His and Her Permanent Birth Control Options

When you are truly certain that you don't want to ever be pregnant again, permanent birth control may be worth considering. It buys you peace of mind, means you can be more spontaneous about your sex life, and can be a great choice for those who've completed their family.

A vasectomy is the procedure of choice for men. In a surgical procedure that takes only about 30 minutes, the tube through which sperm pass is blocked. Typically, a man goes home the same day; recovery is less than a week in most cases. Side effects are pain and bruising, for which ice packs can be helpful.

If the woman opts for sterilization, one traditional procedure is a tubal ligation in which the fallopian tubes are blocked by one of several methods. It's done under general anesthesia with the aid of a laparascope, so gas is used to expand the abdomen.

Women also now can opt for a transcervical surgical sterilization implant. In this procedure, a small, flexible metal coil is inserted through the vagina to the fallopian tube. Only local anesthesia is needed, rather than general. Scar tissue forms around the coil, blocking the fallopian tube and effectively preventing pregnancy. The advantage of this method over a traditional tubal ligation is that surgery is not required.

Recovery time is shorter than with a traditional tubal ligation, and the procedure can be done in the doctor's office. "It is good for a select group of women," says Jill Rabin, MD, professor of obstetrics and gynecology at Hofstra-North Shore LIJ School of Medicine on Long Island, New York. "For instance, if a woman does not want a scar on her abdomen, this can be a good thing."

The downside of the procedure is that you need to have a follow-up test after three months to make sure that it worked. For this confirmation, a woman must undergo a hysterosalpingogram, a procedure in which the fallopian tubes are visualized and it is clear if the procedure worked. While it takes only 15 to 30 minutes, the procedure can cause pain that feels like menstrual cramping.

"You also have to use another birth control method for the first three months, until you have the test that shows the tubes are closed," says Dr. Anne Davis, a gynecologist with NewYork-Presbyterian Hospital/Columbia University Medical Center in New York City.

Many women today are using long-acting reversible birth control methods, she says. "There is about a 10% incidence of regret among people who have sterilizations," she sys. "Life and partner situations change, and then people may decide they want another baby. So then we try to go with the long-acting reversible birth control."

A couple of new IUDs are meant to be used for several years, she explains. A T-shaped IUD with progestin is inserted by your health care provider and is good for up to five years, after which it is possible to get pregnant.

Another option: An implantable rod that contains the hormone progestin is inserted under the skin on the inside of a woman's upper arm, and it prevents the ovaries from releasing eggs. It may work by thickening the cervical mucus, making it inhospitable, and it is good for up to three years.


"Birth Control Guide" FDA's Office of Women's Health"


"Vasectomy." Medline Plus. National Institutes of Health.