Pros and Cons of Getting Your Tubes Tied

Tubal ligation is the medical term for surgical procedures commonly known as “getting your tubes tied” or tube-tying surgery. Tube-tying is one of the most common forms of permanent birth control, is safe, effective, and can be done at any time.

In this surgery, a woman’s fallopian tubes are permanently closed or removed to prevent pregnancy. Due to how invasive tubal ligation sounds, it is often assumed that getting your tubes tied is a painful procedure or that getting your tubes tied is a major surgery.

While laparotomy tubal ligation is considered a major surgery because it involves making a large incision in the abdomen, there are less invasive tube-tying surgery methods, such as a laparoscopic tubal ligation or mini-laparotomy, which are usually outpatient procedures with smaller incisions, faster recovery, and less discomfort.

Every woman has a different reason for considering female sterilization. It could be that you’re done having children or have made the decision not to have children. Some women also have health risks associated with becoming pregnant, while others may not want to pass down a genetic disorder that they or their partner carries.

Whatever the reason for considering female sterilization, having your tubes tied can be a great option for many women. There are advantages to getting tubal ligation that are not possible with other forms of birth control.

However, as with any surgical procedure, there are pros and cons you’ll want to weigh before deciding if getting your tubes tied is the best solution for your body. Tubal ligation is recommended for adult women who have had time to weigh the benefits against the potential disadvantages and risks carefully.

In this article, we’ll discuss:

The advantages and downsides to getting your tubes tied
Tying tubes procedure options
The getting your tubes tied process
Requirements for getting your tubes tied
Tubes tied costs, and if the procedure is covered by insurance

We’ll also answer commonly asked questions about tube-tying surgery, such as whether or not you get a period after having your tubes tied, if you can gain weight after fallopian tube removal, the chances of becoming pregnant after the procedure, and more.

After reading this, if you have questions or would like to move forward with a tying tubes procedure, give Dr. Lodge a call at Cool Springs OBGYN, located near Nashville, TN.

What is Tubal Ligation?

The fallopian tubes connect your uterus and ovaries and provide a passageway for the egg to pass through once released.

Tubal ligation is a type of permanent birth control where these tubes are either cut completely or closed off, preventing the egg from reaching the uterus and being fertilized by sperm.

Your tubes stay tied forever, and the procedure is about 99% effective in permanently preventing pregnancy. This high level of effectiveness is why many women consider it once they are certain about their family plans.

Is Tubal Ligation Reversible?

Although a tubal ligation is considered a permanent form of birth control, depending on the sterilization method, getting your tubes tied can sometimes be reversed through surgery.

However, the success of the reversal and the chance of being able to get pregnant vary widely depending on several factors. It is also important to note that some methods of tubal ligation, such as a bilateral salpingectomy, where both fallopian tubes are completely removed, are not reversible. The only option after a bilateral salpingectomy is in vitro fertilization (IVF), assuming the uterus and ovaries are still intact and functional.

Given the complexity and uncertainty of reversal surgery, doctors recommend that women not rush into the decision to have their tubes tied and only move forward once they are confident that permanent sterilization is the right choice.

While tube-tying surgery can reduce your risk of pregnancy, it doesn’t protect against sexually transmitted infections (STIs). Make sure to use protection during sexual activity if you want to reduce your risk of contracting an STI.

Reasons People May Choose To Get Their Tubes Tied

Every woman has her own reasons for considering permanent birth control. For some, it’s about protecting their health. For others, it’s about peace of mind knowing that pregnancy is no longer a possibility.

Regardless of the reason, it’s important to be certain that permanent birth control aligns with your future plans. As with any medical decision, the best choice depends on your long-term goals, your health history, and a full discussion with your doctor.

Advantages and Disadvantages of Getting Your Tubes Tied

The Pros of Tubal Ligation

There are various advantages to consider that are different from what other forms of non-permanent birth control offer.

