Contraception guide

Female sterilisation

A woman can get pregnant if a man’s sperm reaches one of her eggs (ova). Contraception tries to stop this happening by keeping the egg and sperm apart or by stopping egg production. One method of contraception is female sterilisation.

Female sterilisation is usually carried out under general anaesthetic but can be carried out under local anaesthetic, depending on the method used. The surgery involves blocking or sealing the fallopian tubes, which link the ovaries to the womb (uterus). 

This prevents the woman’s eggs from reaching sperm and becoming fertilised. Eggs will still be released from the ovaries as normal, but they will be absorbed naturally into the woman's body.  

At a glance: facts about female sterilisation

  • In most cases, female sterilisation is more than 99% effective, and only one woman in 200 will become pregnant in her lifetime after having it done. 
  • You don't have to think about it every day, or every time you have sex, so it doesn't interrupt or affect your sex life. 
  • Sterilisation can be performed at any time during the menstrual cycle. It won't affect hormone levels.
  • You'll still have periods after being sterilised.
  • You will need to use contraception until the operation is done and until your next period or for three months afterwards (depending on the type of sterilisation).
  • As with any surgery, there's a small risk of complications. These include internal bleeding, infection or damage to other organs. 
  • There's a small risk that the operation won't work. Blocked tubes can rejoin immediately or years later. 
  • If the operation fails, this may increase the risk of ectopic pregnancy (when a fertilised egg implants outside the womb, usually in a fallopian tube). 
  • The sterilisation operation is difficult to reverse.
  • Female sterilisation doesn't protect against sexually transmitted infections (STIs), so always use a condom to protect yourself and your partner against STIs.

How female sterilisation works

Female sterilisation works by preventing eggs from travelling down the fallopian tubes. This means a woman's eggs cannot meet sperm, and fertilisation cannot happen.

How female sterilisation is carried out 

Before the operation

Recovering after the operation

How female sterilisation is carried out

There are two main types of female sterilisation:

  • when your fallopian tubes are blocked, for example with clips or rings (tubal occlusion)  
  • when implants are used to block your fallopian tubes (hysteroscopic sterilisation, or HS) 

It can be a fairly minor operation, with many women returning home the same day. Sterilisation is usually carried out using tubal occlusion (blocking the fallopian tubes).

Tubal occlusion

First, your surgeon will need to access and examine your fallopian tubes, using either laparoscopy or mini-laparotomy.

A laparoscopy is the most common method of accessing the fallopian tubes. The surgeon makes a small cut in your abdominal wall near your belly button and inserts a laparoscope. A laparoscope is a small flexible tube that contains a tiny light and camera. The camera relays images of the inside of your body to a television monitor. This allows the surgeon to see your fallopian tubes clearly.

A mini-laparotomy involves a small incision, usually less than 5cm (2 inches), just above the pubic hairline. Your surgeon can then access your fallopian tubes through this incision.

A laparoscopy is usually the preferred option because it is faster. However, a mini-laparotomy may be recommended for women who:

Blocking the tubes

The fallopian tubes can be blocked using one of the following methods:

  • applying clips – plastic or titanium clamps are closed over the fallopian tubes 
  • applying rings – a small loop of the fallopian tube is pulled through a silicone ring, then clamped shut 
  • tying and cutting the tube – this destroys 3-4cm (1–1.5 inches) of the tube

Hysteroscopic sterilisation (fallopian implants)

You can get contraception at:

  • most GP surgeries
  • community contraception clinics
  • some GUM clinics
  • sexual health clinics
  • some young people's services

Find a clinic near you

The National Institute for Health and Clinical Excellence (NICE) has published guidance about hysteroscopic sterilisation. However, the technique is not yet widely available.

The implants are usually inserted under local anaesthetic, and the procedure doesn't require cuts to be made in your abdomen. You may also be given a sedative to relax you.

A narrow tube with a telescope at the end, called a hysteroscope, is passed through your vagina and cervix. A guidewire is used to insert a tiny piece of titanium metal (called a microinsert) into the hysteroscope, then into each of your fallopian tubes. This means that the surgeon does not need to cut into your body.

The implant causes the fallopian tube to form scar tissue around it, which eventually blocks the tube.

You should carry on using contraception until an imaging test has confirmed that your fallopian tubes are blocked. This can be done with one or more of the following: 

  • a hysterosalpingogram (HSG) – a type of X-ray that is taken after a special dye has been injected to show up any blockages in your fallopian tubes 
  • a hysterosalpingo-contrast-sonography (HyCoSy) – a type of ultrasound scan involving injecting dye into your fallopian tubes

Removing the tubes (salpingectomy)

If blocking the fallopian tubes has been unsuccessful, the tubes may be completely removed. Removal of the tubes is called salpingectomy.

