GynoFiles

Although IUDs and long acting progesterone contraceptives have virtually the same effectiveness of tubal ligation as a strategy for contraception, sterilization is still very popular. Women had been more interested in transcervical techniques like Essure as belly incisions are not ever that popular. However the newest information is that acutally removing the fallopian tube is an effective ovarian cancer strategy and is thus gaining popularity. , not so much. Boys don't destroy that six pack to wind down the production factory, obvious anatomic differences aside, it's time women realize that they don't have to either. Soon we will have reached the first decade of the less invasive, inserted through the cervix into the fallopian tube techniques known as transcervical sterilization. The Essure device was approved in 2002. Adiana came available to American women in 2009, and has been gone since 2012, so there really is no Adiana, and much of the information in this po...

For many years getting the 'belly button' surgery, or just 'tying the tubes' has been the gold standard for female tubal sterilization. And then there was a trend away from abdominal surgery with the Essure procedure which prevented cutting into the abdomen and thus became popular, and again, we've gone full circle to reconsider a very old procedure called salpingectomy for sterilization .  And the ACOG group is saying that taking out the tubes, but saving the ovaries may be one of the better ovarian cancer prevention strategies.  The American College of Obstetricians and Gynecologists in 2003 said that gynos "should advise patients that the morbidity and mortality of tubal ligation, although low, is higher than that of vasectomy, and the success rates of both procedures are similar". But couples are three times more likely to have the gal cut her tubes than have his cut. And the stand up (or stand down, depending on how you relate to these procedures)...

Endometrial ablation technology controls heavy menstrual bleeding but it doesn't provide adequate contraception. If there remains any viable endometrium (uterine lining tissue) then a woman can still get pregnant, thus contraceptive planning at the time of endometrial ablation is very important. Pregnancy after the endometrial ablation is considered dangerous. At least 1/3 pregnancies after an ablation will miscarry, there is a 5 times greater ectopic pregnancy rate, there is up to a 30% risk of premature birth, and there is a 25% risk of the placenta being implanted abnormally. There have been rare reports of uterine rupture during pregnancy and also cases of bands growing in the uterus that can cause several fetal deformities. And the newest MRI studies show that 95% of women with prior endometrial ablation will still have some viable endometrial tissue. Even women who no longer get menstrual cycles will still likely have some small amount of viable uterine lining tissue and h...

Right fallopian tube getting a laparoscopic cautery sterilization A healthy left fallopian tube undergoing laparoscopic sterilization, the instrument is holding the tube, the white blanch is the tube being heated so that it will seal closed, and a  normal left ovary is shown next to the tube Once you've make the decision not to have more children using some type of long term contraception definitely simplifies life. For many women, once they have had their children, they still want to retain fertility, so that the Implanon (now they have updated, and most of us use Nexplanon ) device or Intrauterine devices Mirena and ParaGard are good choices as they last for many years and can successfully prevent pregnancy a high percentage of the time. For others however, if you are sure you do not want children then tubal sterilization is the solution.For most women getting the Essure procedure is going to be a better choice than the old fashioned surgeries shown here. At Women...

1.The method should be very effective 2. Take effect quickly 3. There should be significant non-contraceptive health benefits 4. Be easy to use 5. Be acceptable to your partner 6. Afford you privacy 7. Have no medical reasons you cannot use the method 8. Be affordable 9. Be reversible (if you want to get pregnant, not if you never do) 10. Have minimal mild and serious side effects Self-directed use Low level of side effects

At the end of one year of trying for pregnancy about 85 out of 100 couples will be pregnant. If they contracept using spermacides, with typical use, about 29 of 100 women will be pregnancy, actually worse than the 27 that will get pregnant with spermacide use. A new study published in the June 2012 issue of the American Journal of Obstetrics and Gynecology from researchers rom Merck Implanon Clinical Training Program and the Bayer Research Award grant showed that many women overestimate the effectiveness of their contracption. Perfect use, like in the contraceptive studies and in the contraceptive package inserts are not necessarily the same statistics that we seen in women who have 'typical use'...meaning us humans are a bit more falible when it comes to our contraception! Fertility awareness methods (either the standard days method the two day method or the ovulation tracking method also improves contraceptive effectiveness over spermacides alone and only 1/4 of couples w...