If you are looking for a permanent form of birth control, this is it. There are no pills, shots, prophylactics, vaginal rings, or other types of birth control that you have to remember.
Getting your tubes tied is effective. After the procedure, the odds of getting pregnant again are 1 in 200. Getting your tubes tied does not 100% prevent pregnancy because, over time, tubes may grow back naturally in some women.
Your hormones are left intact. Unlike a hysterectomy, a careful tubal ligation leaves the ovary intact and able to continue making necessary feminine hormones. Other forms of birth control can cause mood swings, weight gain, headaches, and menstrual issues.
No expected weight related changes. Tubal ligation does not affect your ovaries, so the hormones that help control your weight and appetite are not affected. This procedure is one of the many options of birth control that have no direct effect on your weight.
Your risk of developing ovarian cancer lessens. One reason for the decreased occurrence is that many times, this cancer develops in the fallopian tubes. If the tubes are tied off, cancer has a more difficult time traveling to the ovary.

The Cons of Tubal Ligation

While tubal ligation is safe and effective, it’s not without its drawbacks. There are also disadvantages to consider, from the permanence of the procedure to the risks that come with surgery.

There is an increased risk of an ectopic pregnancy. Ectopic pregnancy is where the egg is fertilized and implants inside the fallopian tubes instead of the uterus. This type of pregnancy can not reach full term, and you will need to speak to your ob-gyn to determine an emergency contraception option.
Tubal ligation is permanent female sterilization. Tubal ligation reversal is a possible surgical option to reopen the fallopian tubes. Still, its success will depend on your age, the type of surgery you had, and your reproductive health.
Tubal ligation prevents pregnancy, but it does not prevent STDs. To take control of your reproductive health consider talking with your partner about sexual health, using a condom, or getting vaccinated to reduce the risk of infection.
Like any surgery, there are risks with more invasive procedures. You risk damage to your bladder, bowel, and blood vessels. Incisions can also become infected, leave scars, or cause lingering abdominal pain.

Types of Tubal Ligation Surgery

Tubal ligation can be performed immediately after childbirth, during a C-section, or at a later time as an elective procedure. The timing often determines which surgical method is used.

Understanding these variations can help you and your healthcare provider decide the best approach based on your individual circumstances and preferences.

If you are sure you want to move forward, you’ll be glad to know that getting your tubes tied sounds much scarier than it really is. Here is a more in-depth look at each type of tubal ligation procedure and how the surgery is performed.

Laparoscopic Tubal Ligation

Laparoscopic tubal ligation is the most common and least invasive method of permanent birth control. It is a same-day, outpatient procedure (meaning no hospital stay) that has a shorter recovery time, lower risk of complications, and minimal scarring. It also has a success rate of over 99%, making it one of the most reliable options for permanent birth control.

During the procedure, a small camera called a laparoscope is inserted through a tiny incision near the belly button, allowing the surgeon to see the fallopian tubes. A second small incision is made lower on the abdomen to insert specialized instruments that block, cut, or seal the tubes.

The tubes can be closed using clips, bands, or cauterization (burning), or a section may be removed entirely to create a permanent barrier that prevents eggs from meeting sperm.

Because the incisions are small, recovery is generally quick and very manageable. Most people go home the same day and can return to normal activities within 3 to 7 days. Mild discomfort, bloating, or cramping may occur as the body heals.

Mini Laparotomy

A mini-laparotomy is a slightly more invasive form of tubal ligation often performed immediately after childbirth for those who want permanent birth control without having to wait for a separate surgery later. While slightly more invasive, it is still highly effective and offers the same 99% success rate in preventing pregnancy.

In this procedure, a small incision, typically 1 to 2 inches long, is made just below the belly button. The fallopian tubes are brought through the incision and blocked or cut to prevent future pregnancies. The tubes can be tied and cut, cauterized, or a portion may be removed, depending on the surgeon’s approach.

Since a mini-laparotomy involves a larger incision than a laparoscopic procedure, the recovery period is slightly longer. Most people feel back to normal within 1 to 2 weeks, though it’s common to experience mild soreness and fatigue for a few days after the procedure.

Laparotomy

A laparotomy is the most invasive of the three tubal ligation methods. While it’s not commonly used for standard tubal ligations, it is a necessary option in certain situations when other methods aren’t suitable.

It is most commonly used when a woman wants immediate sterilization after a C-section because the surgeon can use the same incision made for childbirth, eliminating the need for an additional surgical cut.

