Contraception v sterilisation/vasectomies

Sterilisation doesn't make your periods heavier.

However, the Mirena coil makes your periods lighter and is more reliable than sterilisation. So if hubby won't get the snip, I'd go for the Mirena.

Lois, he's very lucky to have you so don't think like that. My H didn't/may not want children but I'm keeping my bits untied hoping he will change his mind. Don't you think Mr Lois could be hoping you'll change your mind.

Can't help with the tube tying question, sorry.

Actually I think it is more squeamishness on his part, rather than thinking we will ever start a family. I think he realises that we couldn't possibly COPE with a child plus a business!

My doctor has told me twice that the coil isn't suitablr for women who haven't had children.

L
xx

Husband has agreed to have a vasectomy but my implanon needs changing in october so we might have left it a bit late to do it before then, i'll probably get another implanon and then we'll have the vasectomy when that runs out. I've never thought about sterilisation because i've just assumed they wouldn't let me have it but i know thinking about it some hitchers that have had it done while childfree so i suppose its not impossible.

Your doctor is talking bollocks Lois.

Fair enough! is there a reason the coils is better than sterilisation? is it permanent? And does it hurt?
I am quite attached to the injections, as I don't get periods. Is there a long term solution that = no periods?

L
xx

Most women on the Mirena don't get periods.

It's better than sterilisation as in more effective at preventing pregnancy.

It's uncomfortable having it put in and can be a wee bit painful but only for a short time. I routinely use local anaesthetic to the cervix on anyone who hasn't had a baby.

It lasts 5 years, but if you have it >40, it can stay til your menopause.

The injection is good too but a bit of a faff having to get it done every 3 months.

Have to run but google the fpa and look for the 'information leaflets' and read the one on the IUS (intra uterine system).

If it was me I would definitely opt for the Mirena coil over having an op (albeit a day case keyhole one).

I have a Mirena. I don't have periods. Took a few months of spotting, but I've been period free for about 3 years.

? well I can't put it any more eloquently than RA. Plus she is the resident contraception expert. However, just to give my experience of having a coil; it is fine. Smarts a bit having it put in, but not terrible. Afterwards you practically forget that it is there. But more importantly I never fell pregnant with it. Also I had a copper one, which I don't think is Mirena. So as far as I am aware that means no chemicals too, though RA might want to confirm that.

Mirena has hormones, which is why you don't bleed (though some are unlucky, and do). Copper doesn't, which is why you do, and I think often more, at least in my experience of scanning heavy bleeders.

Thanks all. If I am going to keep on with the hormones. might I be as well to carry on with the injections? As then at least I know I won't bleed.
If the coils proves to be a nightmare, presumably it can be removed no problem?

L
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I really don't bleed any more heavily with a copper coil. But I don't know how typical I am.

If you arre currently having the depot injections then switching to sterilisation will effectively make your periods heavier because you will go back to having your normal periods (which may nautrally get heavier as you get older), but as R-A says, sterilisation doesn't make periods heavier than no hormonal contraception.

The mirena is way lower maintenance in that it can stay in for years rather than needing 3-monthly injections.

Also the dose of hormone is far lower for the coil, as the hormone is deposited within cms of the ovaries rather than having to be absorbed into the systemic circulation and reaching the ovaries through the bloodstream.

The insertion is a little more uncomfortable for women who haven't had children, but once in place I bet you won't have any problems. I have seen very few women to have it removed aside from to try for a pregnancy, as the majority are really pleased with the reduction in bleeding, menstrual symptoms etc, and personally I have been really pleased with mine in reducing my heavy periods and providing reliable, hassle free, reversible contraception.

As R-A says the coil is quicker, less invasive, less risk of complications than sterilisation, plus it does give t

ETA - But yes, if you didn't like it, removal is even easier than insertion.

The option of reversal later on should you ever choose it for whatever reason. I certainly won't be contemplating sterilisation after completing my family, and my hopsital's sterilisation rates are way down as women with heavy periods, wanting contraception etc are all offered mirena and the majority that take the option very rarely come back for sterilisation instead.

Thank you. I am possibly weird in that the notion have something something inserted freaks me out slightly, as opposed to an operation which seems fine

L
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I'm unusual in that I didn't get on with the Mirena - had weight gain and AWOL sex drive. Now have copper coil and it's fab. I don't have children and insertion of both was sore but okay (copper coil was worse actually) - but no more sore than a wax ?

Not uncommon, but if you sit down and think about it logically and remind yourself it is safer, less invasive, more effective and less likely to result in complications, then hopefully you can tell yourself it is worth a go. I wouldn't choose to have it done just for fun, but it really isn't that bad esp considering the benefits.

Dave - I get the point you are making, but in fact you would still have periods if sterilised, also you would have two foreign bodies inside you, as the sterilisation is usually carried out with a metal clip on each tube. You are right that a hysterectomy would result in no periods, but could also = complications including incontinence,early menopause if ovaries also removed etc.

