Out of desperation, you may be considering getting cut open and having
your plumbing plugged to destroy your fertility, probably forever. You
may be afraid of the alternatives: side effects, sickness or death from
the Pill and/or the IUD; the abortion causing effects of the
IUD and the Pill; fear of unplanned pregnancies resulting from the less
effective barrier methods, perhaps fear of exercising sexual
self-control. After you see the rest of our website on natural family
planning, we hope you will see sterilization as drastic, unwise, and
completely unnecessary, since Natural
Family Planning is very effective, safe, and reversible. We
wouldn't recommend it for your cat. But you are smarter than your
cat.
POP QUIZ:
What are the three 100% effective ways of preventing
pregnancy?
|
Vasectomy or tubal ligation? Nope!
Vasectomy has a failure rate of .15, or 15 pregnancies per 10,000
woman-years of exposure.[1] (Notes are at the end of this piece.)
Recannulation, the reestablishment of a vas deferens by internal
healing processes, occurs in one instance per thousand, and sometimes
the urologist misses a rare third vas deferens. More often pregnancies
result from the failure to wait until two negative sperm counts are
obtained before considering oneself sterile. And it takes over 22 weeks
for sperm counts to go to zero, according to recent research:
http://www.fhi.org/en/fp/fpother/conferences/vascet/vasectomymtg.html
Tubal ligation has an overall failure rate of .04, or four pregnancies
per 10,000 woman-years.[2] (It's happened to someone we know
personally.) But when pregnancy occurs, an ectopic pregnancy occurs
about half the
time, which can be very serious.[1]
The only 100% effective sterilization surgeries are male castration
(removal of the testicles) and female castration (removal of the
ovaries). The other 100% effective way is complete abstinence.
Everything else has a failure rate.
Health
Risks of Vasectomy
Painful sperm granulomas (a lump that forms in the blocked vas
deferens) are a common side effect of vasectomy, but there is more
concern in the medical community about the long term effects on the
immunological system, which can cause serious health problems many
years after the surgery. Up until
recently, vasectomy has simply been assumed to be medically safe. But
"You
just don't operate on a million men a year without looking for effects.
You
don't just rely on impressions."[3] The director of a research
laboratory has noted that "the medical community has made virtually no
serious objection to mass vasectomy. Since information already exists
suggesting possible adverse delayed sequelae, this acceptance poses
cause for concern."[4]
What happens to the sperm? After a vasectomy the sperm production is
the same as before, around 50,000 spermatozoa every minute.[5] They
pile up in the epiditimus and it can blow out, like putting too much
air in a tire. [33] Wherever they go, they still have no normal exit,
so these cells have to be either consumed by destroyer cells
(macrophages) or degenerate and produce antigens which cause antibodies
to be produced that will remove the sperm from the system.[6] These
antigens frequently will infiltrate into the bloodstream and other
cells throughout the body begin to manufacture antibodies
against the sperm. These are "anti-sperm autoantibodies."[7]
Antibodies are the way we immunize ourselves to specific diseases from
the outside environment. Antigens are merely the triggering mechanism
the body needs in order to produce the right antibodies for its
defense. An allergic reaction in which the body becomes highly
sensitive to a particular kind of food cell is an example of this
mechanism's effect. When the body generates its defenses to ward off
cells of its own making, as after a
vasectomy, the body becomes "auto-immune,"--allergic to itself. Several
studies have found such antibodies generated in response to sperm
antigens
in 55% to 75% of patients within two years after vasectomies.[8] It
occurs
3% naturally.
