What is sterilisation? 

Sterilisation is a permanent method of contraception that involves blocking or sealing the fallopian tubes, which connect the ovaries to the uterus (womb). This is usually done under general anaesthetic but can also be performed with local anaesthetic, depending on the method. 

Blocking the fallopian tubes prevents eggs from meeting sperm and becoming fertilised. Eggs will still be released from the ovaries but will be naturally absorbed by the body. 

At a Glance: Key Facts About Sterilisation

  • Sterilisation is over 99% effective. Fewer than 1 in 200 people become pregnant after the procedure. 
  • You don’t need to think about contraception daily or during sex, so it doesn’t affect your sex life. 
  • It can be done at any point in the menstrual cycle and won’t affect hormone levels. 
  • Periods usually continue after sterilisation. 
  • Contraception should still be used until the procedure is complete and, depending on the method, for up to three months afterwards. 
  • As with any surgery, there are risks of complications like internal bleeding, infection, or damage to other organs. 
  • There is a small chance the tubes can rejoin naturally, even years later, which may result in pregnancy. 
  • If pregnancy occurs after sterilisation, there is a higher risk of ectopic pregnancy. 
  • Sterilisation is considered permanent and is very difficult to reverse. 
  • It does not protect against sexually transmitted infections (STIs). Condoms are still recommended for STI protection. 

How sterilisation works 

Sterilisation prevents eggs from travelling through the fallopian tubes, so fertilisation by sperm cannot occur. 

How sterilisation is carried out 

There are two main types of sterilisation: 

  1. Tubal occlusion: blocking the fallopian tubes with clips, rings, or by cutting and sealing them. 
  2. Hysteroscopic sterilisation (fallopian implants): inserting implants to block the fallopian tubes. 

Tubal occlusion 

This is the most common method and is usually done as a day procedure. 

There are two main surgical approaches: 

  • Laparoscopy: A small cut is made near the belly button, and a thin tube with a camera (laparoscope) is inserted to view and access the fallopian tubes. 
  • Mini-laparotomy: A slightly larger cut is made just above the pubic hairline to access the fallopian tubes directly. This may be recommended for individuals who: 
    • Have had previous abdominal or pelvic surgery 
    • Have a higher body mass index (BMI of 30 or above) 
    • Have a history of pelvic inflammatory disease 

Methods for blocking the fallopian tubes include: 

  • Clips: plastic or titanium clamps placed over the tubes 
  • Rings: a loop of the tube is pulled through a silicone ring and clamped 
  • Tying and cutting: removing a section of the tube to permanently close it 

Hysteroscopic sterilisation (fallopian implants) 

This method doesn't require abdominal cuts or general anaesthetic. A narrow tube with a telescope (hysteroscope) is inserted through the vagina and cervix. A tiny titanium coil (microinsert) is placed into each fallopian tube, prompting the body to form scar tissue around it, blocking the tube. 

You will need to use contraception until imaging confirms the tubes are fully blocked. This confirmation may include: 

  • Hysterosalpingogram (HSG): an X-ray with dye to check for blockages 
  • HyCoSy: an ultrasound scan with dye to check the tubes 
  • Some cases may use ultrasound alone, as recommended by the implant manufacturer, three months after the procedure 

Salpingectomy (removing the tubes) 

If blocking the tubes fails, complete removal of the fallopian tubes (salpingectomy) may be considered. 

 

Before the procedure 

Your GP will recommend counselling before referring you for sterilisation. This provides an opportunity to discuss the procedure, raise any concerns, and explore alternatives. 

If appropriate, your partner may be involved in the discussion, but their permission is not legally required. 

Doctors may refuse to perform or refer for sterilisation if they believe it is not in your best interest. In that case, a private procedure may be an option. 

Once you decide to proceed, your GP will refer you to a specialist, usually a gynaecologist. 

Contraception should be used until the procedure and for a time afterwards: 

  • Tubal occlusion: continue contraception until your next period 
  • Fallopian implants: continue contraception for approximately three months 

A pregnancy test will be done before surgery. If you’re pregnant during the procedure, the risk of ectopic pregnancy is higher, which can be life-threatening. 

Recovery after the procedure 

Once you’ve recovered from anaesthetic, passed urine, and eaten, you’ll usually be discharged the same day. Arrange transport home, as you won’t be able to drive if you had general anaesthetic. 

Follow the aftercare advice provided by your healthcare team and use the contact number they give if you have concerns. 

If you had general anaesthetic, avoid driving for 48 hours due to impaired reaction times. 

How you might feel 

  • You may feel tired or unwell for a few days and should rest. 
  • Return to work is typically possible within 5 days, but avoid heavy lifting for about a week. 
  • You may experience mild vaginal bleeding – use sanitary pads rather than tampons until this stops. 
  • You might have some cramping, similar to period pain. Pain relief can be prescribed. 

Caring for your wound 

If you had a surgical incision: 

  • Stitches may be dissolvable or need removal. A follow-up appointment will be provided if needed. 
  • You can usually remove dressings the next day and bathe or shower as normal. 

Sex after sterilisation 

Your sex drive and enjoyment are not affected by sterilisation. You can resume sexual activity when it feels comfortable. 

Use contraception until advised otherwise: 

  • Tubal occlusion: until your next period 
  • Fallopian implants: for around three months, until confirmed effective 

Sterilisation does not protect against STIs. Use condoms if your partner’s sexual health is unknown. 

Who can have sterilisation? 

Sterilisation is available to anyone with fallopian tubes who is certain they do not want children, now or in the future. It’s considered permanent and difficult to reverse. Reversal is rarely funded by the NHS. 

While more commonly performed for individuals over 30 who have had children, younger people without children can also opt for sterilisation. 

Advantages and Disadvantages of Sterilisation

Advantages Disadvantages
More than 99% effective at preventing pregnancy  Does not protect against STIs 
Usually effective immediately (except for fallopian implants, which take ~3 months)  Very difficult to reverse, and reversal is not usually available on the NHS 
No long-term effect on sexual health or hormone levels  In rare cases, further surgery may be needed (e.g., due to implant complications) 
Doesn’t interrupt sex or require ongoing effort   

 

Risks 

  • Small risk of complications such as bleeding, infection, or damage to other organs 
  • Rare chance of sterilisation failure — about 1 in 200 may become pregnant 
  • If pregnancy occurs, there is a higher chance of it being ectopic 

If you miss a period after sterilisation, take a pregnancy test. If it’s positive, see a GP immediately to confirm the pregnancy’s location.