Tubal Sterilization Overview Tubal sterilization is surgery to block a woman's fallopian tubes.Tubal sterilizationis a permanent form of birth control.

After this procedure, eggs cannot move from theovary through the tubes (a woman has two fallopian tubes), and eventually to the uterus.Also, sperm cannot reach the egg in the fallopian tube after it is released by the ovary.Thus, pregnancy is prevented. This procedure is also called tubal ligation or you are said to have your "tubes tied."More formally, it is known as bilateral tubal ligation (BTL). Currently, about 700,000 of these procedures are performed each year in the United States.Half are performed right after a woman gives birth.The rest areelectiveprocedures performed as a one-day operation in an outpatient clinic.Eleven million US women aged 15-44 years rely on sterilization as a means of birth control to prevent pregnancy.More than 190 million couples worldwide use surgical sterilization as a safe and reliable method of permanent birth control. Prior to the 1960s, female sterilization in the United States was generally performed only for medical problems or when a woman was considered "too old" to have children or at risk. The changing cultural climate in the 1960s resulted in safe, minimally invasive female sterilization procedures. During the Procedure While you are under anesthesia, one or two small incisions (cuts) are made in the abdomen (usually near the navel), and a device similar to a small telescope on a flexible tube (called a laparoscope) is inserted. Using instruments that are inserted through the laparoscope, the tubes (fallopian tubes) are coagulated (burned), sealed shut with cautery, or a small clip is placed on the tube. The skin incision is then closed with a few stitches.You are usually feeling well enough to go home from the outpatient surgery center in a few hours. Your health care provider may prescribe pain medications to help you manage the pain, if any.

Most women return to normal activities, including work, in a few days, although you may be advised not to exercise for several days.You may resume sexual intercourse when you feel ready. Tubal ligation can also be performed immediately after childbirth through a small incision near the navel or during a Cesarean delivery. Currently, laparoscopy (bipolar laparoscopy, Falope ring, Filshie clip) is the most popular method of female sterilization in nonpregnant women. Periumbilical minilaparotomy (Pomeroy, Parkland) is the most common procedure right after childbirth. A new device acts much like tubal sterilization by blocking the fallopian tubes. The Food and Drug Administration has approved a small metallic implant (called the Essure System) that is placed into the fallopian tubes of women who wish to be permanently sterilized. Unlike other currently available tubal sterilization procedures for women, placement of the device does not require an incision or general anesthesia. During the Essure procedure, your health care provider inserts an obstructive device into each of the 2 fallopian tubes at the time of hysteroscopy. This is done with a special catheter that is inserted through the vagina into the uterus and then into the fallopian tube. The device works by inducing scar tissue to form over the implant, blocking the fallopian tube and preventing fertilization of the egg by the sperm.

Risks

As with any surgery, there is always a risk when you are given general anesthesia.You may have a bad reaction to the medication used.Surgery itself may present problems with bleeding or infection. There is still a chance you may become pregnant after tubal sterilization. About 1 in 200 women become pregnant who have their tubes tied.This may be caused by an incomplete closure of the tubes.If pregnancy occurs after the procedure, you are at increased risk for anectopic pregnancy in which the pregnancy develops in the fallopian tubes.This is a dangerous situation. Because the procedure is performed by tiny instruments inserted into your abdomen, you may have injury to other organs in your body.

Results
Most women recover from the laparoscopic procedure with no problems. There are no tests required to confirm that you are now sterile (that is, unable to become pregnant) after a laparoscopic procedure. During the first 3 months after the Essure procedure, you must use another form of birth control. At the 3-month point, you must undergo a final x-ray procedure in which dye is placed in your uterus and an x-ray is taken to confirm that the device is in place. This procedure cannot be reversed.

Alternatives
If you feel you want a permanent solution to birth control, discuss your options with your health care provider.Many younger women who choose this procedure regret their decisions later.The younger the woman, the more likely she will regret choosing this permanent form of birth control. Your doctor will discuss your current number of children, your plans for your future and family, and will want to talk with your spouse.This is an important decision.Women with certain medical conditions may not be suited for this procedure. Tubal sterilization is surgery.Many couples, in looking at their birth control options, especially when they are ready to stop having children, weigh the benefits and risks of whether the woman would undergo tubal sterilization or the man avasectomy. Tubal ligation is not temporary.Do not think of it as a procedure to be reversed.When reversal is attempted, the operation becomes major surgery and is only successful about 50-80% of the time (meaning the woman is able to become pregnant after reversal).