Becca thats why I wouldnt consider a sterilisation due to the chance Id get my periods back and I dont fancy the metal clip thing either, even though my FP doc has no probs referring me if I want it. My mum had a hysterectomy aged 32 and kept her ovaries, she had no other problems since, she is 60 now and just went though the menopause over the last 5 years or so.

Im happy on the mini pill for now, but if the worst came to the worst, I would honestly consider getting my womb whipped out even considering everything. I feel that strongly about not having children and not having periods that last 9 days and loosing a pint of blood everytime in excruciating agony and not knowing when my period would happen. I realise Im an oddity!

Don't know if it helps but I had an implanon implant put in back in Feb and not had a period since. ?

I'd been on the pill for 15 years and def didn't want children, read up on different options and asked on here, then approached my GP who was only too happy to recommend it. Why they'd never mentioned it was beyond me! I'd considered sterilisation but as only 34 wasn't sure I was "allowed it".

I have had two c sections and have a coil in - (ie my cervix is as narrow as someone who's never had children). It really wasn't too bad having it in, honestly. And I have the world's lowest pain threshold.

If it were me I'd definitely go for the Mirena. If they can't put it in then you could always consider the implanon - it's dead easy to put in, lasts 3 years and can be repeated indefinitely. It's slightly less likely to give you no periods though - Mirena better for that. But implanon often gives no or v scanty periods.

I did have one women who had the narrowest cervix ever. I tried really hard to put a oil in but it just wouldn't go. She decided just to have an implant and is v happy. When you're GP says "you can't" I rather suspect your GP means he or she can't ie they're not confident doing it or they trained before we routinely put coils in nulliparous women. They can always refer you to the FP clinic if they don't want to.

(Sterilisation is a very unsatisfactory operation tbh - it's less reliable than Mirena or Depo or Implanon, you still have periods etc etc. OK for those who've tried and failed with other methods and whose H's won't have a vasectomy. I refer for it very very seldom these days. And I refer very seldom for hysterectomy too now we have the Mirena as it's so good at sorting out troublesome periods).

Can I ask a quick question - I had bad side effects with the depo and my GP said Implanon was the same drug so I would have the same side effects, would it be the same with Mirena? Thanks (sorry to crash the thread!)

BB - because Mirena is "local" it's a very small dose. So a small amount of progesterone is absorbed by the womb lining but nowhere near as much as the implant or depo. So at the start you may get some hormonal side effects. However, as the initial bleeding settles down the womb lining gets thinner and thinner, and after about 6 months there's very little there at all, so if you did get any side effects they would be very mild indeed - because the womb needs lining to absorb the hormone, and there is no lining to speak of. That's why I always suggest to Mirena patients that whilst they may get side effects at the start they'll be lighter than the progesterone only pill or depo, and every month that goes by it should get less and less. I don't recommend taking a Mirena out before 6 months as it's only then you know whether it's really working or not.

Thanks Rache - I've just changed pill brand so am hoping that will change a few things, but good to know for the future.

There is a chip you can have inserted into your upper arm, it lasts for 5 years and can stop periods completely. I didn't know this existed until a year or so ago, it's not well publicised by doctors, but is mentioned on the contraception leaflet I had and a friend of mine said it was great.

This is Implanon, the contraceptive implant, mentioned above (but it's 3 years not 5)

I'm sure that I heard somewhere that having your tubes clipped or tied can raise the chances of needing an hysterectomy in later life. I have been racking my brains trying to remember where I heard it but I *think* it was at a conference I was at dealing with contraception for adults with disabilities. Maybe some of the medical people on here can shed some light?

Lilyfitz - it depends what age you are, but every five years you can have the mirena taken out and a new one refitted - up to the age of menopause

Hmm. I'd pretty much decided to ask to be sterilised following this baby (I don't want H to get a vasectomy as it'll limit his options when he runs away with someone younger, thinner and less mad)*

but if it's not that reliable? Erk. I've had a copper coil and really didn't get on with it, depo worked for a few years then gave me terrible acne and other side effects. I've been told, after several tries, that combined pill or mini pill are verboten due to side effects. I really, really don't want any more babies after this one - so what to do?

*that's sort of a joke, I think.

PL - we still do them but the failure rate is 1 in 200 - that's ok for most people - but it isn't a small operation - takes a couple of weeks to recover from comparred to the 2 days with vasectomy. It sounds like it would be a reasonable choice for you.

Why not mirena coil - see above re side effect profile?

I will investigate the coil, my doctors' surgery does not offer it, same with implant, would have to go to FPC, so maybe that is why they're not very positive about it.
FPC is only one evening a week, no appointments though so it's awkward.

L
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I have had the implanon implant for about 3 months now and it is fine. I had some slight spotting about two weeks after having it fitted and it was abit uncomfortable for the first couple of weeks but I don't even know it is there now and haven't had any bleeding since, although Iam still feeding my daughter so that could also be stopping the bleeding.