Types of Permanent Birth Control and Sterilization

Permanent birth control is the second most popular birth control method in the United States (with the pill being number one). Nearly one-third of American women rely on permanent sterilization for contraception.

Currently, permanent birth control methods include surgical procedures that lead to permanent sterilization. People choose permanent birth control methods when they know for sure that they don't want any more children or any children at all.

Things to Consider Before Choosing Permanent Birth Control

There are permanent birth control options for people of any sex. These procedures are safe and effective. For women, they are non-hormonal. This means that permanent birth control methods will not affect your menstrual cycles. Male sterilization procedures are also non-hormonal, so they do not lower your sex drive. You can still have an erection and ejaculate just as you did before the procedure.

Are These Methods Truly Permanent?

Although all procedures have a risk of failure, they are meant to result in permanent sterilization. For women, surgical procedures to reverse sterilization are difficult, expensive, and often ineffective. However, some women are better candidates for reversal than others, depending on age and the type of tubal ligation done—sometimes they remove only small parts of the fallopian tubes or close the tubes using rings or clips.

Vasectomies are a bit easier to reverse, but they are also expensive and complicated procedures. Following a vasectomy reversal, your chances of getting someone pregnant may be lower than before.

Permanent birth control procedures are not a good option for anyone who thinks they may one day want children. So when making the decision to undergo permanent birth control, you should have the mindset that this is for good—that it is not a temporary birth control method.

What to Expect

Be prepared to read and sign an informed consent form. This is just a way that doctors can document that you understand that these procedures will lead to permanent sterilization, and this is something you really want. Some states and hospitals require a 30-day waiting period before a tubal ligation can be completed. This is to ensure no one rushes into the procedure without thinking about the consequences.

Many doctors will not perform a permanent birth control procedure if you are younger than 30 or have no kids. This is based mainly on research that shows that young women who have no children are more likely to end up regretting their permanent birth control procedure in the future.

Vasectomy

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Vasectomy is a permanent birth control procedure in which a small incision is made in the upper part of the scrotum. The two tubes (vas deferens) that carry sperm into the semen are cut apart and then tied off. The incision is closed with stitches.

Vasectomies are often performed in a surgeon's office. You are awake, and the doctor will use local anesthesia to numb the area. After the procedure, you will still produce semen, but it will be free of sperm and will not cause pregnancy.

Besides condoms, a vasectomy is the only other birth control method for men. An alternative to a traditional vasectomy is a keyhole (or no-scalpel) vasectomy, which is a quicker procedure that usually doesn't require stitches.

The cost of a vasectomy can vary depending on where you live as well as in what kind of office the procedure takes place. Believe it or not, vasectomy rates rise during the NCAA's March Madness basketball tournament, a time when many doctors around the country actually offer "Vas Madness" promotions.

Tubal Ligation

Woman in surgery

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Tubal ligation (or tubal sterilization) is a surgical procedure that permanently sterilizes a person by preventing an egg from traveling to the uterus. It also blocks sperm from being able to enter the fallopian tube where fertilization normally occurs.

This permanent birth control method is performed in a hospital or outpatient clinic while you are under anesthesia. During these procedures, one or two small incisions are made in the abdomen. The fallopian tubes may be clipped, tied, or cauterized (sealed shut). The incision is typically closed with stitches.

A mini-laparotomy (typically performed after childbirth) and laparoscopic sterilization are the two most common tubal ligation procedures.

Non-Surgical Options

Make sure you have a trusting relationship with your doctor
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Unfortunately, non-surgical sterilization is no longer an option. In the past, a product known as Essure provided a less-invasive, non-surgical alternative to tubal ligation. The Essure procedure (hysteroscopic sterilization) worked by blocking the fallopian tubes with small metal inserts, which were fed up through the vaginal canal. These inserts triggered a build-up of scar tissue that eventually blocked the entryway for sperm.

Essure devices have not been available since 2019. They are no longer produced by Bayer, the device manufacturer, and all unused devices have been recalled. This means doctors no longer perform the procedure. The recall happened after a significant number of women reported serious side effects, like chronic pain, to the FDA.

You may have friends or family that had an Essure procedure in the past. These people can continue to use Essure as a contraceptive method if they are happy with the outcome. Surgical removal of the Essure device is a very difficult procedure and is only attempted when the side effects become too difficult to live with.

8 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  2. Handelsman D. Male contraception. National Center For Biotechnology Information.

  3. Kumari S. Permanent sterilisation to long-acting reversible contraception: Is a paradigm shift necessary? J Obstet Gynaecol India. 2016;66(3):149-53. doi:10.1007/s13224-016-0866-2

  4. Urology Care Foundation. Vasectomy reversal.

  5. Zerden M, Castellano T, Doll K, Stuart G, Munoz M, Boggess K. Risk-reducing salpingectomy versus standard tubal sterilization: Lessons from offering women options for interval sterilization. South Med J. 2018;111(3):173-177. doi:10.14423/SMJ.0000000000000779

  6. Gossman W, Canela C, Nama N. Tubal sterilization. National Center For Biotechnology Information.

  7. American College Of Obstetricians And Gynecologists. Sterilization of women: Ethical issues and considerations.

  8. US Food and Drug Administration. Information for patients and health care providers: Essure.

Additional Reading

By Dawn Stacey, PhD, LMHC
Dawn Stacey, PhD, LMHC, is a published author, college professor, and mental health consultant with over 15 years of counseling experience.