What is sterilization?

Sterilization is a very safe method of birth control. Sterilization of men is a smaller operation in the body than sterilization of women.

Who can be sterilized?

Anyone over the age of 18 has the right to be sterilized.

Young people between the ages of 18-25 can only have the sterilization carried out six months after they have approached the doctor about being sterilised.

In special cases, persons under the age of 25 may be sterilized earlier than six months after presenting their wish for sterilization, e.g. if there are serious hereditary diseases in the family, or if a pregnancy could endanger the life of the woman or the child.

Who is the method suitable for?

Before having a sterilization performed, you should know that you cannot expect to have the procedure reversed in case you regret it later. Approximately 6-7% regret sterilization. Only about half manage to achieve pregnancy after undone sterilization.

It is sometimes possible to recreate the passage in both the sperm and fallopian tubes: this is called refertilisation, but the operations do not always succeed as expected. In most cases, you have to pay for the operation yourself at a private clinic.

If artificial insemination is used instead of refertilization or because refertilization has not been successful, there may also be an out-of-pocket payment. For women under the age of 40 with a new partner, with whom she does not already have a child, artificial insemination is free.

Sterilization is most suitable if you:

• Have had the children you want
• Are 30 years of age or older
• Have agreed the sterilization with a permanent partner
• Are not subjected to pressure to undergo sterilization from your partner
• Haven't had a recent personal crisis
• your relationship is not a new relationship

It is therefore a very good idea to consider whether you can use other contraceptive methods before choosing to be sterilised. If in doubt, do not opt for sterilization. Better talk to a doctor or other counselor one more time.

Sterilization of men

The procedure is carried out under local anesthesia on an outpatient basis in a hospital or at a specialist practitioner who has received a special permit.

During the operation, a small piece of the vas deferens is removed so that the sperm cannot pass out through the penis. The procedure itself takes 10-15 minutes.

After a man is sterilized

Even if you are sterilized, you will still ejaculate and you will have the same orgasms. Almost as much seminal fluid flows out as before you were sterilized, but there are just no sperm in it.

Sperm cells are still formed, but they are absorbed into the body in the same way as other cells. Your hormone production is unchanged and you will have the same desire for sex as before.

When does the method work?

For the first 3-6 months or approximately 40 ejaculations after the procedure, there may still be sperm in the seminal fluid. It is therefore necessary to use another method of contraception in the first three months.

After three months, a semen sample is examined. The semen sample must be sperm-free before you and your partner stop using other contraception. Only 1 in 1000 sterilized men still have sperm in the ejaculate three months after sterilisation.

Male sterilization is a very effective birth control method. It can, however, in very few cases fail because the passage in the vas deferens re-emerges.

Discomfort after sterilization

There are few inconveniences afterwards. Immediately after the operation, the scars may tighten a little, and there may be some swelling and blood collection. You can continue to attend to your work, but must avoid major physical activity, including sex, for the first week after surgery.

In some cases, there may be slight pain for days and weeks after the procedure. A few may experience infection in the surgical wound.

In the case of men, the accumulated sperm can in some cases form small nodules in the scrotum. These often disappear on their own, but in rare cases must be removed surgically.

Some men can develop pain/discomfort in the scrotum for a long time after the operation - the so-called post vasectomy pain syndrome, PVPS. It varies from study to study how many men experience these pains. According to some studies it is experienced by 4% while in others it is experienced by 15%.

Sterilization of women

Female sterilization is a much larger operation than male sterilization. During sterilization, the passage through the oviduct is interrupted, so that sperm and egg cannot meet and fertilization takes place. The fallopian tubes can be closed by putting a clip or ring on them, by burning the fallopian tubes or placing a small spiral inside the fallopian tube.

The intervention is carried out with the help of binoculars, through one or two small incisions between the navel and the hairline by clip, ring or burning. IUDs are placed in the fallopian tubes from the inside through the uterus. Sterilization of women is in most cases an operation carried out in a hospital under full anaesthesia.

Local anesthesia or no anesthesia is used only for sterilization with a spiral in the fallopian tubes.

After a woman is sterilized

Even if you have been sterilized, you will still ovulate once a month. The egg cells are absorbed into the body like other cells, and menstruation continues as usual.

Your hormone production is unchanged and you will have the same desire for sex as before. Your orgasms will not be affected either.

When does the method work?

Sterilization of women is a very safe contraceptive method. The method works immediately after the procedure, except for the spiral method, which is only effective three months after placement.

Method failure can occur in 0.8-4% of sterilizations of women due to incomplete surgical technique or because channels occur that reconnect the two parts of a fallopian tube after surgery.

If menstruation does not occur after sterilization, it is therefore necessary to take a pregnancy test to check.

What do you do if you want to be sterilized?

If you are thinking about being sterilised, you must contact your doctor or one of the birth control clinics of the country. Here, the doctor will explain about the procedure, how it is performed and what complications may arise.

You will also be told that it is a final decision, as the procedure is difficult to reverse. After the interview, both you and the doctor must sign that you have received this information.

Can you undo?

Once you have decided on sterilization, you will only get an appointment a few months after you have signed up. This is a so-called safety period that can reduce the risk of you regretting the procedure.

In the wards where sterilization of women is carried out, it is standard procedure to talk to the woman about having a hormonal IUD installed instead of being sterilised. Choosing a hormonal IUD has many advantages:

• You should not undergo an operation with the risks it entails
• The spiral is a safe solution (safety is as high as sterilization)
• The spiral can be taken out again if you regret it
• The hormonal IUD reduces the frequency of heavy bleeding - a problem many women have when they reach the age when they start to consider sterilization.

You can regret your choice of sterilization until the doctor begins the procedure itself.

Advantage

• Sterilization is permanent
• The method is close to 100% safe
• You don't have to think about contraception in everyday life
• Sterilization does not cause an interruption in intercourse

Disadvantage 

• Sterilization is difficult to reverse
• You cannot be sure of achieving pregnancy if the fallopian tubes/fallopian tubes are surgically opened
• Does not protect against sexually transmitted diseases