Women's Health

This is educational info only, talk to a provider about what fits your body and life. Effectiveness numbers are "typical use" unless noted.

• Combined pill (estrogen + progestin), ~91% effective
• Mini-pill (progestin only), ~91%, strict timing
• Patch, weekly, ~91%
• Ring (NuvaRing), monthly, ~91%
• Shot (Depo-Provera), every 3 months, ~94%
• Hormonal IUD (Mirena, Kyleena), 3–8 years, >99%
• Implant (Nexplanon), up to 3 years, >99%

• Copper IUD (Paragard), up to 10 years, >99%
• Condoms (external/internal), 85–79%, also protect against STIs
• Diaphragm + spermicide, ~88%
• Cervical cap, 71–86%
• Spermicide alone, ~72%

• Track BBT, cervical mucus, and cycle length to identify fertile window
• Symptothermal method: ~76–98% depending on consistency
• Requires daily tracking and a regular cycle

• Tubal ligation / salpingectomy, >99%
• Vasectomy (partner), >99%, simpler procedure

Female sterilization is a permanent form of contraception that closes, blocks, or removes the fallopian tubes so an egg and sperm cannot meet. It is one of the most effective options available, and it is also one of the most personal decisions a woman can make. Whatever brings you to read this, your reasons are valid, and you deserve clear, gentle information.

• Tubal ligation: the fallopian tubes are cut and then tied, sealed, or cauterized so eggs can no longer travel to the uterus.
• Tubal occlusion: the tubes are blocked using small clips, rings, or bands placed around them, with no cutting of the tube itself.
• Salpingectomy: one or both fallopian tubes are removed completely. This is increasingly recommended because it may also lower the lifetime risk of ovarian cancer.

• Most are done laparoscopically: a few tiny incisions in the abdomen, a small camera, and gentle work on the tubes under general anesthesia.
• Some are performed right after childbirth (mini-laparotomy) through a small cut near the belly button, or at the time of a cesarean.
• The ovaries and uterus are left in place, so your body keeps producing eggs and hormones as before.

• All forms are more than 99% effective at preventing pregnancy.
• Bilateral salpingectomy (both tubes removed) is considered the most effective and has the lowest failure rate.
• In rare cases pregnancy can still occur, and when it does there is a higher chance it could be ectopic, so any missed period or unusual pain afterwards is worth a call to your provider.

• You will meet with your provider to talk through your medical history, your reasons, and any questions or doubts. There are no wrong feelings to bring into that room.
• You may be asked to confirm you are not currently pregnant, sometimes with a test close to the date.
• Expect simple prep: no food or drink for several hours beforehand, a list of medications to pause, and someone to drive you home.

• Most procedures take around 30 minutes to an hour.
• You will be asleep under general anesthesia, or in some cases have spinal anesthesia, and will not feel the surgery itself.
• Many people go home the same day once they are awake, eating, and comfortable.

• Soreness around the incisions, mild belly cramping, and shoulder discomfort from the gas used during laparoscopy are common for a few days.
• Most women feel noticeably better within 3 to 5 days and return to desk work or light routines within about a week.
• Full recovery, including heavier lifting and exercise, usually takes 2 to 4 weeks. Recovery after a postpartum or cesarean sterilization follows the broader birth recovery timeline.
• Be gentle with yourself emotionally too. Relief, grief, peace, sadness, joy, or a mix of everything are all normal.

• Sterilization does not remove the ovaries or uterus, so your natural hormones, ovulation, and menstrual cycle continue as before.
• It does not cause menopause and does not directly change your hormone levels.
• If you stop a hormonal method (like the pill or an IUD) around the same time as sterilization, your periods may feel different simply because you are now seeing your natural cycle again.

Female sterilization is intended to be permanent. It is a beautiful, valid choice for many women, and it is also one worth sitting with. A few gentle questions to consider:

• How would I feel about this choice in 5, 10, or 20 years, in the life I imagine and the life I do not?
• Am I making this decision from a place of clarity, or from pressure, fear, or a hard season?
• Have I explored long-acting reversible options (like an IUD or implant) that offer similar effectiveness without permanence?
• If my circumstances changed (a new partner, a loss, a different stage of life), would I still feel at peace?
• Whose voice is loudest in this decision, and is it mine?

There are no right answers, only your answers. Taking your time is not the same as changing your mind.

• Reversal surgery (tubal reanastomosis) may be possible after tubal ligation or occlusion, but it is a larger procedure, often not covered by insurance, and not always successful.
• Success rates for pregnancy after reversal vary widely, roughly 40–80%, depending on age, the original method used, how much healthy tube remains, and overall fertility.
• Salpingectomy (full removal of the tubes) cannot be reversed. Pregnancy afterwards would require IVF.
• IVF is also an option for many women after any form of sterilization, since the ovaries and uterus are still in place.

• Fever, chills, or worsening pain in the days after surgery.
• Redness, swelling, warmth, or discharge from an incision.
• Heavy vaginal bleeding, severe belly or pelvic pain, or fainting.
• Trouble breathing, chest pain, or pain or swelling in a leg.
• A missed period or a positive pregnancy test at any time after sterilization, especially with one-sided pain (possible ectopic pregnancy).
• Emotional heaviness that lingers. A trusted provider or therapist can hold space for that too.

This guide is shared with care and is not medical advice. Please talk with your healthcare provider about what is right for your body, your story, and your future.

• Plan B / levonorgestrel, within 72 hours, less effective above ~155 lbs
• Ella (ulipristal), within 120 hours, prescription
• Copper IUD insertion, within 5 days, most effective option

• Withdrawal alone (high failure rate, 22%)
• Douching after sex
• Specific positions or standing up
• "Safe day" guessing without tracking