Hysterectomy/ Vasectomy hysterectomy is a surgical removal of the uterus, resulting in the inability to become pregnant (sterility). It may be done through the abdomen or the vagina. Hysterectomy is an operation that is commonly performed. There are many reasons a woman may need a hysterectomy. However, there are non-surgical approaches to treat many of these conditions. Talk to your doctor about non-surgical treatments to try first, especially if the recommendation for a hysterectomy is for a cause other than cancer.

During a hysterectomy, the uterus may be completely or partially removed. The fallopian tubes and ovaries may also be removed. A partial (or supracervical) hysterectomy is removal of just the upper portion of the uterus, leaving the cervix intact. A total hysterectomy is removal of the entire uterus and the cervix. A radical hysterectomy is the removal of the uterus, the tissue on both sides of the cervix (parametrium), and the upper part of the vagina. A hysterectomy may be done through an abdominal incision (abdominal hysterectomy), a vaginal incision (vaginal hysterectomy), or through laparoscopic incisions (small incisions on the abdomen -- laparoscopic hysterectomy). Your physician will help you decide which type of hysterectomy is most appropriate for you, depending on your medical history and the reason for your surgery. Indications Hysterectomy may be recommended for:

y y y y y y y
Risks

Tumors in the uterus like uterine fibroids or endometrial cancer Cancer of the cervix or severe cervical dysplasia (a precancerous condition of the cervix) Cancer of the ovary Endometriosis, in those cases in which the pain is severe and not responsive to non-surgical treatments Severe, long-term (chronic) vaginal bleeding that cannot be controlled by medications Prolapse of the uterus Complications during childbirth (like uncontrollable bleeding)

The risks for any anesthesia are:

y y

Reactions to medications Problems breathing

The risks for any surgery are:

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Bleeding Infection

Other risks that are possible from a hysterectomy include:

y y y

Injury to nearby organs, including the bladder or blood vessels Injury to bowel Pain with intercourse

Expectations after surgery Most patients recover completely from hysterectomy. Removal of the ovaries along with the uterus in premenopausal women causes immediate menopause, and estrogen replacement therapy may be recommended. Some women worry that their sexual function will be decreased after removal of the uterus. Researchers have found that sexual function after a hysterectomy depends most on sexual function before the surgery. If a woman had good sexual function before the surgery, she will continue to have good sexual function afterward. If you experience a new decrease in your sexual function after hysterectomy, talk to your health care provider about possible causes.

Convalescence The average hospital stay depends on the type of hysterectomy performed, but is usually from 2 to 3 days. Complete recovery may require 2 weeks to 2 months. Recovery from a vaginal or laparoscopic hysterectomy is faster than from an abdominal hysterectomy, and may include less pain. Intravenous and oral medications are used after the surgery to relieve postoperative pain. A catheter may remain in place for 1 to 2 days to help the bladder pass urine. Moving about as soon as possible helps to avoid blood clots in the legs and other problems. Walking to the bathroom as soon as possible is recommended. Normal diet is encouraged as soon as possible after bowel function returns. Avoid lifting heavy objects for a few weeks following surgery. Sexual intercourse should be avoided for 6 to 8 weeks after a hysterectomy. What are erection problems? A man has erection problems if he cannot get or keep an erection that is firm enough for him to have sex. Erection problems are also called erectile dysfunction or impotence. Erection problems can occur at any age. But they are more common in older men, who often have other health problems. Treatment can help both older and younger men. What causes erection problems? Erection problems may be caused by physical problems, such as injury to nerves or loss of blood supply to the penis .

They can also be linked to other health problems. These include diabetes, high blood pressure, high cholesterol, and atherosclerosis. Erection problems can also be linked to problems with the nervous system, such as multiple sclerosis andParkinson's disease. Many medicines for other health problems may cause erection problems, but most do not. If you recently began taking a new medicine and started having erection problems, this could be a side effect of the medicine. Talk with your doctor. He or she may be able to change the dose or type of medicine you take. Men who drink too much alcohol, smoke, or use illegal drugs also are at risk for erection problems. Anxiety, stress, or depression can cause erection problems. Other causes include surgery, such as for prostate cancer, or injury to the pelvic area. What are the symptoms? The only symptom of an erection problem is being unable to get and keep an erection that is firm enough to have sex. But even with an erection problem, a man may still have sexual desire and be able to have an orgasm and to ejaculate. How are erection problems diagnosed? Your doctor can find out if you have an erection problem by asking questions about your health and doing a physical exam. Your doctor will want to know if the problem happens all the time or just from time to time. The exam, lab tests, and sometimes mental health tests can help find out the cause of the problem.