This procedure can be done after a vaginal delivery or a C-section. After a vaginal delivery, a small cut is made under the belly button to access the fallopian tubes. During a cesarean section, the surgeon can perform the tubal ligation using the same incision made to deliver the baby. Often, a complete salpingectomy is performed, where the entire fallopian tube on each side is removed to further reduce the risk of ovarian cancer. In some cases, this may be done as a laparoscopic salpingectomy when surgical access and patient health allow, offering a minimally invasive approach with a quicker recovery.

If you elect to have tubes tied after recovery from childbirth, a laparoscopic tubal ligation can be performed. This outpatient procedure may also be done as a laparoscopic salpingectomy, where the fallopian tubes are completely removed instead of being clipped or sealed. Removal further decreases ovarian cancer risk while still serving as a permanent form of birth control.

If tubal ligation is performed at a time that is not connected to pregnancy, it is called an interval tubal ligation. This is usually done laparoscopically with general anesthesia. The tubes may be sealed by cautery (burning with an electric current) or blocked with clips or rings.

After completing the tubal ligation, the incision is closed with stitches, and the healing process begins. Because it’s an open abdominal surgery, a laparotomy generally requires a hospital stay of one to two days and comes with a longer recovery period compared to laparoscopic or mini-laparotomy procedures.

How to Prepare for a Tubal Ligation

Preparing for tubal ligation surgery involves a few important steps to make sure everything goes as planned. By following these steps, you’ll be well-prepared for your tubal ligation surgery, helping ensure a smoother process and faster recovery.

Consult with Your Healthcare Provider

Make an Informed Decision: Talk in detail with your doctor about the procedure. Understand the risks, benefits, and that tubal ligation is a permanent decision.
Ask Questions: Clear up any doubts about the surgery, recovery time, and what to expect long-term.
Medical History Review: Share your complete medical history with your doctor to avoid any potential complications.

Preoperative Instructions

Fasting Requirements: Per your medical team’s guidelines, you may need to fast for a period before surgery.
Medication Adjustments: You might need to stop certain medications or supplements before the procedure, like blood thinners. Your doctor will give you specific instructions.
Pre-Surgery Tests: Be ready for any preoperative tests, such as blood work or imaging, that your doctor might order.

Home Preparation

Arrange Transportation: Make sure you have someone to take you to and from the hospital.
Prepare Your Recovery Space: Set up a cozy area at home for rest. Have pain relievers, easy-to-make meals, and plenty of fluids on hand.

Tubal Ligation: Day of Surgery

Some details on the day of surgery may look a little different depending on which method you’re having. Regardless, you’ll follow your provider’s instructions closely to ensure the safest and smoothest experience.

Follow Instructions: Stick to any specific instructions for the day of surgery, like avoiding jewelry or makeup.
Wear Comfortable Clothing: Wear loose, comfy clothes to keep you at ease before and after the procedure.

Tubal Ligation Recovery: What to Expect After Getting Your Tubes Tied

After your tubal ligation, you’ll be moved to a recovery area where medical staff will monitor you. The length of your hospital stay depends on the type of procedure you had.

Laparoscopic Tubal Ligation: Most patients go home the same day, often within a few hours. Recovery at home is usually quick, with most women feeling back to normal within 3 to 7 days.
Mini-Laparotomy: Typically requires staying overnight in the hospital. At home, recovery usually takes 1 to 2 weeks.
Laparotomy: Requires at least one to two nights in the hospital. Full recovery at home may take 4 to 6 weeks because of the larger incision and longer healing time.
Post-Childbirth Tubal Ligation: If the procedure is done immediately after delivery, recovery is built into the postpartum hospital stay. At-home healing usually follows your overall childbirth recovery timeline.

Common Post-Surgery Guidelines and Restrictions

In general, most women are advised to follow these common post-surgery guidelines:

Incision Care: Keep the incision site clean and dry. Avoid baths, swimming, or hot tubs until your doctor clears you.
Showering: You can usually shower right away, but avoid soaking in a bath or swimming for about two weeks to allow your incision to heal.
Driving: Avoid driving for at least 24 hours after anesthesia or until you feel comfortable moving without pain medications.
Sexual Activity: Most providers recommend waiting about one week, or longer if you had the procedure after childbirth, until your doctor confirms healing.
Activity: Light activity is usually fine after a few days, but avoid heavy lifting or strenuous exercise for one to two weeks after laparoscopic surgery. More invasive procedures may require a longer rest period, and if the procedure was done right after childbirth, avoid lifting more than your baby for at least four weeks.
Alcohol: Don’t drink alcohol for at least 24 hours after surgery.
Follow-Up: Keep your post-op appointment so your provider can check healing, remove stitches if needed, and clear you for normal activity.

