If a woman is sexually active and she is fertile -- physically able to become pregnant -- she needs to ask herself, "Do I want to become pregnant now?" If her answer is "No," she must use some method of birth control (contraception).

There are a number of different ways to describe birth control. Terms include contraception, pregnancy prevention, fertility control, and family planning. But no matter what the process itself is called, sexually active people can choose from a plethora of methods to reduce the possibility of their becoming pregnant. Nevertheless, no method of birth control available today offers perfect protection against sexually transmitted infections (sexually transmitted diseases, or STDs), except abstinence.

Sterilization is considered a permanent method of contraception. In certain cases, sterilization can be reversed, but this is not guaranteed. For this reason, sterilization is meant for men and women who do not intend to have children in the future.

Vasectomy

A vasectomy is a form of sterilization for a man. A vasectomy ensures that no sperm will exit from his penis when he ejaculates during sexual intercourse.

A vasectomy is usually performed by either a urologist or a general surgeon. Under local anesthesia, the spermatic duct (vas deferens), which carry the sperm from the testicles, are cut and the open ends closed off. After a vasectomy, the man may feel tenderness or bruising around the incision site.

A vasectomy does not interfere with the ability of a man to have an erection or the quantity of his ejaculation fluid. After a man has a vasectomy, another second form of birth control should be used until his ejaculate fluid is found to be free from sperm. This usually takes 10 to 20 ejaculations. A vasectomy is over 99% effective if a man has two sperm-free ejaculates (as determined by laboratory testing) to confirm his sterility.

Tubal ligation

Tubal ligation is also known as "having ones tubes tied," or having a "tubal." Tubal ligation is for women, and like a vasectomy, should be considered a permanent form of birth control.

A tubal ligation is performed under general, regional, or local anesthesia and can be performed as an outpatient procedure. The surgeon or ob/gyn uses one of several procedures in order to access a woman's Fallopian tubes (which run from the top part of her uterus to each ovary). A laparoscopy is a procedure in which a small incision is made just below the navel. A scope can then be inserted through this incision to view and reach the Fallopian tubes. A minilaparotomy is a small incision in the lower abdomen. A laparotomy is a long incision that is made through the muscle layers of the abdomen.

Once the physician has access to a woman's Fallopian tubes, they are closed off by using a clip, cutting and tying, or cauterizing (burning) the tubes. The procedure takes anywhere from 10 to 45 minutes.

Selective tubal occlusion procedure (STOP)

Selective tubal occlusion procedure (STOP) is a nonsurgical form of permanent birth control in which a physician inserts a 4-centimeter (1.6 inch) long metal coil into each one of a woman's two Fallopian tubes via a scope passed through the cervix into the uterus and from there into the openings of the Fallopian tubes. Over the next few months, tissue grows over the coil to form a plug that prevents fertilized eggs from traveling from the ovaries to the uterus.

STOP takes 15 to 30 minutes, can be done in a doctor's office, and usually requires only a local anesthetic. During a 3-month period after the coils are inserted, women must use other forms of birth control until their physician verifies by X-ray that the Fallopian tubes are completely blocked.

STOP is permanent (not reversible) and is designed as an alternative to surgical sterilization which requires general anesthesia and an incision. About 6% of women who have had STOP have side effects, mainly due to improper placement of the coils.

Hysterectomy

A hysterectomy is the surgical removal of a woman's uterus and, depending on her overall health status, perhaps her ovaries as well. No woman who has had a hysterectomy can become pregnant; it is an irreversible method of birth control and absolute sterilization.

If a woman has other chronic medical problems that may be helped by a hysterectomy, than this may be an appropriate procedure for her to consider. Otherwise, contraception should be considered a secondary benefit and not a reason to have the procedure in the first place.