Auto-immunity has been implicated in multiple sclerosis, diabetes
mellitus, rheumatoid arthritis some types of hepatitis, Addison's
disease (malfunctioning adrenal glands) and lupus erythematosis.[10]
One study concluded that the immunologic response to sperm antigen that
often accompanies vasectomy can exacerbate atheroclerosis.[11]
Atherosclerotic diseases, such as coronary thrombosis, pulmonary
embolism, thrombophlebitis, arteritis, and angina pectoris, are
aggravated by high cholesterol intake, which accurately describes the
diet of American males.[12]
Dr. Roberts' analysis of his own patients found a high correlation
between systemic diseases and men with fairly recent vasectomies. He
noted sudden occurrences of thrombophlebitis, pulmonary embolism, lymph
node enlargements, joint inflammation, severe narcolepsy
(uncontrollable
sleeping), hypoglycemia, diabetes mellitus, hormonal imbalances, liver
dysfunctions, skin eruptions, inflammation of the heart lining,
inflamed prostate glands, pulmonary fibrosis, allergic disorders, acute
multiple sclerosis, and altered blood coagulation.[13] According to
Roberts, "Their patterns of response suggest a cause-and-effect
relation between vasectomy and various disorders, especially in light
of the fact that the majority had enjoyed good health before surgery
."[14]
Your doctor will probably have a pamphlet saying how safe vasectomy
appears to be, and quote a 1992 British Medical Journal study that
found no significant difference in health problems within less than 10
years after vasectomy, and saying all those other studies (
scroll down this page!) don't
prove anything either. The fact remains that no one has done any kind
of animal or human "double blind" study to see what the effect of
vasectomy is on the male body. Would you like to be a guinea
pig, given that the operation is
unnecessary?
Health Risks of Tubal
Ligation
There are two common forms of tubal ligation: the
mini-laparotomy and laparoscopy. A mini-laparotomy involves making a
small incision in
the abdomen and exploring for the Fallopian tubes which conduct the
eggs
from the ovaries to the uterus. After the tubes are found, a portion of
each is removed, and the ends are tied. In laparoscopy the woman's
abdomen
is first blown up with gas. A fiberoptic light is inserted by
puncturing
the abdominal wall, and an instrument either chops the tubes or burns
them
shut with electricity. It is common to have it done after delivering a
baby, when the woman is most distressed about having another
immediately, although she has to then recuperate from both the ligation
and the delivery.
The procedure itself is reasonably safe, but it is still surgery.
Complications can occur, such as perforation of the bowel leading to
massive
infection of the abdominal cavity, injuries from poorly administered
anesthesia, pulmonary embolism, and cardiac deviations if gas is
used.[15]
The real damage occurs later. There are significant increases in
gynecological problems experienced by women who have tubal ligations. A
follow up study of 374 patients with tubal ligations revealed that 43%
had subsequent gynecological treatment for such conditions as
menorrhagia (heavy menstrual bleeding), menstrual disturbances
requiring hormonal treatments, cervical erosion,
ovarian tumors, and recanalization of the Fallopian tubes requiring a
second
operation.[16]
A 1979 British study found a 40% increase in menstrual blood loss, and
26% of the women with tubal ligations reported increased menstrual
pain. It was also discovered that women who had been using the birth
control pill before their tubal ligation reported a higher incidence of
these complaints than did other patients.[17]
There is an increased incidence of women with tubal ligations
undergoing subsequent hysterectomy because of severe menstrual
problems. Of the
patients followed in the study cited above, 18.7% returned for a
hysterectomy.[18] A study by James G. Tappan found a 40.7% incidence of
menorrhagia and suggested that cystic degeneration of the ovary as a
result of an interruption of the uterine artery might account for
this.[19] In any case, the figure of a
40% increase in menstrual problems as the result of tubal ligation
seems standard. In addition, the rate of cervical cancer experienced by
one group of 489 women three and a half years after tubal ligation was
three and a half
times the normal rate.[20]
Pelvic venous congestion (and even thrombosis) can be a problem after
tubal ligation. Also, medical authors have described all types of
derangements of reproductive hormones as a consequence of TL, including
most prominently PMS and progesterone deficiency (producing migraines,
hot flashes, night sweats, and swelling). TL thus also explains part of
the rise in hormone replacement therapy over recent years. The health
risks of HRT have just come to light in 2002.
More references to tubal problems
here.
Psychological Side
Effects of Sterilization
A 1966 study of vasectomy patients and their wives by Dr.
Frederick Ziegler found "striking adverse changes and reduced marital
satisfaction in husband and wife notwithstanding general satisfaction
with the procedure itself."[21] A standard personality disorder test
found that over 40%
of a vasectomy study group experienced personality disturbances between
their first testing and that of a year later, after the operation.[22]
Since it takes longer than the time frames of most follow-up studies to
encounter the full effects of a sterilization operation, it is
difficult to gauge the true psychological stress involved.
Complicating the findings of those attempts[23] that have been made to
understand the real effect of sterilization on mental health is what
Dr. Helen Wolfers calls "the need to proselytize" for these
surgeries.[24].
