Tubal ligation: Difference between revisions
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[[Tubal ligation]], also called getting one's tubes tied, is a form of sterilization. It works by stopping the egg cell from being able to travel through the fallopian tube to the uterus. For people who have a uterus, this procedure is meant to make it permanently virtually impossible for them to get pregnant. For some [[transgender]] and [[nonbinary]] people, if their only concern about their uterus is that a risk of pregnancy is a source of distress and body dissonance (called [[gender dysphoria]]), this is an alternative to removing the uterus (called [[hysterectomy]]).<ref>Laura Erickson-Schroth, ed. ''Trans Bodies, Trans Selves: A Resource for the Transgender Community.'' Oxford University Press, 2014. Pp. 236, 267-268.</ref> Tubal ligation has no effect on the person's menstrual flow, menstrual cycle, hormone balance, the ability to orgasm, | [[Tubal ligation]], also called getting one's tubes tied, is a form of sterilization. It works by stopping the egg cell from being able to travel through the fallopian tube to the uterus. For people who have a uterus, this procedure is meant to make it permanently virtually impossible for them to get pregnant. For some [[transgender]] and [[nonbinary]] people, if their only concern about their uterus is that a risk of pregnancy is a source of distress and body dissonance (called [[gender dysphoria]]), this is an alternative to removing the uterus (called [[hysterectomy]]).<ref>Laura Erickson-Schroth, ed. ''Trans Bodies, Trans Selves: A Resource for the Transgender Community.'' Oxford University Press, 2014. Pp. 236, 267-268.</ref> Tubal ligation has no effect on the person's menstrual flow, menstrual cycle, hormone balance, the ability to orgasm, vulnerability to sexually transmitted infections,<ref name="planned parenthood">"Sterilization." ''Planned Parenthood.'' Retrieved July 9, 2020. https://www.plannedparenthood.org/learn/birth-control/sterilization</ref> or when or how the person will go through menopause.<ref>Nelson, D. “Tubal ligation does not affect hormonal changes during menopausal transition.” 2005.</ref> It does not elevate any cancer risks.<ref name="brinton cancer">Brinton LA, Gammon MD, Coates RJ, Hoover RN. “Tubal ligation and risk of breast cancer.” British Journal of Cancer 2000 May; 82(9), 1600–1604. doi:10.1054/bjoc.1999.1182 </ref><ref name="turney">Turney, Lyn. “Risk and contraception: What women are not told about tubal ligation.” Women’s Studies International Forum 16:5 (1993).</ref> Sometimes a person can choose to have [[uterine ablation]] done at the same time as tubal ligation, which is supposed to stop menstrual flow. If someone chooses to get ablation, then they have to get a tubal ligation or some other kind of contraception too.<ref name="donnadieu 2007">Donnadieu, A., et al. “Essure sterilization associated with endometrial ablation.” 2007.</ref><ref>Donnadieu, A., and Fernandez. “The role of Essure stabilization performed simultaneously with endometrial ablation.” 2008. </ref> | ||
There are various methods for tubal ligation, which can be considered either a laparoscopic surgery (meaning it is done by cutting only a few tiny holes on the lower belly, and putting long thin laparoscope tools through them to do the work), or a procedure (meaning it can be done without cutting into the body). The fallopian tubes (which connect the ovary to the uterus) can be blocked off by a variety of different methods. The tubes can be tied and cut (ligation), clipped, pinched off in a loop with a band, burned (cauterization), blocked with scar tissue or an implant (tubal occlusion), or completely destroyed (salpingectomy). Any of these methods can be called tubal ligation on paperwork and health insurance. Cutting or tying the tubes has the most risk of still being able to get pregnant, whereas destroying the tubes is the most effective at preventing pregnancy. Blocking the tubes with an implant can be done by putting it in through the vagina, without cutting into the body, which is safer,<ref name="donnadieu 2007" /> but an implant has the risk of later traveling into parts of the body where it is not supposed to be, which can be harmful. | There are various methods for tubal ligation, which can be considered either a laparoscopic surgery (meaning it is done by cutting only a few tiny holes on the lower belly, and putting long thin laparoscope tools through them to do the work), or a procedure (meaning it can be done without cutting