Before the operation

Your GP will strongly recommend counselling before referring you for sterilisation. Counselling will give you a chance to talk about the operation in detail, and talk about any doubts, worries or questions that you might have.

If you decide to be sterilised, your GP will refer you to a specialist for treatment. This will usually be a gynaecologist at your nearest NHS hospital. A gynaecologist is a specialist in the female reproductive system.

If you choose to have a sterilisation, you will be asked to use contraception until the day of the operation, and to continue using it: 

  • until your next period if you are having your fallopian tubes blocked (tubal occlusion)  
  • for around three months if you are having fallopian implants (hysteroscopic sterilisation)

Sterilisation can be performed at any stage in your menstrual cycle.

Before you have the operation you will be given a pregnancy test to make sure that you are not pregnant. It is vital to know this because once the surgeon blocks your fallopian tubes there is a high risk that any pregnancy will become ectopic (when the fertilised egg grows outside the womb, usually in the fallopian tubes). An ectopic pregnancy can be life-threatening because it can cause severe internal bleeding.

Recovering after the operation

Once you have recovered from the anaesthetic, passed urine and had something to eat, you will be allowed home. If you leave hospital within hours of the operation, ask a relative or friend to pick you up, or take a taxi.

The healthcare professionals treating you in hospital will tell you what to expect and how to care for yourself after surgery. They may give you a contact number to call if you have any problems or any questions.

If you have had a general anaesthetic, do not drive a car for 48 hours afterwards. This is because even if you feel fine, your reaction times and judgement may not be back to normal.

How you will feel

It is normal to feel unwell and a little uncomfortable for a few days if you have had a general anaesthetic, and you may have to rest for a couple of days. Depending on your general health and your job, you can normally return to work five days after tubal occlusion. However, you should avoid heavy lifting for about a week.

You may have some slight vaginal bleeding. Use a sanitary towel rather than a tampon until this has gone. You may also feel some pain, similar to period pain. You may be prescribed painkillers for this. If the pain or bleeding gets worse, seek medical attention.

Caring for your wound

If you had tubal occlusion to block your fallopian tubes, you will have a wound with stitches where the surgeon made an incision (cut) into your abdomen. Some stitches are dissolvable and disappear on their own, and some will need to be removed. If your stitches need removing you will be given a follow-up appointment for this.

If there is a dressing over your wound, you can normally remove this the day after your operation. After this, you will be able to have a bath or shower as normal.

Having sex

Your sex drive and enjoyment of sex will not be affected. You can have sex as soon as it is comfortable to do so after the operation.

If you had tubal occlusion, you will need to use contraception until your first period to protect yourself from pregnancy.

If you had hysteroscopic sterilisation, you will need to use another form of contraception for around three months after surgery. After scans have confirmed that the implants are in the correct position, you will no longer need contraception.

Sterilisation will not protect you from sexually transmitted infections, so continue to use barrier contraception such as condoms if you are unsure of your partner's sexual health.

Who can have it done?

Almost any woman can be sterilised. However, sterilisation should only be considered by women who do not want any more children, or do not want children at all. Once you are sterilised it is very difficult to reverse the process, so it's important to consider the other options available before making your decision. Sterilisation reversal is not usually available on the NHS.

Surgeons are more willing to perform sterilisation when women are over 30 years old and have had children, although some younger women who have never had a baby choose it.

Advantages and disadvantages of female sterilisation

Advantages

  • female sterilisation can be more than 99% effective at preventing pregnancy
  • tubal occlusion (blocking the fallopian tubes) and removal of the tubes (salpingectomy) should be effective immediately – however, doctors strongly recommend that you continue to use contraception until your next period
  • hysteroscopic sterilisation is usually effective after around three months – research collected by the National Institute for Health and Clinical Excellence (NICE) found that the fallopian tubes were blocked after three months in 96% of sterilised women

Other advantages of female sterilisation are that:

  • there are rarely any long-term effects on your sexual health
  • it will not affect your sex drive
  • it will not affect the spontaneity of sexual intercourse or interfere with sex (as other forms of contraception can)
  • it will not affect your hormone levels

Disadvantages

  • female sterilisation does not protect you against sexually transmitted infections so you should still use a condom if you are unsure about your partner's sexual health 
  • it is very difficult to reverse a tubal occlusion – this involves removing the blocked part of the fallopian tube and rejoining the ends, and reversal operations are rarely funded by the NHS