Any person contemplating sterilization is, or should be, told that the
operation is relatively irreversible. Only about 33% of vasectomy
and tubal reversals are functionally successful.[25] When a person
takes
such an irrevocable course of action, it is psychologically difficult
for
him or her to admit that a mistake has been made. This explains why the
number of those willing to recommend or express satisfaction with
sterilization is always higher than the number of patients who have no
complaints about the actual results of their own operation. As Dr.
Wolfers explains this
discrepancy in the questionnaires received from patients, "The need to
convince ourselves is served by convincing others."[26]
Thus, a study of 1,191 vasectomized participants in a sterilization
campaign in India revealed decreased sexual desire appearing in 53% of
those surveyed. But 92% of that same group expressed satisfaction with
the
operation.[27] Removing the fear of pregnancy probably
accounts for
a lot of the satisfaction with the operation. Of course, this is
unnecessary and you can postpone pregnancy as long as you want, forever
if need be, through NFP while improving your marital relationship.
Social Consequences of
Sterilization
There is a crying need for research on the social consequences of
sterilization. It has been suggested that men who believe themselves to
be truly sterilized may feel more inclined toward marital infidelity.
Vasectomy
may also play an important part in aggravating the tendency of some
middle-aged
men to discard their middle aged wives in favor of younger women.[28]
The same goes for women. "Now that my husband's been fixed, I
need to be more careful".
Another concern is the implication of viewing one's body as a machine
that can be disconnected if one of its functions is no longer
necessary. This has grave consequences. Cats and dogs are spayed in
order to suit the convenience of their masters. But who are the masters
in the human social order?
Sterilization attacks the integrity of the human person.
While this may sometimes be justified as a punishment for crime, the
evil of sterilization may not be forced upon anyone as a matter of
social policy. However, the Nazis sterilized those considered unfit by
Nazi standards, and Indira Gandhi launched a massive coerced
sterilization drive that finally brought about a revolt of the masses
and led to her electoral defeat.
In the United States, Margaret Sanger, the foundress of Planned
Parenthood,
advocated sterilization of the poor[29] and there have been other
attempts
to use sterilization for forced population control.[30] Have you
been led to think you have no other choice?
The Moral View of
Sterilization
Before 1930, no Christian Church accepted sterilization or any form of
contraception as morally acceptable. The Catholic Church and some
Protestant Churches teach that deliberate sterilization is an immoral
form of birth control. "Equally to be excluded (as morally
permissible), as the teaching authority of the Church has frequently
declared, is direct sterilization, whether perpetual or temporary,
whether of the man or of the woman" (Humanae Vitae. 14).[31]
Regrets
Some of the most heartbreaking letters received by the Couple to Couple
League come from couples who have the deepest sorrow and bitter regrets
about a sterilization operation. Another sad place is the
alt.infertility newsgroup. One poor fellow has given up trying to
regain fertility after a reversal, and is considering another vasectomy
so they aren't surprised with a child in their 50's. (Not a good idea.
The vasectomy, that is! Besides, after age 50, only 1 in 25,000 women
get pregnant.) One e-mail we
got recently was from a 30 year old who had a tubal at age 22 and
deeply
regrets it now.
Reversals are possible. The cost can be in the thousands, with no
guarantee of success, or how long it will take to regain fertility, or
other complications such as drugs needed to regain mobility. One
vasectomy reversal patient describes the pain: "Remember the vasectomy?
[It's] the difference between a mosquito bite and an alligator. 2 weeks
with codeine and an ice bag." The chances of vasectomy
reversal success go down with time, probably due to the increased
antibodies attached to the sperm. Tubal ligation reversal is not easy,
cheap
or effective,either. It's worth trying, but it is way better not to get
sterilized
in the first place!
"Sterilization Reversal, A Generous Act of Love", a new book from
OneMoreSoul ,
features the intimate personal stories of 20
couples who reversed their sterilization. These stories make clear that
sterilization reduces intimacy, damages the marriage, is rarely taught
as intrinsically evil, and often leads to deep regret. The book also
has thorough,
clear explanations of the theological arguments aggainst sterilization.