Managing Discomfort After Tubal Ligation Surgery

Here are the most common types of discomfort and what to expect:

General Pain: Mild cramping or soreness around the incision sites is common for the first few days. This usually improves quickly and can be managed with over-the-counter pain relievers or medication prescribed by your doctor.
Gas Pain: You might feel discomfort in your neck, shoulders, and chest from the gas used during the procedure. This can last up to 72 hours. A warm shower, heating pad, or gentle walking can help ease the pain.
Nausea: Mild nausea is common. Eating a light meal like soup, toast, or crackers the evening after surgery can help.
Swelling: Your abdomen might be swollen for a few days. Over-the-counter pain relief or prescription medication from your doctor can help manage this.
Bleeding: You might experience some vaginal bleeding for up to a month. Your next period could be delayed by four to six weeks and might be heavier and more uncomfortable than usual.

Side Effects and Potential Complications of Tubal Ligation

While most side effects and risks are similar across all types of tubal ligation procedures, the degree of invasiveness can slightly affect recovery time and potential complications.

The most common side effects of tubal ligation surgery are mild cramping, abdominal pain, nausea, and bloating. Some also report shoulder pain from the gas used in the laparoscopic procedure and fatigue or lightheadedness if you have a method that requires anesthesia.

Complications from tubal ligation are uncommon, but as with any surgical procedure, there are some potential risks:

Infection: A low risk, but possible if bacteria enter the incision sites.
Bleeding or Hematoma: Rare, but bleeding can occur internally or at the incision.
Damage to Surrounding Organs: In extremely rare cases, nearby organs such as the bladder or intestines can be accidentally injured during the procedure.
Reaction to Anesthesia: As with any surgery, there’s a slight risk of adverse reactions to anesthesia.
Ectopic Pregnancy: In the rare event that pregnancy does occur after getting your tubes tied, it’s more likely to be ectopic. Ectopic pregnancies require immediate medical attention as they can be life-threatening if untreated.
Post-Tubal Ligation Syndrome (PTLS): Some women report experiencing changes in menstrual cycles, hormone fluctuations, or other symptoms after the procedure. Doctors call this Post-Tubal Ligation Syndrome (PTLS).

Understanding Post-Tubal Ligation Syndrome (PTLS)

Post-tubal ligation syndrome (PTLS) refers to a set of symptoms that some people experience after having a tubal ligation.

Common Symptoms of PTLS

PTLS symptoms can show up months or even years after the procedure. Some of the common symptoms include:

Pelvic or Back Pain: Discomfort in the lower abdomen or back.
Dyspareunia: Pain during intercourse.
Headaches: Frequent or severe headaches.
Menstrual Irregularities: Cramps, unusual bleeding, or missed periods.
Hormonal Fluctuations: Symptoms similar to PMS or menopause, like mood swings, hot flashes, and irritability.

When to Seek Medical Advice for Post-Tubal Ligation Syndrome

If you’ve had a tubal ligation and are experiencing these symptoms, it’s important to talk to your healthcare provider. They can help manage the symptoms and check for any other underlying issues. Early intervention can make a big difference in managing PTLS and improving your quality of life, so don’t hesitate to seek professional help if you think you might have PTLS.

Frequently Asked Questions About Tubal Ligation

What is the recommended age to get your tubes tied?

Many wonder if a woman can get her tubes tied at any age. Federally, there is no legal age requirement to get your tubes tied. However, the legal age varies between states, but you must be between 18 and 21 to undergo this procedure.

It is reported that 25% of women under 30 years of age who choose tubal ligation experience regret. We all change as we grow and mature, and many times our life goals change with time or even with a partner. It is recommended to wait until your 30s to choose to get your tubes tied.

If getting your tubes tied isn’t the form of pregnancy prevention that works for you, there are many other options. Some low-maintenance options that are 99% effective include an IUD and a birth control implant.

