Permanent contraception: vasectomy and female sterilisation

Some people know they never want to get pregnant, or never want to cause a pregnancy. Others are sure their family is complete. For them, permanent contraception can be a good fit. There are two main kinds: a vasectomy (for people with testicles) and female sterilisation (for people with fallopian tubes). Both are over 99% effective.

Vasectomy

• A short operation, usually about 15 minutes under local anaesthetic. The tubes that carry sperm are cut, blocked or sealed.
• It does not change your sex drive, erections or ejaculation. Semen looks the same, but it has no sperm in it.
• It is not effective straight away. Sperm are still in the tubes at first, so you need other contraception for at least 8 to 12 weeks. Local services often ask for a semen test at around 12 to 16 weeks, and sometimes a second test.
• Only stop using other contraception when a clinic tells you the semen test shows no sperm.
• Bruising, swelling and a sore scrotum for a few days are common, and so is a little blood in semen for the first few times. A small number of people have longer-lasting aching.
• Very rarely, the cut ends can rejoin years later and a pregnancy can happen.

Female sterilisation

• An operation in hospital that blocks or closes the fallopian tubes so an egg cannot meet sperm.
• It is permanent, so other long-term methods such as the implant or coils are usually offered first because they are reversible.
• It is more than 99% effective. Rarely it does not work, and if you do become pregnant after sterilisation there is a higher chance the pregnancy is ectopic. Get urgent help for sudden one-sided tummy pain.
• As with any operation, there is a small risk of infection, blood clots or damage to a nearby organ.

Thinking it through

• Both are meant to be permanent. Reversal is difficult, often does not work, and is not usually available on the NHS.
• You should be offered counselling. It is fine to talk it over with a partner, but you do not legally need their permission.
• A GP can decline to refer you if they do not think it is right for you yet, especially if you are young or have no children. You can ask for a second opinion.
• It is free on the NHS in much of the UK, but waiting lists can be long. Some people pay privately.
• If you want to keep your options open, a long-acting reversible method such as a coil or the implant is just as effective and can be removed whenever you choose.