Associated
with the book is a web-based sterilization reversal discussion group
where
you can learn about and discuss sterilization and reversals, at
http://members.cox.net/longjl/Sterilization_Reversal_Book.shtml.
Mainly Catholics, they discuss the spiritual emptiness caused by
sterilization,
the joy of reversal, and the Church's teachings on both. Everybody is
welcome,
although there are many more Protestant anti-sterilization groups and
websites.
If you have a most serious reason to avoid pregnancy, the
Sympto-Thermal Method of Natural Family Planning (NFP) offers a
realistic and moral alternative. It's completely safe, and can be
reversed to increase your fertility any
time you want. Plus, it can help improve your relationship, increase
marital
satisfaction, and increase bodily health awareness.
As we said above, no methods are 100% effective except total
abstinence. However, one study showed that a temperature-only form of
NFP had an unplanned pregnancy rate even less than that for vasectomy
and tubal ligation.[32] (The
difference in abstinence required between the normal rules and
super-conservative rules is usually a few days or so.) If the usual 99%
method effectiveness rate is OK (which we've used successfully for 21
years), you can use any of
the normal rules.
For more information on NFP, go to one of our other pages such as the
"Info"
page .
ENDNOTES
1. Robert A. Hatcher, et. al., "Contraceptive Technology (New
York, Irvington) This book is revised about every 3
years, so the page numbers change, but you can look up these
references in the index.
Hatcher is the standard reference on family planning.
2. Ibid.
3. Harold Lear quoted in "Vasectomies Beget Baby Doubts," "National
Observer" January 20, 1973. 15
4. H. J. Roberts, "Is Vasectomy Safe? (West Palm Beach, Florida,
Sunshine Academic Press, 1979). 18
5. Ibid.
6. Nancy J. Alexander and Thomas B. Clarkson, "Effect of vasectomy on
diet-induced atherosclerois," "Vasectomy Immunologic and
Pathophysiologic Effects in Animals and Man" Irwin H. Lepow and Ruth
Crozier, eds (New York
Academic Press, 1979.) 122
7. Nancy J. Alexander quoted in "Vasectomy" John Fried (New York,
"Saturday Review" 1972) 52-53
8. K S K Tung, "Human sperm antigens and antisperm antibodies"
"Clinical Experiences in Immunology" (1975); 20, 93-104. R. Ansbacher
et al "Sperm antibodies in vasectomized men," "Fertility and Sterility
22 629. Rudi
Ansbacher "Vasectomy, sperm antibodes," "Fertility and Sterility, 24
788-792.
Nancy J. Alexander, B. J. Wilson and G. D. Patterson, "Vasectomy
Imnmunologic effects in rhesus monkeys and men." "Fertility and
Sterility" 25 149. S. Shulman, E. Zappi, U Ahmed and J. E. Davis,
"Immunologic consequences of vasectomy," "Contraception" 5(4) 269-278
(April 1972)
10. Fried. 46
11. Nancy J. Alexander and Thomas B. Clarkson, "Effect of vasectomy on
diet-induced atherosclerosis. 154
12. Enos. Holmes and Beyer (1953) reported some degree of coronary
atherosclerosis in 77.3% of United States combat casualties in Korea.
McNamara and associates (1971) found comparable evidence of
atherosclerosis
in 45% of 105 American soldiers killed in Vietnam The mean age was 22.1
years in both studies.
13. Ibid. 37-86
14. Ibid. 39
15. D. B. Scott and D. G Julian. "Observations on cardiac arrhythmias
during laparoscopy" "British Medical Journal" 1:411 (1972)
16. M. J. Muldoon, "Gynaecological Illness after sterilization"
"British Medical Journal" (January 8, 1972). 84-85. Table III.
17. S. Lawson, R. A. Cole and A. A. Templeton. "The effect of
laparoscopy sterilization by diathermy or silastic bands on post
post-operative pain, menstrual symptoms and sexuality." "British
Journal of Obstetrics and
Gynecology" 66: 659 663 (August. 1979). This updates J. R.
Neil's
follow up of 454 women in 1975. which found an incidence of
between
22% to 39%
of the study experiencing menstrual problems after their tubals.