into the body). The fallopian tubes (which connect the ovary to the uterus) can be blocked off by a variety of different methods. The tubes can be tied and cut (ligation), clipped, pinched off in a loop with a band, burned (cauterization), blocked with scar tissue or an implant (tubal occlusion), or completely destroyed (salpingectomy). Any of these methods can be called tubal ligation on paperwork and health insurance. Cutting or tying the tubes has the most risk of still being able to get pregnant, whereas destroying the tubes is the most effective at preventing pregnancy. Blocking the tubes with an implant can be done by putting it in through the vagina, without cutting into the body, which is safer,<ref name="donnadieu 2007" /> but an implant has the risk of later traveling into parts of the body where it is not supposed to be, which can be harmful. | ||
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Sepsis is an extremely rare complication. | Sepsis is an extremely rare complication. | ||
Tubal ligation does not increase the risk of cancer. In fact, tubal ligation correlates with a significantly lower rate of breast cancer<ref name="brinton cancer" /> and ovarian cancer.<ref name=" | Tubal ligation does not increase the risk of cancer. In fact, tubal ligation correlates with a significantly lower rate of breast cancer<ref name="brinton cancer" /> and ovarian cancer.<ref name="brinton cancer" /> | ||
Tubal ligation makes it virtually impossible to get a pregnancy of any kind. It is extremely rare for a pregnancy to happen afterward anyway, but it does happen. This can happen if the fallopian tubes weren't fully cut, tied, blocked, or destroyed, so that there was still enough of an opening in the tube for an egg or sperm to pass through. There is a tiny risk that if someone does get pregnant after a tubal ligation, then the embryo might implant in the wrong part of the uterus. This is called an ectopic pregnancy. Whether the embryo implants in the ovary (an ovarian pregnacy) or in the fallopian tube (a tubal pregnancy), it can cause the pregnant person to suffer circulatory collapse and die.<ref>Raziel, et al. “Ovarian pregnancy—a 12-year experience of 19 cases in one institution.” 2003.</ref> If someone gets an ectopic pregnancy, it is a life-threatening emergency that can only be fixed by removing the embryo (an abortion), which can sometimes only be done by surgery. For every 1,000 women who have their tubes cut, about 5 will later get pregnant, and of those, about 1 in 3 gets an ectopic pregnancy,<ref name="planned parenthood" /> which is still much rarer than ectopic pregnancies in people who have not had a tubal ligation. For comparison, even if someone has had their uterus removed, but still has ovaries, there is still a chance that they could get an ectopic pregnancy. The only kind of surgery that makes it completely impossible to get pregnant is removal of the ovaries, but that means the person's body won't make hormones anymore. | Tubal ligation makes it virtually impossible to get a pregnancy of any kind. It is extremely rare for a pregnancy to happen afterward anyway, but it does happen. This can happen if the fallopian tubes weren't fully cut, tied, blocked, or destroyed, so that there was still enough of an opening in the tube for an egg or sperm to pass through. There is a tiny risk that if someone does get pregnant after a tubal ligation, then the embryo might implant in the wrong part of the uterus. This is called an ectopic pregnancy. Whether the embryo implants in the ovary (an ovarian pregnacy) or in the fallopian tube (a tubal pregnancy), it can cause the pregnant person to suffer circulatory collapse and die.<ref>Raziel, et al. “Ovarian pregnancy—a 12-year experience of 19 cases in one institution.” 2003.</ref> If someone gets an ectopic pregnancy, it is a life-threatening emergency that can only be fixed by removing the embryo (an abortion), which can sometimes only be done by surgery. For every 1,000 women who have their tubes cut, about 5 will later get pregnant, and of those, about 1 in 3 gets an ectopic pregnancy,<ref name="planned parenthood" /> which is still much rarer than ectopic pregnancies in people who have not had a tubal ligation. For comparison, even if someone has had their uterus removed, but still has ovaries, there is still a chance that they could get an ectopic pregnancy. The only kind of surgery that makes it completely impossible to get pregnant is removal of the ovaries, but that means the person's body won't make hormones anymore. | ||