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Surgical Sterilization (cont.)

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Hysteroscopic sterilization

Hysteroscopic sterilization 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 (hysteroscope), 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.

The procedure takes about 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 an imaging test known as a hysterosalpingogram (HSG) that the Fallopian tubes are completely blocked.

Like tubal ligation, this form of sterilization 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 the procedure develop side effects, mainly due to improper placement of the coils.

This form of sterilization, like other methods of surgical sterilization, does not protect a woman or her partner from sexually transmitted diseases (STDs).


A hysterectomy is the surgical removal of a woman's uterus and, depending on her overall health status and the reason for the operation, 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. A laparoscopic hysterectomy (removal of the uterus through tiny incisions in the abdomen through which instruments are placed) is possible when there are no complications and no suspicion of cancer. A partial hysterectomy, which spares the cervix and removes the upper part of the uterus, is also a common surgical technique.

If a woman has other chronic medical problems that may be helped by a hysterectomy (such as abnormally excessive menstrual bleeding, uterine fibroids, uterine growths), than this may be an appropriate procedure for her to consider. Otherwise, contraception should be considered a secondary benefit and not a sole reason to have the procedure.


Peterson HB, Jeng G, Folger SG, Hillis SA, Marchbanks PA, Wilcox LS; U.S. Collaborative Review of Sterilization Working Group. The risk of menstrual abnormalities after tubal sterilization. U.S. Collaborative Review of Sterilization Working Group. N Engl J Med. 2000 Dec 7;343(23):1681-7.

Previous contributing authors: Barbara K. Hecht, Ph.D. and Carolyn Janet Crandall, MD, FACP

Last Editorial Review: 1/3/2011


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