How are they treated? There are a number of treatments for erection problems. Doctors usually start with lifestyle changes and medicines. They usually don't advise surgery or other treatments unless those first steps don't help. Treatment can include:

y y y

Making lifestyle changes, such as avoiding tobacco, drugs, and alcohol. It may also help to talk about the issue with your partner, do sensual exercises, and get counseling. Finding and then stopping medicines that may be causing the problem. In some cases you can take a different medicine that does not cause erection problems. Taking prescription medicine that can help you get erections. These include pills such as sildenafil (Viagra), tadalafil (Cialis), and vardenafil (Levitra). Check with your doctor to see if it is safe for you to take one of these medicines with your other medicines. These can be dangerous if you have heart disease that requires you to take nitroglycerin or other medicines that contain nitrates.

y y y

Taking medicines and getting counseling for depression or anxiety. Using vacuum devices or getting shots of medicine into the penis. Having surgery to place an implant in the penis. Can you prevent erection problems? Because erection problems are most often caused by a physical problem, it's important to eat healthy foods and get enough exercise to help you stay in good health. To reduce your risk of having an erection problem, do not smoke, drink too much alcohol, or use illegal drugs. You may be able to avoid erection problems related to anxiety and stress by talking with your partner about your concerns. This may help you relax.

Fertility Problems
What are fertility problems?
You may have fertility problems if you have not been able to get pregnant after trying for at least 1 year. Another word for this is infertility. Infertility may not mean that it is impossible to get pregnant. Often, couples conceive without help in their second year of trying. Some do not succeed, but medical treatments help many couples. Age is an important factor if you are trying to decide whether to get testing and treatment for fertility problems. A woman is most fertile in her late 20s. After age 35, fertility decreases and the risk of miscarriage goes up. y y If you are younger than 35, you may want to give yourself more time to get pregnant. If you are 35 or older, you may want to get help soon.

What causes fertility problems?

Fertility problems can have many causes. In cases of infertility:2

y y y y

About 50 out of 100 are caused by a problem with the woman's reproductive system . These may be problems with her fallopian tubes or uterus or her ability to release an egg (ovulate). . The most About 35 out of 100 are caused by a problem with the man's reproductive system common is low sperm count. About 5 out of 100 are caused by an uncommon problem, such as the man or woman having been exposed to a medicine called DES before birth. In about 10 out of 100, no cause can be found in spite of testing.

Should you be tested for fertility problems?

Before you have fertility tests, try fertility awareness. A woman can learn when she is likely to ovulate and be fertile by charting her basal body temperature and using home tests. Some couples find that they simply have been missing their most fertile days when trying to conceive. If you are not sure when you ovulate, try this Interactive Tool: When Are You Most Fertile? If these methods don't help, the first step is for both partners to have some simple tests. A doctor can: y y y y Do a physical exam of both of you. Ask questions about your past health to look for clues, such as a history ofmiscarriages or pelvic inflammatory disease. Ask about your lifestyle habits, such as how often you exercise and whether you drink alcohol or use drugs. Do tests that check semen quality and both partners' hormone levels in the blood. Hormone imbalances can be a sign of ovulation problems or sperm problems that can be treated. Your family doctor can do these tests. For more complete testing, you may need to see a fertility specialist.

How are fertility problems treated?

A wide range of treatments is available. Depending on what is causing the problem, you may be able to: y y y y Take a medicine that helps the woman ovulate. Have a procedure that puts sperm directly inside the woman (insemination). Have a surgery that corrects a problem caused by endometriosis or blocked fallopian tubes. Have a procedure that might increase the man's sperm count. If these options are not possible or don't work for you, you may want to think about in vitro fertilization (IVF). During an IVF, eggs and sperm are mixed in a lab so the sperm can fertilize the eggs. Then the doctor puts one or more fertilized eggs into the woman's uterus. Many couples try IVF more than once. Treatment for fertility problems can be stressful, costly, and hard on your body. Before you start testing, make some decisions about what you want to do. You may change your mind later, but it's a good idea to start with a plan. y Learn all you can about the tests and treatments, and decide which you want to try. For example, some couples agree to try medicines but don't want surgery or other treatments.

Find out how much treatments cost and whether your insurance will cover them. If you don't have insurance coverage, decide what you can afford. Treatments for infertility can increase your chances of getting pregnant. But they also increase your chance of having more than one baby at a time (multiple pregnancy). Be sure to discuss the risks with your doctor. Fertility problems can put a lot of strain on a couple. It may help to see a counselor with experience in infertility. Think about joining an infertility support group. Talking with other people with the same issue can help you feel less alone.
SIDE EFFECTS

1.

