

The main benefit of sterilization is that life-long birth control can be provided with one simple procedure. For many women and men, sexual pleasure is elevated, because they no longer have to worry about unwanted pregnancies occurring.

Sterilization does not affect a woman’s hormones. The hormones still flow through the body normally after sterilization, and most women who have had the procedure will continue to have regular periods.

Sterilization is beneficial to women

• who don’t want to have a biological child in the future
• whose health would be threatened by a future pregnancy
• who don’t want to pass on hereditary illness or disability
• who agree with their partner that sterilization for her is better than a vasectomy for him or
• for whom other methods are unacceptable.

Among the kinds of sterilization, there can be additional benefits and risks for each method. The advantages of Adiana and Essure include the simplicity of the procedure – no incision, no general anesthesia or surgical setting is necessary – and a quicker recovery.

Risks

A big risk of sterilizations is its permanency. You must be sure this is the best choice for you for the rest of your life, because it can be irreversible.

Sterilization does not protect against sexually transmitted infections (STIs) or HIV (AIDS).

Among the kinds of sterilization, there can be different benefits and risks for each method. Risks for the incision methods include

• Bleeding
• Infection (rare)
• Reaction to anesthetic

Complications develop in approximately 1-4% of women who are sterilized via the tubal ligation method.

The insert method (including brands Essure and Adiana) can lead to

• One or both of the inserts being placed incorrectly. This can lead to a second procedure.
• Inserts moving out of place.
• Tubes not being completely blocked after three months. This can lead to a second procedure.
• In rare cases, the uterus can become injured during the insertion. This could require surgery to remedy.

Additional rare complications can include changes in the menstrual cycle, infection, too much fluid build-up in the woman’s bloodstream, and pelvic or back pain.