Tubal ligation

Dear Alice,

What is the difference between getting your tubes tied vs. tubal ligation? Which is the best? What are the side effects? Could getting one of these surgeries cause hormonal imbalances?

Dear Reader,

Getting your tubes tied (the popular expression) and tubal ligation (the medical term) actually refer to the same process! Tubal ligation is generally considered a permanent form of pregnancy prevention, or sterilization, for people assigned female at birth. The tubes in question refer to the fallopian tubes, which are a set of thin tubes that transport eggs from the ovaries to the uterus during ovulation. If an egg and a sperm meet in the fallopian tube, fertilization can occur. A fertilized egg then travels to the uterus, where it imbeds itself on the uterine wall and may develop as a pregnancy. Tubal ligation is a procedure that cuts, ties off, or blocks the fallopian tubes in order to prevent an egg and sperm from meeting. To your question about hormonal imbalance as a result of the procedure, recent research suggests that tubal ligations don’t have a significant impact on reproductive hormones (more on that later).

So what can be expected during the procedure? Some types of tubal ligation involve small incisions near the belly button to cut or block the fallopian tubes. Anesthesia is generally used, and the type of anesthesia depends on how the procedure is done, which is a decision that can navigated with a health care provider. With this procedure, the results are considered permanent. While surgery can be performed to attempt a reversal, it tends to be quite complicated and there’s no assurance that it’ll be successful.

Tying tubes can also come with a host of benefits. The procedure won’t affect the body’s hormones — that means no changes to menstrual periods or initiation of early menopause. It’s a great option for those who know they never want to become pregnant and are hoping to avoid hormonal contraception methods. It may also be of interest to know that some people who undergo tubal ligation find that they’re better able to relax and enjoy sex even more because they aren’t worried about becoming pregnant.

As with any type of medical procedure, there are potential risks. With tubal ligation, risks include adverse reactions to anesthesia or medications, infection, pain, and (in rare cases) accidental damage to nearby organs and tissues. Although tubal ligation is 99 percent effective at preventing pregnancy, if pregnancy does occur, there is a greater risk of having an ectopic pregnancy. This type of pregnancy occurs when a fertilized egg grows and develops in the fallopian tube. It’s considered to be life-threatening and requires immediate medical attention. Note that tubal ligations don’t protect against sexually transmitted infections (STIs), so condoms may be used to reduce the risk of STI transmission. 

Tying it all together, Reader, tubal ligation is considered a low risk and reliable form of permanent birth control. For people who don’t wish to become pregnant, who’d like to limit the size of their family, or who haven’t been satisfied with other birth control methods, tubal ligation may be an appropriate option to discuss with a health care provider.

Last updated May 08, 2020
Originally published Mar 28, 2003

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