After the procedure, you will still have your periods and have sex normally. In fact, women may feel more at ease because they do not have to worry about unwanted pregnancy.
Getting Your Tubes Tied: Pros, Cons, What to Know
Tubal ligation — also known as having your tubes tied — is a kind of surgery that will keep you from ever getting pregnant. If you’re thinking about having it done, it’s important to understand the procedure and the advantages and disadvantages before making a decision.
“Tubal” refers to your fallopian tubes, and “ligation” means to tie off. Fallopian tubes are thin tubes that connect each of your ovaries to your uterus — they’re passageways for unfertilized eggs. In a tubal ligation, you’ll have surgery to cut or block your fallopian tubes. That way, the eggs released by your ovary each cycle can’t meet up and be fertilized by sperm.
The Pros of Tubal Ligation
It’s permanent. This is a big plus if you don’t want to have children or you don’t wish to have any more.
It works. Only about 1 in 200 of those who’ve had a tubal ligation get pregnant. That’s less than 1%.
It doesn’t affect your hormones. It won’t change your periods or bring on menopause. And it doesn’t cause the side effects that birth control pills can, like mood swings, weight gain, or headaches, or the ones sometimes caused by IUDs , like cramps, heavier periods, or spotting.
You don’t need to remember to do anything. You don’t have to put in a diaphragm, take a pill, use a condom, or count days on the calendar to avoid pregnancy. That may make you feel more relaxed about sex.
It may lower your chances of ovarian cancer. Scientists aren’t sure exactly why this happens, but research has shown that tubal ligation can greatly lower the odds of this type of cancer.
If pregnancy would be a health risk for you, or if you or your partner has a genetic disorder that would be risky to pass on to a child, tubal ligation may be right for you.
The Cons of Tubal Ligation
It’s permanent. While it can sometimes be reversed with surgery, that’s not always possible. Only around half of those who have a reversal are able to get pregnant. Unless you’re certain you’ll never want to get pregnant, tubal ligation isn’t right for you.
It doesn’t protect against STDs. You’ll need to use condoms to prevent sexually transmitted diseases, including HIV.
Pregnancy. It’s rare, but tubal ligation can fail. If your tubes aren’t completely closed, you can get pregnant.
It may lead to an ectopic pregnancy. If you do get pregnant, you’re more likely to have this type of pregnancy, which occurs someplace other than the uterus, usually in one of your fallopian tubes. Ectopic pregnancy may cause the tube to burst. This can lead to severe bleeding. You’ll need surgery right away to fix it.
There are risks to surgery. Problems are very rare, but this type of surgery can cause bleeding or damage your bowel, bladder, or major blood vessels.
After tubal ligation, you might have a rapid decline in the hormones estrogen and progesterone. Whether this may occur is often debated but it is referred to as post-tubal ligation syndrome (PTLS). Symptoms are a lot like menopause : hot flashes, night sweats, a dry vagina, mood swings, trouble sleeping, a lower sex drive, and irregular periods. Or you could have heavy, painful periods.
The cut made from your surgery can get infected, or you might react to the anesthesia. There’s also a small chance of lingering belly pain.
Your risk for these types of issues is higher if you’re overweight, have had surgery in the same area before, or have diabetes, lung disease, or pelvic inflammatory disease.
Burns to your bowel or skin are also possible if your surgeon uses electric current to seal off your fallopian tubes.
What Happens During Tubal Ligation?
You’ll get your tubal ligation in a hospital or at an outpatient surgical clinic. The doctor will give you medicine to make you “sleep” so you won’t feel anything during the surgery.
The surgeon will make one or two small cuts in your belly, then inflate it with gas. They’ll put a long, thin device called a laparoscope into one cut to look into your belly. They’ll put tools into the other to cut, seal, band, clamp, or tie your fallopian tubes shut.
Your surgeon will then stitch up the cuts on your belly. You can go home a few hours later to rest.
Tubal Ligation Recovery
Your incision sites (where you got the cuts) may be a little uncomfortable afterward. You might also have pain or cramps in your belly, fatigue, mild vaginal bleeding, dizziness, or a sore throat from the anesthesia.
If the surgeon used gas to inflate your abdomen to do the tubal ligation, you may have some bloating. It could cause belly or shoulder pain. This should go away in a couple of days.
Wait 48 hours after your tubal ligation to bathe or take a shower. Don’t rub or scrub your incision sites for at least a week. Pat your skin dry carefully after your bath or shower.
You should be able to get back to your normal routine a few days after your tubal ligation. But don’t lift anything heavy until your doctor says it’s safe to do so.