J. R. Neil. et al . "Late complications of sterilization by laparoscopy
and tubal ligation, a controlled study" "The Lancet" (October 11. 1975)
699-700
18. Muldoon Table II.
19. James G. Tappan, "American Journal of Obstetrics and Gynecology,"
115:8. 1056
20. Ibid.
21. F. J. Ziegler, D. A. Rodgers, S. A. Kriegsman. "Effect of vasectomy
on psychological functioning" "Psychosomatic Medicine" 28:50. (1966)
22. H. Edey "Psychological aspects of vasectomy," "Medical
Counterpoint" (January, 1972). 19
23. Ziegler. op cit Helen Wollers. "Psychological aspects of
vasectomy," "British Medical Journal" 4:297.(1970). For an excellent
review of this topic see John Fried's "Vasectomy" (New York. "Saturday
Review Press"
1972).
24. Wollers quoted in Fried. 97
25. H. Y. Lee. "Clinical experience of vasovasostomies," "Korean
Journal of Fertility and Sterility" 2(1):2-20 (December. 1975)
26. Fried, loc. cit.
27. K. Dandekar. "Alter-effects of vasectomy," Artha Vijnana" (Gokhale
Institute of Politics and Economics. Poona. India) 5:212.
(1963).
28. The psychological forces which might be responsible for this
distressing phenomenon are described superbly in George Gilder's
"Sexual
Suicide" (New York Quadrangle. 1973)
29. Margaret Sanger "Pivot of Civilization (New York
Brentano's. 1922) 124-145
Sanger expresses an especially strong paranoia that "subhumans
irresponsibly copulating will overpopulate the earth and contaminate
the gene-pool."
30. Sterilization as a tool of the state has a long history in America.
In the mid-1890's castration was used on the feeble- minded. In Kansas
in 1899 a 19-year-old boy was castrated at the Indiana Reformatory
because of his addiction to masturbation. 1907 marked Indiana's
sterilization of the criminal and unfit elements in the state. Fifteen
states enacted similar
sterilization laws between 1907 and World War I. The eugenics movement
touted the social benefits of involuntary sterilization into the
1930's. In 1974 two Alabama sisters age 12 and 14 were sterilized
without their consent at a Montgomery birth control clinic.
31. Pope Paul VI. Encyclical letter "Humanae Vitae" dated July 28,
1968.14
32. B. Vincent et al "Methode Thermique a et Contraception," "Approches
medicale et psychologique" (Paris Masson, 1967) 52- 73
33. Sherman Silber, M.D., "How To Get Pregnant With The New
Technology", book about vasectomy reversal.
-------------------------------------------------------------------------------------------------
(c) 2003 The Couple to Couple League International, Inc. This
information is adapted from CCL's brochure "Sexual Sterilization: Some
Questions and Answers". Revised, embellished and polished by Jim Van
Damme.
A few more references
in medical literature regarding problems with sterilization:
- Women having tubals have a higher hysterectomy
rate than non-sterilized controls, and higher also than "vasectomy"
wives, but "vasectomy " wives also have higher rates than nonsterilized
controls (something not mentioned or emphasized but clearly present in
the data).
1. Hillis et al. Obstet. Gynecol. 1998; 91: 241-6 Higher Hysterectomy
Risk for Sterilized than Non Sterilized Women: Findings from the U.S.
Collaberative Review of Sterilization
2. Stergachis et al. JAMA 1990; 264: 2893-2898. Tubal
Sterilization and the Long-Term Risk of Hysterectomy
- Women having tubal ligation place themselves at
risk for menstrual disorders (these include PMS by their very nature),
but "vasectomy" wives are also at increased risk for these compared to
nonsterilized controls.
1. Visvanathan et al. Journal of Women's Health and Gender-Based
Medicine. Vol. 9, Number 5, 2000. Tubal Ligation, Menstrual
Changes, and Menstrual Symptoms.
2. Shy et al. Am Journal Obstet Gynecol. 1992; 166:1698-1706. Tubal
Sterilization and Risk of Subsequent Hospital Admission for
Menstrual Disorders
- Women whose partners are Vasectomized can suffer increased
allergy rates, even anaphylaxis (the most serious or deadly kind of
allergy).
1. Ebo et al. Allergy 1995: 50: 747-750. Human
seminal plasma anaphylaxis (HSPA): Case Report and Literature Review
2. Friedman et al. JAMA 1984; 251: 2684-2687.
Successful Long-Term Immunotherapy for Human Seminal Plasma
Anaphylaxis.