Risks

  • with tubal occlusion there is a very small risk of complications, including internal bleeding and infection or damage to other organs
  • it is possible for sterilisation to fail – the fallopian tubes can rejoin and make you fertile again, although this is rare (about 1 in 200 women become pregnant in their lifetime after being sterilised)
  • if you do get pregnant after the operation, there is an increased risk that it will be an ectopic pregnancy (when the fertilised egg grows outside the womb, usually in the fallopian tubes)

If you miss a period, take a pregnancy test immediately. If the pregnancy test is positive, you must see your GP so that you can be referred for a scan to check if the pregnancy is inside or outside your womb.

With hysteroscopic sterilisation, there is a small risk of pregnancy even after your tubes have been blocked. Research collected by NICE has shown that possible complications after fallopian implants can include:

  • pain after the operation – in one study, nearly eight out of 10 women reported pain afterwards
  • the implants being inserted incorrectly – this affected two out of 100 women  
  • bleeding after the operation – many women had light bleeding after the operation, and nearly a third had bleeding for three days

Where to get contraception

Most types of contraception are available free in the UK. Contraception is free to all women and men through the NHS. You can get contraception, and information and advice about contraception, at:

  • most GP surgeries – talk to your GP or practice nurse
  • community contraceptive clinics
  • some genitourinary medicine (GUM) clinics 
  • sexual health clinics – they also offer contraceptive and STI testing services
  • some young people’s services (call 0300 123 7123 for more information)

Find your nearest sexual health clinic

Contraception services are free and confidential, including for people under the age of 16.

If you're under 16 and want contraception, the doctor, nurse or pharmacist won't tell your parents (or carer) as long as they believe you fully understand the information you're given and your decisions. Doctors and nurses work under strict guidelines when dealing with people under 16. They'll encourage you to consider telling your parents, but they won't make you. The only time that a professional might want to tell someone else is if they believe you're at risk of harm, such as abuse. The risk would need to be serious, and they would usually discuss this with you first.  

Page last reviewed: 10/01/2013

Next review due: 10/01/2015

Ratings

How helpful is this page?

Average rating

Based on 114 ratings

All ratings

Add your rating

Comments

The 9 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Lynn12 said on 16 March 2014

I was sterilised (laparoscopy/clips method) 30 years ago and have had nothing but severe sharp stabbing pains since, mainly in my right side of abdomen. I have been back for laparoscopies twice but have only been told the clips are in place, there are no adhesions, and everything is ok as far as they are concerned!! However, I never had these pains before, and I have lived on Ponstan (mefenamic acid) or other strong painkillers ever since. Also suffered heavier, more prolonged periods after having the op. Even though my periods have stopped, the pain carries on.
I have seen on other forums, I am not alone in this, although for years without a computer, I thought I was alone. I am amazed and horrified this operation is still being carried out on unsuspecting women and I bitterly regret having it done - I was never warned of possible side-effects. After all, these clips are foreign bodies in your abdomen.
My advice would be to stay away from unnecessary surgery , I have told my daughters never to have it done, it could ruin your life. Avoid at all costs..

Report this content as offensive or unsuitable

jmarie24 said on 15 March 2014

Hi I'm 24 years old going on 25 this summer. I have 4 beautiful children (aged between 6 and 5 months), I myself was unsure whether or not to get the sterilisation done. Many people told mee not to go ahead with as I was still so young. Having said that as young as I may be, 4 boisterous little boys is a lot of hard work and even though we remain great friends their father and I have split up which confirmed to me that going ahead with sterilisation was the right choice. After I had last little boy in October 2013 I got the procedure done and I am so glad I made that choice. If you're afraid that you'll change your mind later on I'd suggest you go for the clips on the tubes rather than go for full removal or getting them cut as both of these options are 100% non reversible. Don't let anyone medical or professional or not sway your choice as you and only you know what's right for you. Saying that make sure you look at your life now, how you see your future and you know in your heart it's what you want. I wish all of you the best of luck for the future.xx

Report this content as offensive or unsuitable

dcu90 said on 19 February 2014

Hi, I am 23 going on 24, I have 2 children and thats all I want. But I am petrified about getting pregnant again and its making me not want intercourse with my partner, im scared contraception will fail! Would I be able to be steralized? I have done alot of research and it is certainly what I want but I have also read it wont be done untill I am 30, and im afraid my partner will leave me before I am 30 if it continues. I have never been so sure of something in my life, I dont wish to have any more children at all, we have our perfect family, and even if (heaven forbid) we split, I still wouldnt want anymore children, as much as I love my 2, I hated pregnancy! Any help or information from anyone in similar situation?

