The symptoms of menopause may start up to a decade before its onset, but until a whole year has passed without a period, pregnancy is still possible. Birth control options used in our 20s and 30s may not be as suitable as our bodies and lives change. Hormonal birth control may increase the chance of developing breast cancer, heart trouble, or blood clots. It’s a good idea to discuss contraceptive choices with your doctor regularly to ensure that they can determine if you are still using the most appropriate option for your situation.
Tubal ligation, referred to as having your tubes tied, is a permanent form of birth control. Doctors may recommend a tubal ligation procedure as an option for women who are very certain they will not want children in the future. These procedures prevent the passage of sperm through the fallopian tubes, typically through surgical means. Some patients are later able to restore function to the fallopian tubes, but not always.
Women considering any form of permanent birth control may be worried about the effect it will have on their hormones. As tubal ligation can interfere with blood flow to the ovaries, some women may experience fluctuations in hormone levels, but this is the exception rather than the rule. In most cases, tubal sterilization does not alter the balance of hormones at all.
Recent studies show that while women report more perimenopause symptoms after tubal ligation, the average age of menopause onset remains the same. The most commonly experienced perimenopause-like symptoms after tubal ligation includes hot flashes, poor sleep, night sweats, depression, and irritability. So, while tubal ligation might cause some women to experience menopause-like symptoms, it does not actually cause a woman to enter menopause, and women will continue to have their period after the procedure has been completed.
Types of Tubal Ligation
There are several effective forms of tubal ligation. Most tubal ligations are surgical, therefore effective immediately. Hysteroscopic tubal sterilizations are a non-surgical alternative to more traditional forms of tubal ligation. Patients preparing for a tubal ligation of any sort should disclose each of their medications and supplements to their doctor before anesthesia to prevent the possibility of negative interactions occurring.
During the Parkland method of tubal litigation, two ligatures are placed around the fallopian tubes that starve the middle section of blood. This excises the section between the two ligatures. Tubal reversal microsurgery, reattaching the two new ends of the fallopian tubes to one another, is often successful.
This method of tubal ligation involves not only re-sectioning portions of the fallopian tube but also suturing the open segment of one tube to the outside wall of the uterus. This method is both exceptionally effective and exceptionally difficult to reverse as there is very little left of the original fallopian tube.
Pomeroy Tubal Ligation
The Pomeroy method of tubal ligation involves elevating a segment of the fallopian tube, tying off the base with an absorbable ligature. The elevated loop is then severed. New tissue soon grows over the exposed ends of the fallopian tube. This scar tissue prevents the segments from reattaching to one another even after the ligature has been absorbed. As with most forms of tubal ligation, reversal is possible, but success rates are very low.
This method of sterilization involves cauterizing a section of the fallopian tube using an electrical current. Tubal coagulations are focused on just one fallopian tube, monopolar tubal coagulation, or on both, bipolar tubal coagulation. A large portion of the fallopian tube is removed during this procedure, making reversal exceptionally challenging.
Fimbriectomy Tubal Ligation
Instead of removing a section in the middle, fimbriectomy removes the fimbrial and infundibular portions of the fallopian tube. When these portions, which sit closest to the ovary, are removed from the reproductive system, the fallopian tube can no longer draw eggs from the ovaries. Fimbriectomy is typically not reversible, and women who wish to later conceive may opt for IVF to meet their goal.
Tubal Clips or Rings
Clips or rings may be surgically inserted to cut off circulation to a section of the fallopian tube. A ring, also known as a Falope, Yoon, or Lay loop, is placed around the bottom of an extended loop, much like the Parkland method. Instead of cutting the loop, the band’s tightness cuts off circulation, and the loop is replaced by scar tissue. This method is extremely difficult to reverse. The spring-clip, or Hulka, is a single mechanical clip placed over the fallopian tube. This is the least damaging ligation method to the fallopian tubes, with a higher possibility of pregnancy following a reversal.
The idea of starting a new family in our 40s or 50s is daunting, and for most, is high risk. Women who are pregnant after 40 are more likely to experience gestational diabetes, high blood pressure, and birth defects than younger women. Many women can use hormonal methods of contraception right through to menopause. For other women, the higher estrogen levels also increase the chances of developing breast cancer, blood clots, and stroke. Tubal ligation, which has almost no long-term effect on the hormone balance, may be a good option for these women.