Types of Contraceptives Contraception can be swallowed in pill form, inserted in IUD/diaphragm form, received in a patch or endured through a shot. Some popular birth control brands include Seasonique, Yaz, Yasmine and Loestrin 24 Fe. Birth control pills come in different durations, including 28-day pills, such as Yaz and Loestrin, which contain 24 days of hormones and four days of placebo pills. Due to the artificial hormones, all of these pills may cause side effects. For those first using hormones, breakthrough bleeding is a major side effect. This can occur for several months after beginning to take birth control. Function

Birth control is responsible for mimicking the hormones that the body produces by providing artificial hormones (estrogen and progestin). This helps to suppress ovulation in women. The hormones also increase and thicken the cervix mucus, which also helps protect against sperm. This is a major reason why fertilization of the egg does not occur with the use of contraceptives. Features

While all contraceptives have some type of side effects, others have long-lasting effects that make the negative effects worth the trouble. Birth control pills, such as Yaz, are used to treat premenstrual dysphoric disorder (PDD) and acne. This is the first pill used to treat the symptoms of PMS and mood swings in women. Misconceptions

Many using birth control believe that the use of the pill protects them from STDs. However, for full protection it is imperative that a condom is used in conjunction with birth control pills, IUDs, patches or a shot. Condoms are the only protection against direct contact and bacteria that may result in HPV and HIV. Even then, condoms do not offer 100 percent protection. Warning

It is important to note that if breakthrough bleeding continues for several months, to consult your OB/GYN. Spotting is normal for the first three months, but if bleeding persists heavily for more than a week afterward, hemorrhaging can result. Consult a doctor right away.

Advantages & Disadvantages of Contraceptives

Advantages & Disadvantages of Contraceptives 1. What are contraceptives? The term "contraceptive" denotes anything that is intended to prevent pregnancy during heterosexual vaginal intercourse or, in the form of emergency contraceptives, to end a potential pregnancy within the first few days after a sexual encounter. The most commonly used contraceptives are so-called "barrier" contraceptives such as condoms, cervical sponges, diaphragms and spermicidal agents. There are also certain hormonal medications, taken in the form of a pill, shot, patch or implant, which fool a woman's body into thinking that it is already pregnant and keep her from actually becoming pregnant. There are also IUD's (intrauterine devices), which are placed inside of the uterus to prevent a pregnancy from occurring. What are the advantages of contraceptives?

There are many potential benefits of contraceptives. To begin with, they are used by many as a form of family planning that allows for sex without the inevitable result of children. Some contraceptives, such as condoms, can also help to keep sexually transmitted diseases from spreading. Contraceptives are also useful tools in modern society as a form of advancement and liberation for women. Sexually active women in modern society can use contraceptives to ensure that they are able to pursue a career or education while also engaged in a heterosexual romantic relationship. What are the disadvantages of contraceptives?

Many argue that there are moral and psychological disadvantages to using contraceptives. There is also the fact that contraceptives are not foolproof and pregnancy can occur, even when they are used perfectly. Another disadvantage is societal ignorance toward their proper use and efficacy, which can lead to the spread of sexually transmitted diseases. It is also possible for contraceptives to have negative health effects on those using them, such as allergic reactions or blood clots if using the birth control pill.
WhatAreSome Health RisksWhen Using Birth ControlPills? Oral contraceptives are used to prevent pregnancy. While there are many advantages to using this medication, there are also disadvantages.

1.

Health Risks The health risks of oral contraceptives include high blood pressure, high cholesterol levels, increased risk of cervical and liver cancer and increased risk of cardiovascular disease for women over 35 who smoke. Causes

These side effects are caused by the synthetic versions of hormones estrogen and progesterone in the oral contraceptives. The increase of cholesterol and blood pressure are due to the amount of progestin in the contraceptives. Smoking reacts badly with these synthetic hormones, which increases the risk of cardiovascular disease. According to Mayo Clinic, the reasons for cancer is currently unknown, but scientific evidence shows that it does increase the chances of certain cancers.