IUD: This is a tiny device that is inserted into the uterus to prevent pregnancy. Different FDA-approved brands may use copper or hormones to prevent sperm from getting to the egg. While it is long-term, it is also reversible. The IUD lasts 3 – 12 years and is 99% effective. This method can cost $0 – $1,300.
Birth Control Implant: This implant, also known as Nexplanon, is a small thin rod that is inserted into your arm. It releases hormones into the body that prevent pregnancy. This method is reversible and can last up to 5 years. It is 99% effective and costs $0 – $1,300.

What are the requirements for getting your tubes tied?

The first step in determining whether you qualify for tubal ligation is to check the age requirements set by both your state and your medical insurance provider.

Laws governing sterilization procedures vary from state to state, and some states may have minimum age requirements or additional consent rules. For example, certain states may require patients under a specific age to undergo counseling or wait a designated period before proceeding with the procedure.

Your insurance provider may also have its own age requirements if you’re hoping to have the procedure covered. While private insurance companies may follow state guidelines, federally funded programs like Medicaid have stricter requirements. For example, if you’re using Medicaid or another federally funded plan, you must be at least 21 years old and considered “mentally competent” to consent to the procedure.

Additionally, federal guidelines require a mandatory waiting period of 30 days between giving informed consent and having the procedure performed. This waiting period is designed to ensure that the decision is voluntary, well-informed, and not made under pressure or emotional distress. The consent process includes receiving detailed information about the procedure, its permanence, and possible alternatives.

How much does it cost to get your tubes tied, and is it covered by insurance?

The cost of tubal ligation can vary widely. The final price will depend on the type of procedure you receive and whether your health insurance company will cover some or all of the cost.

Tubal ligation costs range from $0 to $6,000. To find out what you might be paying, schedule an appointment with Dr. Lodge.

Do you still get a period with your tubes tied?

One of the first questions women ask about tube-tying surgery is if they will still have a period after having their tubes tied. Many also wonder if they can have a period without fallopian tubes (after a salpingectomy).

Yes, you’ll still get your period after having your tubes tied. Tubal ligation, or sterilization, does not mess with your hormonal cycle.

Here’s what you need to know:

Menstrual Cycle: The procedure won’t cause menopause or change your period. Your ovaries keep working normally, releasing eggs and hormones.
Period Regularity: If your periods were irregular before, they’ll likely stay that way after the surgery. The procedure doesn’t affect hormone levels or menstrual regularity.
Hormonal Balance: Because tubal ligation doesn’t involve removing your ovaries or uterus, your hormonal balance remains the same.

So, in short, tubal ligation is an effective birth control method that doesn’t affect your menstrual cycle. Your periods will continue as usual.

When can I have sex again after getting my tubes tied?

It’s usually recommended to wait about a week before having sex again. This gives your body time to start healing and lowers the risk of infection or complications.

If You Recently Had a Baby

If your tubal ligation was done right after childbirth, the timeline is different. Typically, it’s best to wait about six weeks or until your healthcare provider gives you the green light. This waiting period allows your body to recover from childbirth and ensures any stitches or incisions from the procedure have healed properly.

Individual Healing Process

Keep in mind that everyone heals at their own pace. Your doctor will give you specific advice based on your overall health, the details of your surgery, and any complications that may have occurred. It’s important to listen to your body, follow your doctor’s guidance, and take things at your own pace.

What are the long-term effects of having your tubes removed?

The main impact is permanent loss of fertility. Removal of the tubes may also lower the risk of ovarian cancer, since some cancers start in the fallopian tubes.

What happens to my eggs after a tubal ligation?

Even after a tubal ligation, your ovaries continue to release eggs as part of your normal ovulation cycle. Here’s what happens to those eggs:

Release: During ovulation, your ovary releases an egg, just like before the procedure.
Blocked Passage: Because your fallopian tubes are blocked or sealed, the egg can’t travel through them to meet sperm for fertilization.
Absorption: The egg stays in the reproductive system and will eventually dissolve or be reabsorbed by your body.

This process is completely natural and doesn’t harm your body. The dissolution and absorption of the egg are just like how your body handles other cells that naturally expire.

Schedule a Consultation for Tubal Ligation

If you would like more information about the advantages of female sterilization or would like to know if this option of pregnancy prevention is right for you, please schedule an appointment with an experienced gynecologist.

Dr. Jefrey Lodge is a compassionate and experienced women’s health doctor who can assess your current health status and give you the best options that will work for you.