How Soon Can I Have Sex After a Tubal Ligation?
You should be able to have sex a week after your tubal ligation.
You don’t need to use a backup form of birth control after the procedure, but it won’t protect you from sexually transmitted diseases (STDs). Using a condom during sex will help prevent STDs.
Tubal Ligation Cost
The cost of your tubal ligation may vary based on where you live, your doctor, and your insurance coverage. Average costs range from $1,500 to $6,000.
Other Methods of Birth Control
Up to 20% of those who have tubal ligation eventually wish they hadn’t, so it’s important to think about all the possibilities. Those younger than 30 are more likely to change their minds later.
If you’re not sure, you might think about these long-term options for birth control :
Vasectomy. If you’re in a committed relationship, your partner might be willing to get this procedure that keeps sperm from getting into semen. It’s a safer procedure than a tubal ligation, and it can be done while the patient is awake.
IUD. Your doctor puts this small T-shaped plastic device into your uterus. It can stay in place from 3 to 10 years. IUDs are more than 99% effective in preventing pregnancy.
Implant. Your doctor puts a plastic rod about the size of a matchstick under the skin of your upper arm. It releases the hormone progestin and can stay in place for up to 3 years.
Show Sources
Johns Hopkins Medicine: “Tubal Ligation.”
Mayo Clinic: “Tubal Ligation,” “Tubal Ligation Decreases Risk of Developing Ovarian Cancer.”
University of Florida Health: “Tubal Ligation,” “Birth Control Pills — An Overview,” “Deciding About an IUD.”
The American College of Obstetricians and Gynecologists: “Postpartum Sterilization,” “Sterilization for Women and Men,” “Ectopic Pregnancy,” “Sterilization by Laparoscopy,” “Long-Acting Reversible Contraception: Intrauterine Device and Implant.”
Hillis, S.D. Obstetrics and Gynecology, December 1999.
Urology Care Foundation: “What is a Vasectomy?”
American Cancer Society: “Can Ovarian Cancer Be Prevented?”
Coalition for Post Tubal Women: “Post Tubal Ligation Syndrome (PTLS).”
FDA: “Condoms and Sexually Transmitted Diseases.”
Cleveland Clinic: “Tubal Reversal.”
Kaiser Family Foundation: “Sterilization as a Family Planning Method.”
Ryoikibetsu Shokogun Shirizu : “Post-tubal ligation syndrome.”
New England Journal of Medicine: “The risk of menstrual abnormalities after tubal sterilization.”
StatPearls: “Tubal ligation.”
United Nations University: “Health Consequences of Sterilization.”
British Journal of Cancer: “Tubal ligation in relation to menopausal symptoms and breast cancer risk.”
Fertility and Sterility: “Complications of female sterilization: immediate and delayed.”
Contemporary OB/GYN/OBGyn.net conference coverage: “Post-Tubal Ligation Pain.”
Society to Improve Diagnosis in Medicine: “Feeling Dismissed and Ignored by Your Doctor? Do This.”
Tubal Ligation
Tubal ligation is surgical procedure to prevent pregnancy. It has commonly been called “getting your tubes tied.” It is also called a female sterilization.
- Tubal refers to the fallopian tubes. Each month, an egg is released from an ovary and travels through the fallopian tube to the uterus.
- Ligation means to tie off. This prevents the egg and male sperm from connecting to prevent pregnancy.
During this surgery, both fallopian tubes are blocked or cut. It is usually done in the hospital or in an outpatient surgical clinic. In most cases, you will be able to go home on the day of surgery. You may have this surgery done under general anesthesia (being asleep), or local or spinal anesthesia (anesthesia that leaves you awake, but unable to feel pain).
After the procedure, you will still have your periods and have sex normally. In fact, women may feel more at ease because they do not have to worry about unwanted pregnancy.
Tubal ligation is permanent birth control. Although it may be reversed by another operation, only about 50% to 80% of women are able to become pregnant after having their fallopian tubes reattached. This surgery doesn’t prevent sexually transmitted disease. You will still need to practice safe sex.
Why might I need a tubal ligation?
Reasons for choosing this birth control include:
- You are an adult woman
- Pregnancy would be a health risk for you
- You or your partner has a genetic disorder that you don’t want to pass on to a child
This form of birth control may not be the best choice for you if you are unsure if you will want to become pregnant in the future. It also may not be a good choice if you may have other partners in the future. Having a new partner might make you reconsider getting pregnant.
What are the risks of a tubal ligation?