.  Normal Fallopian Tube Sterilization via Laparoscopy Interestingly about 700,000 women get tubal sterilization each year. Here is an intraoperative picture of the left fallopian tube getting sterilized. Most women are very happy with their decision, some women are not and in some studies only a few women ever regret their tubal ligation, but in some studies about 30% of women regret their tubal sterilizaiton. If you get a clip or a ring put on the tube, some studies show about 100% reversibility. But if you got your tubes burned or tied at the time of c-section you may only have about 40-75% chance of successful reversal procedure. The procedure is generally safe, quick, well tolerated and very effective. Always discuss risks and benefits with your individual provider. 

A writer asked what is the chance of getting endometriosis after a tubal ligation if you have not had this before? Not that the post tubal ligation syndrome has ever been really validated, exactly, but there are issues to review. Some studies have reported that between 16-63% of the stumps of the tubes after traditional tying or burning tubal sterilization procedures will have spots of endometriosis. So as sterilizations evolve into the newer procedures, with the metal inserts, it may be seen that some women will have a risk of post tubal ligation syndrome if they have an Essure placed. It is very unlikely that either, tubal ligation or tubal blockage with the Essure of would increase the chance of endometriosis or endometrial implants that were not in the pelvis before the surgery. But before you get sterilized find out from you gyno, have you been assessed for risk of this syndrome? 1951 was first report of the post tubal ligation syndrome, and in the years since there are man...

If you are gabbing with your girls the discussion over thirty five and what to do about contraception will often turn to sterilization. It is true that many are still wanting pregnancies, and contraception by sterilization should still be thought of as permanent although IVF(in vitro fertilization) and tubal reversals will allow sterilized women to carry a baby again. The most common sterilization procedure in the US today has still been tubal sterilization by the laparoscope. In some instances this is going to be your best choice, and with over 700,000 performed in the US in 2009, you're in good company if this is what you have chosen. But laparoscopy is still a surgery with a small but real risk of serious medical problems like bowel burns. In fact the CREST study looked at the rates of serious complications 20 years ago and found that almost 1% of women had serious problems. It is hard to know whether risks today are less or more,but laparoscopic surgical instrument optics a...

Sterilization is sill popular, belly cutting is never quite as popular, but there are a lot of things to consider when deciding on permanent contraception.. Couples who discuss whether him or her should made the decision, statistically it is found that boys don't as likely (in the US) wind down their production factory capabilities, obvious anatomic differences aside, it's time women realize that they don't have to either, as there are methods of effective contraception that do not prevent pregnancy. We have reached the first decade of the less invasive, inserted through the cervix into the fallopian tube techniques known as transcervical sterilization. The Essure device was approved in 2002. Adiana came available to American women in 2009, and has been gone since 2012, so there really is no Adiana, and much of the information in this post is left for historical interest. But we do have laparsocpic tubal ligation, something to consider if you are getting surgery for ovaria...

After the Essure sterilization coils are placed in the uterus they can be clearly seen on ultrasound as these are in this ultrasound picture.

Tying your tubes or getting a vasectomy will not change your ability to have sex or your desire to have sex. In fact sterilization generally reduces fear of pregnancy and encourages having sex with abandonment. Shain et al in 1991 and published in Obstetrics and Gynecology studied married women and their sexuality. It was an interesting concept, they followed a group of heterosexual couples: one group got tubals, one got vasectomies, one group were not planning any sterilization. And in general, all groups reported less interest and satisfaction in sexuality over time, but all groups were about the same. And though they reported less interest, sex frequency actually stayed about the same. This was a follow up to the information we got from a study of sexual adjustment after laparoscopic sterilization was investigated by Kjein a Danish population in the early 1980s and published in the Eur Jr Ob Gyn. The study comprised 659 patients who underwent laparoscopic sterilization during a fo...

Is the contraception revolution is back? We can think back to the start of the revolution. Russell E. Marker, one of the five principal founders of oral contraceptives, worked on the problem of making cheap progesterone. At the time of his research at Pennsylvania State University in 1935, it required 2500 pregnant pigs to produce 1 mg of progesterone. He then discovered that Beth’s root in North Carolina, then a popular herbal remedy for menstrual pains, also a species of Trillium the wild Mexican Yam, contained a plant steroid disogenin that could be manufactured into progesterone. The first birth control pill that was approved in the United States was Enovid-10® in 1960. By 1988 63 million women were using oral contraceptives worldwide. So how far have we come exactly? In the 1950s we had five methods of contraception that were used in the US these were condoms, douches, withdrawal, rhythm and diaphragms. Generally, not very effective. Fifty years later the top five methods are ...