- Vasectomy Causes Advanced Atherosclerosis in Monkeys.
1. Alexander et al. Science, 201, 538-541. Vasectomy
increases the severity of diet-induced atherosclerosis in Macaca
fascicularis.
- Vasectomy May Cause Atherosclerosis in Man.
1. Campbell et al. British Journal of Urology (1983), 55, 430-433.
Vasectomy and Atherosclerosis: An Association in Man?
2. Fahrenbach et al. J. Androl 1980; 1:299-303. Effect of
Vasectomy on the Retinal Vasculature of Men.
- Vasectomy Causes Atherogenic Lipid Profile, Affecting
Adversely
both LDL and HDL as well as Triglycerides, even in the prestigious
Framingham Cohort.
1. Hubert et al. AM J Epidemiol. 1987 May; 124 (5): 812-31. Life-style
correlates of risk factor change in young adults: an eight-year study
of coronary heart disease risk factors in the Framingham offspring.
2. Ritchey et al. The Journal of Urology Vol 133, Jan. 1985. Effect of
Vasectomy On High Density Lipoproteins.
- When circulating immune complexes (CICs) and coronary heart
disease (CHD) events are measured, both the vasectomized and the CHD
men have elevated CIC levels, suggesting vasectomy may elevate CICs and
in this way mediates CHD events.
1. Alexander et al. AM J Reprod Immunol Microbiol 1986 Oct; 12 (2):
38-44.
- Vasectomy increases CHD risk factors and CHD events, such
as hospitalization for heart attacks, angina, etc.
1. Mullooly et al. J Clin. Epidemiol. Vol 46, No.1, 101-109, 1993,
Vasectomy, Serum Assays, and Coronary Heart Disease Symptoms and Risk
Factors.
2. Goldacre et al. N Engl J Med. 1983; 308: 805-8. Cardiovascular
Disease and Vasectomy.
3. Petitti et al. Journal of Urology. 1983; 129 (4): 760-2 Apr.
Vasectomy and the Incidence of Hospitalized Illness.
- Vasectomy Increases the Risk of Infections and Parasites
(1.8X), endocrine, nutritional, and metabolic disease (1.3X), diseases
of blood and
blood-forming organs (1.3X), respiratory diseases (1.7X), genitourinary
diseases
(1.2 to 1.4X), "symtoms and ill defined conditions (ICD 780-796)"
(1.3X),
accidents, poisoning, and violence (1.2X), acute myocardial infarction
(1.2
to 1.3X), other ischemic heart disease (1.3X), but especially,
arthritis and and rheumatism (1.8X), and autoimmune disease (3.0X).
1. Petitti et al. Journal of Urology 1983; 129 (4): 760-2 Apr.
Vasectomy and the Incidence of Hospitalized Illness. (On
autoimmune disease the authors couldn't exclude a factor of
42X).
2. Roberts, HJ. Is Vasectomy Worth the Risk? West Balm Beach, FLA;
Sunshine Sentinel Press, 1993.
3. Bigazzi, PE. Reproductive Immunology 1981, pg. 461-476
- Vasectomy may prove in future studies to Harm Blood Pressure
1. Alexander et al. Int J Epidemiol. 1981, 10 (3) 2127-22. Sep.
Evaluation of Blood Pressure in Vasectomized and Nonvasectomized Men.
- Vasectomy has been reported to increase rates of prostate
cancer, lung cancer, and testicular cancer.
1. Rosenberg et al. Am J Epidemiol. 140 (5): 431-8, 1994. Sept 1 The
Relation of Vasectomy to the Risk of Cancer
- Vasectomy can be seen as a hostile (interpersonally) act,
and leads to depression, pychiatric illness, and "hostility against
oneself."
1. Luo et al. Contraception, 1996; 54 (6): 345-57, Dec. Psychological
Long-term Effects of Sterilization on Anxiety and Depression
2. Erickson: The Psychological Significance of Vasectomy In therapeutic
Abortion. Edited by H. Rosen. New Yourk: Julian Press, Inc. 1954.
- Some authorities consider fibromyalgia an autoimmune
disease.
1. Taylor et al. Rhematology 200; 39:620-23. Lupus patients with
fatigue - is there a link with fibromyalgia syndrome?