Tubal ligation is safe, but all surgeries carry some risks. Serious problems occur in less than 1 out of 1,000 women. You will need to sign a consent form that explains the risks and benefits of the surgery and you should discuss these risks and benefits with your surgeon. Some potential risks include:
- Bleeding from an incision or inside the abdomen
- Infection
- Damage to other organs inside the abdomen
- Side effects from anesthesia
- Ectopic pregnancy (an egg that becomes fertilized outside the uterus)
- Incomplete closing of a fallopian tube that results in pregnancy
Even though tubal ligation is a safe and effective form of birth control, about 1 out of 200 women may still become pregnant after the procedure. Having the surgery just after your period starts may avoid the chance that an already fertilized egg will reach your uterus after surgery.
These conditions may increase your risk for problems after surgery:
- Diabetes
- Previous abdominal surgery
- Pelvic inflammatory disease
- Lung disease
- Overweight
You may have other risks, depending on your specific health condition. Be sure to discuss any concerns with your healthcare provider before the procedure.
How do I get ready for a tubal ligation?
In the days before your surgery, tell your surgeon about any medicines you take. This includes herbal supplements and over-the-counter medicines. You may have to stop taking aspirin or other medicines that thin your blood and may increase bleeding.
Other points to go over include:
- Tell your surgeon if you or someone in your family has ever had a reaction to general or local anesthesia.
- If you smoke, you may be told to stop smoking well before surgery.
- On the day and night before surgery you may be given instructions for when to stop eating and drinking. If you are having general anesthesia, it is common to have nothing to eat or drink after midnight.
- Ask your surgeon if you should take your regular medicines with a small sip of water on the morning of the procedure.
- Wear loose comfortable clothing on the day of surgery to have an easier time getting dressed afterward.
- If you are having the surgery as an outpatient, arrange for someone to drive you home and stay with you during the early recovery period.
What happens during a tubal ligation?
Before the procedure starts you will have an intravenous line (IV) started so you can receive fluids and medicines to make you relaxed and sleepy. If you are having general anesthesia, you may get medicine through the IV to put you to sleep. A tube may be inserted in your throat so that you can inhale the anesthesia through your lungs.
If you are having local or spinal anesthesia, you will be given a numbing medicine in your abdomen or in your spinal area. You may remain awake during surgery, but you should not feel any pain. The actual surgery takes about 30 minutes.
Here is what typically happens during the procedure:
- The surgeon will make one or more small cuts (incisions) near your belly button. Sometimes the surgeon makes a small incision in your lower abdomen as well.
- Gas may be pumped into your belly to inflate it. This gives your surgeon a better view and more room to work.
- The surgeon will put a narrow tube with a light and a camera on the end into your abdomen. This tube is called a laparoscope.
- Your surgeon will use long, thin instruments put through the laparoscope or through another tiny cut to find and grab hold of the fallopian tubes.
- The tubes may be cut, tied, clamped, banded, or sealed off with an electric current.
- After surgery is done, the surgeon will close the incisions in the skin, probably using 1 to 2 stitches. He or she will cover the area with small dressings.
What happens after a tubal ligation?
After your surgery, you will be taken to the recovery room to be watched while you recover from the anesthesia. Your IV will be removed once you can drink fluids. You will probably be able to go home in a few hours.
Here is what you can probably expect at home:
- You will be able to gradually resume your normal diet.
- Some discomfort is normal. Ask your surgeon what medicines to take for pain.
- You may have shoulder pain for a few days. This is from the gas that was pumped into your belly. Lying down for a while often relieves this pain.
- Keep your incision areas dry for a few days. Follow your surgeon’s instructions on bathing and dressing care. You may need to go back to have your stitches removed. Keep all your follow-up appointments.
- Gradually resume normal activities in a few days.
- Avoid heavy lifting for a few weeks. Ask your surgeon when you can return to specific activities.
- You may be able to return to sexual activity in about 1 week.
Tell your surgeon about any of the following:
- Increasing pain or pain that is not relieved by medicine
- Any drainage, bleeding, redness, or swelling
- Fever
- Vomiting or nausea
- Dizziness or fainting spells
Next steps
Before you agree to the test or the procedure make sure you know:
- The name of the test or procedure
- The reason you are having the test or procedure
- What results to expect and what they mean
- The risks and benefits of the test or procedure
- What the possible side effects or complications are
- When and where you are to have the test or procedure
- Who will do the test or procedure and what that person’s qualifications are
- What would happen if you did not have the test or procedure
- Any alternative tests or procedures to think about
- When and how will you get the results
- Who to call after the test or procedure if you have questions or problems
- How much will you have to pay for the test or procedure
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Find a Treatment Center
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