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[1, 2]

To Snip or to Tie, A Discussion on Sterilization
Chapter 2

One further insidious side effect of vasectomy was published in The New England Journal of Medicine recently, that had researchers positively correlating vasectomies with a decrease in sex drive. As a sex therapist, I believe that many of my patients with a decreased libido noticed the dip in their primal urges soon after they had a vasectomy. For couples with different sex drives where the male partner wants sex much more often, a vasectomy can level out the desire between partners. If your partner has his hand more often on the remote control than on your leg, then a vasectomy with it's potentially dwindling sex drive side effect may need to be reconsidered. The problem stems from the pressure of having the body stop making the hundred million or so sperm every day, that the testicles naturally produce versus stopping one egg a month for the tubal ligation. Vasectomies are a fantastic option for many guys, but the truth is that they may not be as benign as originally thought.

Female Sterilization is by the very nature of the plumbing, a more intrusive procedure. The procedure also has it's own problems associated with it. To access the fallopian tubes and cauterize them with an electric needle, you first have to get to them. That means either surgically cutting into the abdominal wall or more likely being done by a laparoscopy through your bellybutton. Here's what happens: You arrive for day surgery at the hospital and are put into a gown to wait for your turn in the operating room. After you are on the table, the anesthesiologist gives you a general anesthetic and you lose consciousness. Your navel is disinfected and then a small cut is made into your abdominal cavity. Gas is inserted which pushes the intestines away from the fallopian tubes and uterus. A tube with a light is inserted to have a great view of all your reproductive organs. An inch of each fallopian tubes is excised and zapped leaving a proportional area the size of the grand canyon to jump across if the sperm and egg were ever to possibly meet. You wake up with a bandage on or near your navel, and you go home to sleep off the gas with a few Tylenol 3's for company. The side effects are usually a sore tummy where you've been poked and prodded, a lot of internal rumblings caused by the gas finding it's way out, and the possibility of getting an infection if you're not careful. It takes you a little longer to be up feeling like your usual self, especially if you are sensitive to the anesthetic which makes some people feel like they've been hit by a bus. Finally, as with the vasectomy, there is a 1 in 500 chance of having a spontaneous reversal, kind of like fate playing a huge joke on those of us who have already given away all our baby stuff.

One last thought, as both tubal ligation and vasectomy's are considered permanent procedures, you need to be very sure of your decision to stop any further baby-making on your part. While it is sometimes possible to reverse these procedures, the pain, complications and expense are significant, and the success rates vary from 40 to 60% for vasectomy reversals, to less than that for female sterilization. Reversing a cut to a vas or fallopian tube is like trying to line up two pieces of thread end to end so the hole lines up and then sewing it with the smallest needle imaginable - not for the faint of heart.

So whatever you decide, to go for the big snip or tie off those tubes, there are pro's and con's with each. Speak with your doctor, talk to your friends who have older kids if they've had it done and get their perspective. Bring it up around the water cooler at work. It's always fun to watch the hands of your male co-workers as they move south to protect the family jewels. Realize it's not as bad as they make it out in the movies, it's responsible, and besides, you'll now have even more in common than before with your family pet.


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