Significance

Some of these side effects can have a serious impact on your overall health. High blood pressure can lead to many complications such as aneurysms, heart failure and ruptured blood vessels in the brain. High cholesterol can lead to a stroke and cancer can be fatal. Benefits

While there are negative side effects, birth control can prevent unplanned pregnancies as well as reduce the risk for some cancers such as endometrial and ovarian cancer. Prevention/Solution

Most of these effects can be prevented by switching to a lower dose of progesterone birth control, or by eating properly and having regular check-ups at the doctor and monitoring your blood pressure and cholesterol closely.

What are the Advantages and Disadvantages of Male Contraception? o According to the Male Contraception Information Project, more than 20 percent of unwanted pregnancies end in abortion in the United States. Unfortunately, the contraception methods used by couples don t meet the needs of all people, putting them at risk of unwanted pregnancies and sexually transmitted diseases (STDs) from unprotected sex. Males generally rely on two forms of contraception condoms and vasectomies to engage in safe sex. Each has its own advantages and disadvantages. Condom Advantages o Males use condoms to prevent unwanted pregnancies and STDs, such as genital herpes, HIV and chlamydia. It s the only male method of birth control that provides protection from both. Condoms don t produce side effects. Men young and old purchase them in grocery stores, pharmacies and convenience stores for relatively little cost and without the need for a prescription from a doctor. Condoms come in a variety of options such as ribbed, nonribbed, spermicidal, latex and lamb skin to suit the needs of each partner. Condom Disadvantages o Male Contraception Information Project states condoms are 98 percent effective when worn properly, but not 100 percent. Put simply: condoms break. For this reason, couples need to use other forms of protection, such as spermicidal foam and/or the female sponge, among other contraception options for additional protection. Some men don t like the sensation of sex when using condoms. Also, condoms expire over time and when exposed to extreme heat and cold, which makes them ineffective. A male must remember to use a condom when it s his primary birth control method each and every time he engages in sex. Vasectomy Advantages o A vasectomy is a surgical procedure whereby a male s vas deferens are cut or sealed off to block sperm from combining with semen released during ejaculation. So long as the semen contains no sperm, a women s egg can t be fertilized and she can t become pregnant. WebMD considers a vasectomy a permanent form of birth control an ideal method of contraception for committed couples who don t want any more children. Although the surgery is expensive, it s usually covered by insurance. Depending on when it s done, it s sometimes cheaper than other forms of birth control, like condoms and the pill used by women, which may cost more over time. Vasectomy Disadvantages o A vasectomy isn t a good option for younger men who either aren t married or desire children one day. It s also not ideal for a male who s not in a committed relationship with one partner as a vasectomy doesn t prevent the transmission of STDs. A male in this situation still must use a condom to prevent contracting an STD from an infected partner. While a vasectomy is reversible, the process doesn t always guarantee a male s sperm is retractable. In addition, not all insurance providers cover the surgery to reverse a vasectomy, which is an expensive procedure.

What Are the Advantages & Disadvantages of Female & Male Sterilization? Only make your decision to get sterilized after speaking to your spouse. Sterilization offers couples a safe alternative for long-term contraception. While the process of sterilization is different between men and women, the result is the same. Sterilization offers some significant advantages, particularly to couples who do not wish to have children, either due to age or personal choice. Sterilization has disadvantages you should study before you make your final decision. 1. o Over 40 Most women remain fertile and able to conceive well into their 50s. Most men also remain fertile into their 50s. However women over the age of 40 face severe health issues if they become pregnant, including the risk of hemorrhaging, losing the baby and endangering their own lives. The chance of birth defects increases as the father ages beyond 40 years old. Sterilization offers couples protection from late-in-life pregnancies. Sterilization Is Safe o Another advantage of sterilization is the procedure itself is safe and effective for the rest of your life. Sterilization is a safe alternative for contraception for men and women. Vasectomies, the male form of sterilization, are safe and one of the most effective forms of long-term contraception available to couples. Women have multiple options for effective sterilization techniques, each safe and effective for the rest of your life. Additionally, only one member of a couple is required to undergo the procedure in order to prevent future pregnancies between the couple. Reversal o One disadvantage of sterilization is the process of reversing a sterilized individual is expensive and requires more invasive surgery than the initial procedure. If you change partners or remarry, your decision to sterilize will require a large investment to reverse. Additionally, most medical insurance plans will not cover the costs involved in a sterilization reversal. Azoospermia o Another disadvantage of male sterilization is a vasectomy is not effective from the moment you have the surgery. Your body requires a period of time before you are effectively infertile, and the time required is different for every patient. The goal is azoospermia, or the absence of living sperm in male semen. Your doctor can test you and determine if you have reached azoospermia; however, you should be aware after your surgery, you still must wait before unprotected intimacy.