Depending on the method used, you would either have a general anaesthetic (be asleep during surgery) or local anaesthetic (you’d be awake but not feel any pain).
At a glance: facts about female sterilisation
- female sterilisation is more than 99% effective at preventing pregnancy
- you don’t have to think about protecting yourself against pregnancy every time you have sex, so it doesn’t interrupt your sex life
- it doesn’t affect your hormone levels and you’ll still have periods
- you’ll need to use contraception up until you have the operation, and until your next period or for 3 months after the operation (depending on the type of sterilisation)
- as with any surgery, there’s a small risk of complications, such as 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 a fertilised egg implanting outside the womb (ectopic pregnancy)
- sterilisation is very difficult to reverse, so you need to be sure it’s right for you
- sterilisation doesn’t protect against sexually transmitted infections, so you may need to use condoms as well
How it works
Female sterilisation works by preventing eggs from travelling down the fallopian tubes, which link the ovaries to the womb (uterus). This means a woman’s eggs cannot meet sperm, so fertilisation cannot happen.
Eggs will still be released from the ovaries as normal, but they’ll be absorbed naturally into the woman’s body.
How female sterilisation is carried out
The surgeon will block your fallopian tubes (tubal occlusion) by either:
- 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, cutting and removing a small piece of the fallopian tube
This is a fairly minor operation, and many women return home the same day.
Tubal occlusion procedure
The surgeon accesses your fallopian tubes by making a small cut either near your belly button (laparoscopy) or just above your pubic hairline (a mini-laparotomy).
They will then insert a long, thin instrument that has a light and camera (a laparoscope) to clearly see your fallopian tubes.
A laparoscopy is usually used because it’s faster, but a mini-laparotomy may be recommended for women who:
- have had recent abdominal or pelvic surgery
- are obese
- have a history of pelvic inflammatory disease, a bacterial infection that can affect the womb and fallopian tubes
The fallopian tubes are then blocked by applying clips or rings, or by tying, cutting and removing a small piece of the tube.
Removing the tubes (salpingectomy)
If blocking the fallopian tubes hasn’t worked, the tubes may be completely removed. This is called a salpingectomy.
Is sterilisation right for me?
Almost any woman can be sterilised, but it should only be considered by women who don’t want any more children or don’t want children at all.
Once you’re sterilised it’s very difficult to reverse it, so consider all options before making your decision. Sterilisation reversal isn’t usually available on the NHS.
You may be more likely to be accepted for the operation if you’re over 30 and have had children.
Before the operation
Your GP may recommend counselling before referring you for sterilisation. This can involve your partner, if you would like, but it doesn’t have to. Counselling will give you a chance to talk about the operation in detail, and discuss any doubts, worries or questions you might have.
Your GP can refuse to carry out the procedure or refuse to refer you for it if they don’t believe it’s in your best interests.
If the GP agrees with your decision, they’ll refer you to a female reproductive specialist (gynaecologist) for treatment at your nearest NHS hospital.
You’ll need to use contraception until the day of the operation, and right up until your next period after surgery if you’re having your fallopian tubes blocked.
Sterilisation can be performed at any stage in your menstrual cycle.
Before you have the operation, you’ll be given a pregnancy test to make sure you’re not pregnant because, once you’ve been sterilised, there’s a high risk that any pregnancy will become ectopic.
Recovering after the operation
You’ll be allowed home once you’ve recovered from the anaesthetic, been to the toilet and eaten. If you leave hospital within hours of the operation, take a taxi, or ask a relative or friend to pick you up.
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 questions.
If you’ve had a general anaesthetic, don’t drive a car for 48 hours afterwards – even if you feel fine, your reaction times and judgement may not be back to normal.
How you will feel
It’s normal to feel unwell and a little uncomfortable if you’ve had a general anaesthetic, and you may have to rest for a few days. Depending on your general health and your job, you can normally return to work 5 days after tubal occlusion, but 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 stopped. You may also feel some pain, like period pain – you can take painkillers for this. If the pain or bleeding gets worse, try contacting the specialist who treated you, your GP or NHS 111.
Caring for your wound
If you had tubal occlusion, you’ll have a wound with stitches where the surgeon made the cut. The stitches would need to be removed at a follow-up appointment unless dissolvable ones were used.
If there’s a dressing over your wound, you can normally remove this the day after your operation. After this, you’ll be able to have a bath or shower.
Your sex drive and sex life shouldn’t be affected. You can have sex as soon as it’s comfortable to do so after the operation.
If you had tubal occlusion, use additional contraception until your first period to protect yourself from pregnancy.
Sterilisation doesn’t protect against sexually transmitted infections (STIs), so you may need to use condoms.
Advantages and disadvantages of female sterilisation
- more than 99% effective at preventing pregnancy
- blocking the fallopian tubes and removal of the tubes should be effective immediately – but use contraception until your next period
- it won’t affect your sex drive or interfere with sex
- it won’t affect your hormone levels
- it doesn’t protect against STIs, so you may need to use condoms
- it can’t be easily reversed, and reversal operations are rarely funded by the NHS
- it can fail – the fallopian tubes can rejoin and make you fertile again, although this is rare
- there’s a very small risk of complications, including internal bleeding, infection or damage to other organs
- if you get pregnant after the operation, there’s an increased risk that it will be an ectopic pregnancy
Where to get more information on sterilisation
You can get more information on sterilisation from:
- GP surgeries
- contraception clinics
- sexual health or genitourinary medicine (GUM) clinics
- some young people’s services