Report this content as offensive or unsuitable

confused2013 said on 18 January 2014

I was sterilised in nov last year and chose the surgical method as opposed to esure as I was adviced due to me having previously heavy periods I could have some further treatment should this be the case in the future if I opted for this method. For the past 6 months I have had the depo which always stops my periods yet since nov (since the op) I have bled continuously, there has been no pain so it is merely a draining inconvenience but it is something had I known about I would never have opted for the sterilisation in the first place

Report this content as offensive or unsuitable

bemused26 said on 15 January 2014

I just had hysteroscopic sterilisation (Essure) done last week. I am 31, in a committed (9 yr) relationship and have no children. I had a termination at 19 and do not want to have to do that again. I have never wanted children and am 100% sure that will never change. My partner has 2 grown up children and never seemed to get round to talking to the doctor about vasectomy... I didn't mind though. I wanted this to be my responsibility and my choice. I'd hate for him to have complications as I would feel it was my fault.

I asked my doctor on many occasions about sterilisation but was always brushed aside. Finally he took me seriously. I have had enough of taking pills and other forms of contraception and have been on birth control for 16 years. It saps my sex drive amongst other side effects that I no longer care for!

I had the procedure under general anaesthetic and was in and out of hospital within 4.5 hours. Everything went well and I'm hoping it will be effective when I go back for the check up in 3 months.

My period started a couple of days after so I am unsure of what was caused by the procedure... But, it is still slightly happening now which is longer than usual so I am putting it down to the op.

My tummy ached and felt bloated for about 1 week. I had cramp like pains for 3 days. Obviously the general made me iffy too for a few hours along with the Tramadol I was given!!

I am so pleased I was given the opportunity to have this done I feel a huge weight has been lifted and I am so excited to be given the all clear and come off these pills. Only downside is I will still get periods :(

Report this content as offensive or unsuitable

Santaella said on 04 October 2013

Taking full control of my fertility was the best decision I ever made and I have had no regrets. After two children, three long term relationships, and one near miss pregnancy I was relieved once the simple operation was over and I know I will have no more children. I have increased confidence in relationships.

The operation was straight forward, and the nursing and surgical team were very good, I had no complications and was back to full health and fitness within a few short days.

Report this content as offensive or unsuitable

Kirkuk said on 15 August 2013

I had it done in 2009 it's the worst thing I've had done I was 23 at the time and was told by the doctor whilst in the process of having an emergency c-section that it was my best option as I would not be able to carry another child to term which since I have found out is not true so I believed them as of course they're a doctor they no best and I was more worried about my child born ten weeks early anyway I have had nothing but pain long heavy periods being diagnosed with endometriosis have been on all kinds of meds and had an op still to no avail I even went to my gp to see if I could have it reversed and they informed me I could I went to my gynaecologist today and have now been told under no circumstances do they do it on the nhs but its all down to them that it has been done and as for no changes in hormone levels or sex drive and the pain u can have during sex is unreal as well but they don't tell u any of this on here or when u see the doctor before hand so please thing long and hard about it xx

Report this content as offensive or unsuitable

Claire83Bear said on 01 August 2013

I'm waiting on the date for mine. As a 30 year old single non mother, it wasn't the original option for the doctors with me. Unfortunately with how ill I am, it convinced them it would be for the best. I'm not worried as never wanted kids, but nervous about the operation in general. Glad to see recovery time is short and the operation itself seems reasonably simple.

Report this content as offensive or unsuitable

nogeissu said on 27 April 2013

I had my surgery 7 weeks ago with A laparoscopy and clips. It was an easy decision as my husband was unable to commit himself to a vasectomy and has been very supportive. I did feel a little strange after the general anaesthetic but this passed quickly and the healing was very simple. I was back to normal within a couple of days and the wound is almost invisible now.

Report this content as offensive or unsuitable

Sexual health services

Find out where you can go if you need advice about STIs, contraception or pregnancy

Which method suits me?

Things to think about when you're considering which contraceptive method to use

Where to get contraception

Find out where you can go to get information about contraception, and to get the method you choose

Talking to your partner about sex

How to talk to a new partner about having sex, including safer sex, and finding the right words

Contraception after a baby

You can get pregnant 21 days after having a baby. Find out when to start contraception

Where to get contraception

Find out where you can go for confidential access to the contraception that's right for you.

Media last reviewed: 11/07/2013

Next review due: 11/07/2015