No more babies?
The 9 things you need to know before you sterilise.
 Female sterilisation is a permanent method of contraception for women. The procedure is permanent, immediate and irreversible. Sterilisation is only recommended for people who are sure they don't want to fall pregnant in the future. Sterilisation does not affect hormone production and will not cause early menopause. Becoming sterilised does not prevent sexually transmitted infections. After sterilisation a woman cannot become pregnant but can still enjoy a natural sex life.  The decision to be sterilised should not be made without discussing your options with your doctor.

1. What is female sterilisation?
Sterilisation is a simple procedure in which a surgeon blocks the fallopian tubes which carry the eggs from the ovaries to the uterus and is usually completed within twenty minutes. It is performed under conscious sedation where you will experience no pain during the procedure. No organs are removed, your ovaries carry on producing hormones and you continue menstruating. Your hormone production and libido should remain the same. Most women continue to have normal periods although 1 in 10 women find that their periods become heavier after sterilisation.

2. Who can be sterilised?
Other than already pregnant women, almost any woman can be sterilised - and every year thousands of women choose to be. However, surgeons are more willing to do it for women who are over 30 and who have had children.  The woman must meet certain medical criteria in terms of:
•    Weight
•    Blood pressure
•    Fibroids
•    Ovarian Cysts
•    Caesarians
•    Belly Fat, etc

3. What is done in the operation?
If you are certain of your decision, the operation itself is fairly simple. The Fallopian tubes (where the egg is fertilised by the sperm) are blocked by the surgeon in one of several ways, making egg transportation and fertilisation almost impossible.  Most sterilisation operations are conducted as day-cases. You will usually be sedated and the operation may well be done laparoscopically. (A few sterilisations are done under local anesthetic.)  A laparoscope is a thin metal 'camera' that is passed through a tiny incision in the tummy to let the surgeon see your tubes. An instrument is inserted through another small cut and this instrument places a clip or ring on each tube.  An operation where the Fallopian tubes are actually cut is less common these days. It is carried out through an incision in the abdomen or through the vagina.

4. Can sterilisation be reversed?
Yes. There is an operation to reverse sterilisation, but no one should opt to be sterilised believing it can be reversed, as the results of reversal are still not very good.

5. What happens after the procedure?

Most women have some discomfort and pain that lasts for a few days. If pain lasts longer than a few days, contact your health worker straight away. It is recommended to take a week off from work to rest.

6. What happens to the egg after sterilisation?
The ovaries still release eggs, but because the fallopian tubes are blocked, the eggs are absorbed by the body.

7. Does sterilisation work immediately?
Sterilisation of women works immediately, but it's important that you're not already pregnant when the op is done. An IUCD is sometimes left in the uterus till the next period in case a fertilised egg is already present in it.

8. What is the risk of pregnancy after sterilisation?
Sterilisation is highly effective and the failure rate is considered to be less than 1%. Please note that every now and then a woman who has been sterilised does get pregnant. The risk is estimated at one in several hundred women.

9. How do you go about getting sterilised?

You should contact your GP. Most good doctors will want to discuss this issue with you in depth, as it is something that should be considered very carefully. The doctor should tell you about the operation, and about the associated risks. Also, most important, he or she should make it clear that sterilisation is not quite 100% effective against pregnancy.

Information supplied by Marie Stopes.

What do you think about sterilisation as an option for contraception?

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