27 July 2004

Tied up over sterilisation?

You're 35, you've had four children, of which the first three were planned, and your body is tired of the pill after many years. What now? Is your sex life doomed? What about female sterilisation?

You're 35, you've had four children, of which the first three were planned, and your body is tired of the pill after many years. What now? Is your sex life doomed? What about female sterilisation?

Female sterilisation is a small operation – well, not exactly as minor as a vasectomy - that can make a very big difference to your life. But it is not reversible, so you have to consider many things before you take this step.

Mention sterilisation and there are many questions that come up, mostly with regards to the pros and cons of this procedure. What are these?

The pros of sterilisation

  • Sterilisation is a simple procedure, in which a surgeon blocks the fallopian tubes, which carry the eggs from the ovaries to the uterus.
  • It can be done free of charge at many Public Sector Hospitals and is performed under general or local anaesthetic.
  • It is a simple operation and can usually be done in a few minutes, and often does not even require an overnight stay in a hospital.
  • No organs are removed, your ovaries carry on producing hormones and you carry on menstruating.
  • It is a permanent one-time method of contraception and enables you to enjoy sex without the fear of falling pregnant.
  • It is immediately effective in preventing pregnancy.

The cons of sterilisation

  • It should be regarded as an irreversible procedure and should not be considered by people who might still want more children down the line. The decision should not be taken lightly.
  • It provides no protection against sexually transmitted infections.
  • There is a small failure rate of about one pregnancy per 200 sterilisations.
  • When considering any medical procedure, one has to accept that there are risks involved. "All surgery involves a small risk," says Dr P.S. Steyn, Head of the Family Planning and Reproductive Health Care Unit at Tygerberg Hospital. "But complications during or after sterilisations are unusual and occur in only one to four percent of patients."

Before you opt for sterilisation
"The most important part of the decision-making process, is the counselling session, during which the reasons are discussed for wanting to have this procedure, " says Carla Johnson, national organiser of the Association for Voluntary Sterilization in Cape Town. "A woman of 25 who has had four children, might be a candidate for sterilisation, but not a woman of 30 who has had only one."

"A woman who is being pressurised by a partner into this, or a woman whose relationship or marriage is unstable, should not consider sterilisation. Also not someone who wonders about whether the procedure can be reversed."

No link to early menopause
And is there any connection between sterilisation and the early onset of menopause?

"None whatsoever," according to Dr Hendrik van der Merwe, Cape Town gynaecologist. "Your ovaries are still producing hormones like they usually do, whether you have been sterilised or not. Menopause will not be delayed or speeded up as a result of sterilisation." (Susan Erasmus, Health24)


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